Perioperative care capacity in East Africa: results of an Ethiopian national cross-sectional survey

Fitsum Kifle* (Corresponding Author), Kokeb Belihu, Bezaye Z. Beljege, Hailu Dhufera, Frezer Keno, Desalegn Taye, Masresha Teklehaimanot, Ermiyas Weldesenbet, Turunesh Gemechu, Jolene Moore

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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Background: Provision of safe surgery has gained focus recently. In 2015, the World Health Organization (WHO) called for the strengthening of surgical and anesthesia services as a universal health coverage component. The same year, the Ethiopian Ministry of Health (MOH) launched the “Saving Lives through Safe Surgery” initiative to prioritize and scale-up surgical services. This study provides an updated overview of perioperative facilities’ status to facilitate the identification of future focus areas.
Methods: An online national cross-sectional survey was conducted in September–November 2020, incorporating elements from recognized surgical and anesthesia facility assessment tools to assess infrastructure, workforce, and availability of resources across Ethiopian government facilities.
Results: Responses were received from 81/289 (28%) facilities, conducting a mean of 6.9 (range: 1–37) surgeries per day. All regions were represented. There were shortages in specialty surgical, obstetric, and anesthesiology workforce, functioning anesthesia machines, airway equipment, recommended monitoring devices, and capnography. Shortages of analgesia, anesthesia, and emergency medications were reported. Sixty-eight (84%) facilities had a postanesthetic care unit with a mean of 3.1 (range: 1–15) beds. The presence of trained nurses, oxygen, monitoring devices, equipment, medications, and postoperative care guidelines was minimal.
Conclusions: This study provides an updated overview of surgical capacity in Ethiopia. Despite the expansion of surgical access, there are ongoing resource deficits. Expansion of surgical capacity should be accompanied by a similar expansion in the provision of adequately equipped and staffed postanesthetic care units and a focus on postoperative care.
Original languageEnglish
Article numbere57
Number of pages7
JournalInternational Journal of Surgery Global Health
Issue number3
Publication statusPublished - 11 May 2021

Bibliographical note

The authors thank all hospitals who participated in the survey, all anesthesia providers, surgeons, obstetricians, nurses, and hospi- tal management staff who provided data voluntarily, and those who helped coordinate the study in their area.


  • Global surgery
  • Surgical capacity
  • Surgical workforce
  • Postoperative
  • Anesthesia


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