Nuffield Department of Anaesthetics, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
Mukinge Hospital, Lusaka, Zambia.
BMJ Open. 2024 May 6;14(5):e078939. doi: 10.1136/bmjopen-2023-078939.
The 68th World Health Assembly, in 2015, called for surgical and anaesthesia services strengthening. Acknowledging the healthcare staff shortages, they referred to task sharing, among others, as a more effective use of the healthcare workforce. While task sharing has been increasingly proposed as an important strategy to increase the reach and safety of anaesthesia as well as a means of supporting the workforce in low-resource settings, most data on task sharing relate to non-anaesthetic healthcare contexts. The aim of this study was to understand anaesthetic task sharing as currently experienced and/or envisaged by non-physician anaesthesia providers in Zambia and Somaliland.
An exploratory qualitative research methodology was used. Participants were recruited initially via contacts of the research team, then through snowballing using a purposive sampling strategy. There were 13 participants: 7 from Somaliland and 6 from Zambia. Semistructured interviews took place synchronously, then were recorded, anonymised, transcribed and analysed thematically. Triangulation and respondents' validation were used to maximise data validity.
Four major themes were identified in relation to task sharing practices: (1) participants recognised variable components of task sharing in their practice; (2) access to task sharing depends both on sources and resources; (3) implicit barriers may inhibit task sharing practices; (4) there is an appetite among participants for amelioration of current task sharing practices.
Empowering task sharing practices can be achieved only by understanding how these practices work, by identifying gaps and areas of improvement, and by addressing them. The findings from this exploratory study could help the global community understand how anaesthetic task sharing in low-resource settings works and inspire further research on the field. This could inform future modelling of workforce planning strategies in low-resource settings to maximise the effectiveness and professional well-being of the workforce.
2015 年第 68 届世界卫生大会呼吁加强外科和麻醉服务。认识到医疗保健人员短缺，他们提到任务分担等，作为更有效地利用医疗保健劳动力的手段。虽然任务分担作为增加麻醉的覆盖面和安全性的重要策略以及支持资源匮乏环境中的劳动力的手段已越来越多地被提出，但大多数关于任务分担的数据都与非麻醉医疗保健背景有关。本研究的目的是了解赞比亚和索马里兰的非医师麻醉提供者目前所经历的和/或设想的麻醉任务分担情况。
采用探索性定性研究方法。参与者最初是通过研究小组的联系招募的，然后通过使用有目的的抽样策略的滚雪球方式招募。共有 13 名参与者：7 名来自索马里兰，6 名来自赞比亚。同步进行半结构化访谈，然后进行录音、匿名、转录和主题分析。三角测量和受访者验证用于最大限度地提高数据有效性。
与任务分担实践相关，确定了四个主要主题：（1）参与者在实践中认识到任务分担的不同组成部分；（2）获取任务分担的机会既取决于来源，也取决于资源；（3）隐含的障碍可能会抑制任务分担实践；（4）参与者希望改善当前的任务分担实践。
只有通过了解这些实践如何运作，确定差距和改进领域，并解决这些问题，才能实现任务分担实践的赋权。这项探索性研究的结果可以帮助全球社会了解资源匮乏环境中的麻醉任务分担是如何运作的，并激发该领域的进一步研究。这可以为资源匮乏环境中的劳动力规划策略的未来建模提供信息，以最大限度地提高劳动力的有效性和职业幸福感。
