Gebregzi Amare Hailekiros, Teko Elubabor Buno, Tantu Abiy Dawit, Jale Natinael Tesfaye, Getahun Genanaw Kassie, Asemu Yohannes Molla
USAID Enhanced Anesthesia Activity, Ethiopian Association of Anesthetists, Addis Ababa, Ethiopia.
Medical Service Lead Executive Office, Federal Ministry of Health, Addis Ababa, Ethiopia.
BMC Health Serv Res. 2025 May 27;25(1):760. doi: 10.1186/s12913-025-12892-6.
In Ethiopia and other low-and middle-income countries, access to emergency and elective surgical care is still inadequate and inequitable. Ethiopia has initiated a nationwide strategic plan aimed at tackling obstacles within the surgical system. The aim of this study was to assess surgical and anesthesia care capacity and productivity in high volume Ethiopian hospitals.
An explanatory mixed-methods study was conducted in 24 high-volume public hospitals across Ethiopia's 10 regions and 2 city administrations. Data were collected through structured document reviews, site observations, and interviews using a validated WHO-aligned tool. Quantitative data were analyzed using SPSS, and qualitative responses were thematically analyzed using ATLAS.ti.
Addis Ababa hosts over 60% of the national surgical workforce, highlighting stark regional disparities. While 80% of hospitals reported adequate infrastructure, site observations revealed functional inconsistencies in PACU design, sterilization units, and equipment availability. Only 77% of hospitals consistently implemented patient monitoring and handover protocols. Surgical productivity was low, with an average of 2.5 surgeries per week per clinician and 52.39% annual workforce productivity. Best practices included the use of EMRs, backlog-reduction campaigns, and daily interdisciplinary briefings. However, persistent challenges included inadequate staffing, poor infrastructure, and uneven adoption of safety protocols.
Ethiopia's surgical system shows promising innovations in select hospitals, yet national scale-up is hindered by infrastructure gaps, uneven workforce distribution, and inconsistent safety practices. Addressing these challenges requires data-driven planning, targeted investment in underserved regions, and expanded use of digital systems and collaborative networks to promote best practice adoption across facilities.
在埃塞俄比亚及其他低收入和中等收入国家，获得急诊和择期手术治疗的机会仍然不足且不公平。埃塞俄比亚已启动一项全国性战略计划，旨在解决手术系统中的障碍。本研究的目的是评估埃塞俄比亚高流量医院的手术和麻醉护理能力及生产率。
在埃塞俄比亚10个地区和2个市辖区的24家高流量公立医院开展了一项解释性混合方法研究。通过结构化文档审查、实地观察以及使用经过验证的与世界卫生组织一致的工具进行访谈来收集数据。定量数据使用SPSS进行分析，定性回答使用ATLAS.ti进行主题分析。
亚的斯亚贝巴拥有全国60%以上的外科手术人员，凸显了明显的地区差异。虽然80%的医院报告基础设施充足，但实地观察发现麻醉后护理单元（PACU）设计、消毒单位和设备可用性方面存在功能不一致的情况。只有77%的医院始终执行患者监测和交接方案。手术生产率较低，每位临床医生平均每周进行2.5台手术，年劳动力生产率为52.39%。最佳实践包括使用电子病历、减少积压活动和每日跨学科简报。然而，持续存在的挑战包括人员配备不足、基础设施差以及安全协议采用不均衡。
埃塞俄比亚的手术系统在部分医院展现出了有前景的创新，但全国范围内的推广受到基础设施差距、劳动力分布不均以及安全实践不一致的阻碍。应对这些挑战需要数据驱动的规划、对服务不足地区的定向投资，以及扩大数字系统和协作网络的使用，以促进各机构采用最佳实践。
