Mohamed Mubarak, Grimm Andie, Williams Christina, Cotache-Condor Cesia, Concepcion Tessa L, Dahir Shukri, Ismail Edna Adan, Rice Henry E, Smith Emily R
Department of Surgery, Edna Adan University Hospital, Hargeisa, Somaliland.
Institute for Cancer Outcomes and Survivorship, University Alabama at Birmingham, Birmingham, Alabama, United States of America.
PLOS Glob Public Health. 2024 Aug 28;4(8):e0003650. doi: 10.1371/journal.pgph.0003650. eCollection 2024.
The burden of pediatric surgical conditions in Somaliland is high and the pediatric anesthesia capacity across the country remains poorly understood. The international standards developed by the World Health Organization and World Federation of Societies of Anaesthesiologists (WHO-WFSA) serve as a guideline to assess the provision of anesthetic care. This study aims to describe anesthesia capacity for children in Somaliland and assess progress towards reaching the WHO-WFSA international standards. In this cross-sectional study, anesthesia infrastructure and workforce data, as well as pediatric clinical and demographic data were collected from fifteen private, charity, and government hospitals in the six regions of Somaliland. We described anesthesia capacity in Somaliland and compared baseline data to the WHO-WFSA international standards. Overall, Somaliland did not reach most of the target goals for anesthesia capacity as defined by the WHO-WFSA. Most markers for anesthesia capacity were far behind the established targets, with deficits of 99% for anesthesiologists density, 83% for operating room density, and 83% for ventilator density. Hospitals in urban Maroodi-Jeex, and private hospitals had more supplies, infrastructure, and surgical personnel than hospitals in rural areas. There are large gaps in current anesthetic resources for children according to WHO-WFSA global standards, as well as wide disparities between regions and types of hospitals in Somaliland. Increased investment in anesthesia infrastructure and workforce is required to meet the needs of pediatric surgical patients across the country.
索马里兰小儿外科疾病负担沉重，而该国小儿麻醉能力仍鲜为人知。世界卫生组织和世界麻醉医师协会联合会（WHO-WFSA）制定的国际标准可作为评估麻醉护理提供情况的指南。本研究旨在描述索马里兰儿童的麻醉能力，并评估在达到WHO-WFSA国际标准方面取得的进展。在这项横断面研究中，从索马里兰六个地区的15家私立、慈善和政府医院收集了麻醉基础设施和劳动力数据，以及儿科临床和人口统计数据。我们描述了索马里兰的麻醉能力，并将基线数据与WHO-WFSA国际标准进行了比较。总体而言，索马里兰未达到WHO-WFSA定义的大多数麻醉能力目标。大多数麻醉能力指标远远落后于既定目标，麻醉医师密度缺口为99%，手术室密度缺口为83%，呼吸机密度缺口为83%。位于城市马鲁迪杰克斯的医院和私立医院比农村地区的医院拥有更多的物资、基础设施和外科人员。根据WHO-WFSA全球标准，目前儿童麻醉资源存在巨大差距，索马里兰不同地区和医院类型之间也存在很大差异。需要增加对麻醉基础设施和劳动力的投资，以满足全国小儿外科患者的需求。
