Challenges and associated factors of anesthesia practice in Ethiopia

Background: Anesthesia is mainly needed in surgical services, for diagnostic services in almost all fields of specialty in medicine. When anesthesia services are inadequate, difficulties are experienced. There are multifactorial reasons for the inadequacy of anesthesia services in sub-Saharan countries. The aim of this study is to assess the challenges and problems of anesthesia practice in Ethiopia. Methodology: An observational survey carried out in 60 hospitals of the Nine regional states and two city administrative states of Ethiopia in 2018. A structured questionnaire sent to each hospital, the questionnaire consisted of eight sections to assess the availability of basic Anesthesia equipment, Drugs, and Professional Anesthetists. The head of anesthetists represented in each Hospital. The data were analyzed using Statistical Package for Social Sciences (SPSS) version 20.0, the results are presented in appropriate statistical tools, and the findings discussed. Results: This study shows that 81% of the anesthetists do have challenges and problems, which weigh down the provision of Safe anesthesia service. Eighty-three percent (83%) of anesthetists working alone without assistant. 83.2% of Anesthetists have main difficulties to perform pre-anesthetic evaluation. Around 55% of hospitals/anesthetists/have no minimum standard of monitoring devices. The availability of Anesthetic drugs in the Operation room is inadequate, for instance, 89.6%, 97.9%, and 45.8% Operation rooms/Anesthetists/have no Isoflurane, Etomidate, and Propofol respectively. Due to lack of Analgesics, only 22.9% of Anesthetists administer Analgesics Intraoperatively. 67% of Anesthetists have no emergency drug kit and 81.2% of Anesthetists have no Cricothyrodtomy set to Manage difficult airway. The overall Challenges stated by Anesthetists include Shortage of workforce, drugs & equipment, Lack of skills & Knowledge in some specialized procedures, less payment in comparison with Work overload, risks & stress, and Lack of insurance to the Anesthetists. Conclusion: Since the Anesthesia service is least addressed, Major focus in terms of Anesthesia working force, Anesthesia drugs, and equipment is required to bring up to date and improve the safety of anesthesia for patients in Ethiopia. (c) 2020 The Author(s). Published by Elsevier Ltd on behalf of Surgical Associates Ltd.