Abstract
Ghana, like other countries in sub-Saharan African, has limited access to surgery. One contributing factor is the inadequate number of anesthesia providers. To address this need, Kybele, Inc., a US-based non-governmental organization, partnered with the Ghana Health Service to establish the third nurse anesthesia training school (NATS) in Ghana. The school, based at Ridge Regional Hospital (RRH) in Accra, opened in October 2009. This paper describes the evolution of the training program and presents the curriculum. Second, the results of a voluntary survey conducted among the first four classes of graduates (2011–2014) are presented to determine their perceived strengths and gaps in training and to identify employment locations and equipment availability. Seventy-five of 93 graduates (81%) responded to the survey. The graduates reported working in 39 hospitals across 7 of the 10 regions in Ghana. Six providers (8%) worked alone and 16 (21%) were one of only two providers. Fifty-three providers (71%) had no physician anesthesiologist at their facility. Most providers had access to basic anesthesia equipment; however, there was limited access to emergency airway equipment. While most graduates felt that their training had prepared them for their current positions, 21% reported experiencing a patient death during anesthesia. The NATS at RRH has been sustained and most of the graduates are working in Ghana, filling an important void. Quality improvement and continuing education must be emphasized in an effort to reduce surgical morbidity and mortality in Ghana.
Highlights
An estimated two billion people have limited or no access to surgery and anesthesia [1, 2]
Forty-seven guest lecturers traveled to Ghana with Kybele from 11 institutions in the USA and Canada from January 2009 through September 2015
A global health partnership recognized a gap in the provision of anesthesia care in Ghana
Summary
An estimated two billion people have limited or no access to surgery and anesthesia [1, 2]. Challenges to improving surgical capacity are many, including insufficient equipment and supplies, improper distribution of staff, and migration of health-care workers to more developed countries [3, 4]. Third semester internship This final part of the program covers a period of 6 months in which the student will work in accordance with his/her work schedule as planned by the facility to which the intern is attached. Patients for emergency cesarean delivery often waited hours and anesthesia personnel availability was a frequent limitation. Access to emergency obstetric surgery has been cited as an indicator of the overall surgical capacity of a health system [14, 15]
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