A profile of surgical burden and anaesthesia services at Mozambique's Central Hospital: A review.

BACKGROUND

Surgical and anaesthesia data, including outcomes, remain limited in low-income countries (LIC). This study reviews the surgical burden and anaesthesia services at a tertiary care hospital in Mozambique.

METHODS

Information on activities within the department of anaesthesia at Maputo Central Hospital for 2014-15 was collected from its annual report and verified by the Chairman of Anaesthesia. Personnel information and health care metrics for the hospital in 2015 were collected and verified by hospital leadership.

RESULTS

Maputo Central Hospital has 1423 beds with 50.1% allocated to primary surgical services. 39.7% of total admissions were to surgical services, and in 2015 the hospital performed 10,049 major operations requiring anaesthesia. The OB/GYN service had the most operations with 2894 (28.8%), followed by general surgery (1665, 16.6%). Inpatient surgical mortality was 4.1% and surgical-related diagnoses comprised two of the top 9 causes of death, with malignant neoplasms and hemorrhage from trauma causing the highest mortality. In 2014-15, Maputo Central Hospital employed 15 anesthesiologists, with 4 advanced and 23 basic mid-level anaesthesia providers. Of 10,897 total anaesthesia cases in 2014, 6954 were general anaesthesia and 3925 were neuraxial anaesthesia. Other anaesthesia services included chronic pain and intensive care consultation. Anaesthesia department leadership noted a strong desire to improve data collection and analysis for anaesthesia outcomes and complications, requested an additional administrator for statistical analysis.

DISCUSSION

This profile of anaesthesia services at a large tertiary hospital in Mozambique highlights several features of anaesthesia care and surgical burden in LICs, including challenges of resource limitations, patient comorbidity, and social dynamics present in Mozambique that contribute to prolonged hospital stays. As noted, enhanced data collection and analysis within the department and the hospital may be useful in identifying strategies to improve outcomes and patient safety.