Bridging the human resource gap in surgical and anesthesia care in low-resource countries: a review of the task sharing literature

Ashengo, Tigistu; Skeels, Alena; Hurwitz, Elizabeth J. H.; Thuo, Eric; Sanghvi, Harshad

doi:10.1186/s12960-017-0248-6

Human Resources for Health

Table 1 Task sharing country profiles: non-physician clinicians involved in task sharing or surgical and anesthesia procedures

From: Bridging the human resource gap in surgical and anesthesia care in low-resource countries: a review of the task sharing literature

Country	Author	Cadre name	Preservice training	Specialized training	Surgical roles/procedures	Regulation system	Geographic location
Eastern Africa
Kenya	Kakande et al. [6]	Clinical officer	3-year diploma in clinical medicine + 1-year internship	1–1.5-year higher diploma course	Ear, nose, and throat; ophthalmology, anesthesia, orthopedics, minor surgery (e.g., circumcision)	Training and practice regulated by the clinical officers council, act of parliament in place to define roles	Mainly rural
Tanzania	Pereira et al. Beard et al.; McCord et al. [3, 12]	Assistant medical officer	3-year training in clinical medicine + 1-year internship	2-year training for advanced diploma	Emergency obstetric surgery, anesthesia, hernia, abdominal surgery including laparotomy, hydrocelectomy, prostatectomy	Diploma award, accreditation and registration by Tanganyika Medical Council	Urban, rural
Sudan	Kakande et al. [6]	Clinical officer	3-year clinical training		Minor surgery, emergency obstetric surgery, anesthesia
Uganda	Paul et al.; Galukande et al. [17, 19]	Clinical officer	3-year diploma in clinical medicine + 1-year internship	1–1.5-year higher diploma course	Orthopedics, anesthesia
Ethiopia	Gessessew et al. [35]	Integrated emergency surgical officer	3–4-year training in clinical medicine, public health, healthcare management	6–9-month training in emergency obstetric care	Emergency obstetric surgery, laparotomy, uterine evacuation, hysterectomy, ophthalmology, anesthesia
Burundi	McAuliffe et al. [10]	Nurse anesthetist		2-year training program
Djibouti	McAuliffe et al. [10]	Nurse anesthetist [7]
Malawi	Wilhelm et al.; Mkandawire et al.; Tyson et al. [4, 25, 30]	Clinical officer	2-year training and 4-year clinical experience as medical assistant	18-month formal training in surgery	Orthopedic, ophthalmology, emergency obstetric surgery, laparotomy	Registration by the Malawi Medical Council,	Urban, rural
Mozambique	Kruk et al.; Cumbi et al. [18, 22]	Surgical technicians Anesthesia technicians	2-year training in clinical medicine as an assistant medical officer + 2–3-year clinical experience	2-year surgical training + 1-year internship for a specialized diploma	Emergency obstetric surgery, orthopedic, general surgery including craniotomy, bowel resection, colostomy, anesthesia	Accreditation by Ministry of Health	Mainly rural
Zambia	Kakande et al. [6]	Medical licentiates	3-year training as clinical officer + 2-year clinical experience	3-year training for a bachelor’s degree in surgery	Anesthesia, orthopedics, emergency obstetric care	Accredited by University of Zambia Regulated by Medical Council of Zambia	Mainly rural
Central Africa
Cameroon	McAuliffe et al. [10]	Nurse anesthetist	3-year training as registered nurse + 2-year pf experience as intensive care unit nurse	2-year anesthesia training program
Chad, Angola	McAuliffe et al. [10]	Nurse anesthetist
West Africa
Guinea-Bissau	Mullan et al. [8]	Clinical officer	3-year training	N/A	Minor surgery, anesthesia		Mainly rural
Ghana	Mullan et al. [8]	Medical assistant	3-year training + 1-year internship		Minor surgery, emergency obstetric surgery, anesthesia		Mainly rural
Togo	Mullan et al. [8]	Medical assistant			Minor surgery, ophthalmology
Senegal	Mullan et al. [8]	Health officer	2-year clinical training + 6-month internship		Minor surgery, anesthesia
Sierra Leone	Mullan et al. [8]	Community health officer Nurse anesthetist	3-year training in community health sciences to earn a higher national diploma in community health sciences	Trainees receive 6 months of surgical training at a central hospital then 6-month rotation to a partner hospital	Cesarean section, laparotomy, hernia repair, hydrocelectomy, appendectomy, tubal ligation, anesthesia
Burkina Faso	Hounton et al. [20]	Clinical officer	3-year training in clinical medicine and surgery	None	Minor surgery, Cesarean section, ophthalmology		Rural, urban
Côte d’Ivoire	McAuliffe et al. [10]	Nurse anesthetist		2-year training program
Gabon	Mullan et al. [8] McAuliffe et al. [10]	Nurse anesthetist	Registered nurse with 2-year clinical experience	2-year training program
Nigeria, Mali, Benin	McAuliffe et al. [10]	Nurse anesthetist
Southern Africa
Botswana, Swaziland, Lesotho, Zimbabwe	McAuliffe et al. [10]	Nurse anesthetist
Central America
Haiti	Rosseel et al. [26]	Certified nurse	2-year training as a nurse	15–18-month program offered by Medicines San Frontieres (1998–2003) and Partners in Health (2007–)	General anesthesia, spinal anesthesia
Asia
Bhutan	Mavalankar et al. [13]	Nurse anesthetist	2-year training as clinical nurse	14-month training combined in Bhutan and Bangkok	General anesthesia, spinal anesthesia
Afghanistan	Mavalankar et al. [13]	Nurse anesthetist	2-year training as clinical nurse	1 year of training in anesthesia	General anesthesia
Nepal	Mavalankar et al. [11]	Anesthesia assistant	6-month training	None	General anesthesia
Cambodia, Laos	Mavalankar et al. [11] McAuliffe et al. [12]	Nurse anesthetist		2-year training
Philippines, Indonesia, Vietnam, Myanmar, India	McAuliffe et al. [10] Mavalankar et al. [11]	Nurse anesthetist

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ISSN: 1478-4491

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