Establishing an Anaesthesia and Intensive Care partnership and aiming for national impact in Tanzania
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COMMENTARY
Open Access
Establishing an Anaesthesia and Intensive Care partnership and aiming for national impact in Tanzania Mpoki Ulisubisya1,2*, Henrik Jörnvall3,4, Lars Irestedt3,4 and Tim Baker3,4,5
Abstract Anaesthesia and Intensive Care is a neglected specialty in low-income countries. There is an acute shortage of health workers – several low-income countries have less than 1 anaesthesia provider per 100,000 population. Only 1.5 % of hospitals in Africa have the intensive care resources needed for managing patients with sepsis. Health partnerships between institutions in high and low-income countries have been proposed as an effective way to strengthen health systems. The aim of this article is to describe the origin and conduct of a health partnership in Anaesthesia and Intensive Care between institutions in Tanzania and Sweden and how the partnership has expanded to have an impact at regional and national levels. The Muhimbili-Karolinska Anaesthesia and Intensive Care Collaboration was initiated in 2008 on the request of the Executive Director of Muhimbili National Hospital in Dar es Salaam. The partnership has conducted training courses, exchanges, research projects and introduced new equipment, routines and guidelines. The partnership has expanded to include all hospitals in Dar es Salaam. Through the newly formed Life Support Foundation, the partnership has had a national impact assisting the reanimation of the Society of Anaesthesiologists of Tanzania and has seen a marked increase of the number of young doctors choosing a residency in Anaesthesia and Intensive Care. Keywords: Anaesthesia, Critical care, Health services, Quality of health care, Capacity building, Developing countries, Africa, Tanzania, Global health, Cooperative behaviour
Background Anaesthesia and Intensive Care is a neglected specialty in low-income countries (LICs). There is an acute shortage of health workers – several low-income countries have less than 1 anaesthesia provider per 100,000 population [1]. In Malawi and Zambia 95 and 78 % of anaesthesia providers are non-physicians respectively [2, 3]. Less than one in fifteen hospitals in Uganda have the facilities to deliver safe anaesthesia for Caesarean section [4]. There is a profound lack of Intensive Care Unit (ICU) capacity in LICs: Uganda has 1.0 ICU bed per million population [5]. Of hospitals in Africa, only 1.5 %
* Correspondence: [email protected] 1 Society of Anaesthesiologists of Tanzania, PO Box 65588, Dar es Salaam, Tanzania 2 Mbeya Zonal Referral Hospital, Mbeya, Tanzania Full list of author information is available at the end of the article
have the intensive care resources needed for managing patients with sepsis [6]. The state of Anaesthesia and Intensive Care in Tanzania, a low-income country in East Africa, is similar to other LICs. There are 22 anaesthesiologists for a population of 47 million (ratio 0.05: 100,000) [7]. Most anaesthesia is carried out by non-physician anaesthetists, many of whom lack formal training and qualifications [7]. The quality
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