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Defining the anesthesia gap for reproductive health procedures in resource‐limited settings
Author(s) -
Anderson R. Eleanor,
Ahn Roy,
Nelson Brett D.,
Chavez Jean,
de Redon Emily,
Burke Thomas
Publication year - 2014
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2014.06.023
Subject(s) - medicine , cinahl , medline , economic shortage , resource (disambiguation) , cochrane library , reproductive health , medical emergency , intensive care medicine , anesthesia , nursing , psychological intervention , surgery , population , environmental health , randomized controlled trial , computer network , linguistics , philosophy , government (linguistics) , political science , computer science , law
Background In resource‐limited settings, severe shortages of anesthetists and anesthesiologists lead to surgical delays that increase maternal and neonatal mortality and morbidity. Objectives To more clearly understand the individual components of the anesthesia gap pertaining to reproductive health surgeries and procedures in resource‐limited settings. Search strategy Medline, the Cochrane Library, CINAHL, Embase, and POPLINE were systematically searched for reports published before December 31, 2013. Search terms were related to obstetric surgery, resource‐limited settings, and anesthesia. Selection criteria Studies that addressed the use of anesthesia in reproductive procedures in resource‐limited settings were included. Data collection and analysis Reviewers independently evaluated the full text of identified studies, extracted information related to study objectives and conclusions, and identified the anesthesia gap. Main results Overall, 14 publications met the inclusion criteria. A significant lack of infrastructure, equipment and supplies, and trained personnel were identified as key factors responsible for a lack of anesthesia services. Conclusions A shortage of trained anesthesia providers, equipment, supplies, medications, and infrastructure, along with limitations in transportation in resource‐limited settings have produced a wide gap between available anesthesia services and the demand for them for reproductive health surgeries and procedures. Safe, affordable, and scalable solutions to address the anesthesia gap are urgently needed.