title: Survey of the capacity for essential surgery and anaesthesia services in Papua New Guinea.
abstract: OBJECTIVE
  To assess capacity to provide essential surgical services including emergency, obstetric and anaesthesia care in Papua New Guinea (PNG) in order to support planning for relevant post-2015 sustainable development goals for PNG.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  Hospitals and health facilities in PNG.
  
  
  METHODS
  21 facilities including 3 national/provincial hospitals, 11 district/rural hospitals, and 7 health centres.
  
  
  METHODS
  The WHO Situational Analysis Tool to Assess Emergency and Essential Surgical Care (WHO-SAT) was used to measure each participating facility's capacity to deliver essential surgery and anaesthesia services, including 108 items related to relevant infrastructure, human resources, interventions and equipment.
  
  
  RESULTS
  While major surgical procedures were provided at each hospital, fewer than 30% had uninterrupted access to oxygen, and 57% had uninterrupted access to resuscitation bag and mask. Most hospitals reported capacity to provide general anaesthesia, though few hospitals reported having at least one certified surgeon, obstetrician and anaesthesiologist. Access to anaesthetic machines, pulse oximetry and blood bank was severely limited. Many non-hospital health centres providing basic surgical procedures, but almost none had uninterrupted access to electricity, running water, oxygen and basic supplies for resuscitation, airway management and obstetric services.
  
  
  CONCLUSIONS
  Capacity for essential surgery and anaesthesia services is severely limited in PNG due to shortfalls in physical infrastructure, human resources, and basic equipment and supplies. Achieving post-2015 sustainable development goals, including universal healthcare, will require significant investment in surgery and anaesthesia capacity in PNG.
authors.affiliation: Department of Anesthesia & Perioperative Medicine, Medical Evidence, Decision Integrity & Clinical Impact (MEDICI) Centre, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada Department of Epidemiology & Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.
authors.forename: Janet
authors.initials: J
authors.lastname: Martin
authors.affiliation: National Department of Health (NDoH), National Health Service Standards, Waigani, Papua New Guinea.
authors.forename: Goa
authors.initials: G
authors.lastname: Tau
authors.affiliation: Emergency & Essential Surgical Care (EESC) Program, Service Delivery and Safety Department (SDS), Health Systems & Innovation, World Health Organisation-HQ, Geneva, Switzerland.
authors.forename: Meena Nathan
authors.initials: MN
authors.lastname: Cherian
authors.affiliation: Department of Anesthesia & Perioperative Medicine, Medical Evidence, Decision Integrity & Clinical Impact (MEDICI) Centre, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Vergel de Dios
authors.affiliation: Kompiam District Hospital, Mount Hagen, Papua New Guinea.
authors.forename: David
authors.initials: D
authors.lastname: Mills
authors.affiliation: University of the West of England, Bristol, UK.
authors.forename: Jane
authors.initials: J
authors.lastname: Fitzpatrick
authors.affiliation: WHO Representation PNG, AOPI Center, Boroko, Papua New Guinea.
authors.forename: William
authors.initials: W
authors.lastname: Adu-Krow
authors.affiliation: Department of Anesthesia & Perioperative Medicine, Medical Evidence, Decision Integrity & Clinical Impact (MEDICI) Centre, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.
authors.forename: Davy
authors.initials: D
authors.lastname: Cheng
mesh_terms: D000758:Anesthesia / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D003906:Developing Countries; D004864:Equipment and Supplies / Q000706:statistics & numerical data / Q000600:supply & distribution*; D019538:Health Care Surveys; D006268:Health Facilities / Q000706:statistics & numerical data*; D006295:Health Resources / Q000600:supply & distribution*; D006280:Health Workforce / Q000706:statistics & numerical data*; D006749:Hospital Design and Construction / Q000706:statistics & numerical data; D010219:Papua New Guinea; D019035:Rural Health Services / Q000592:standards; D013514:Surgical Procedures, Operative / Q000706:statistics & numerical data*; D014944:World Health Organization
keywords: ANAESTHETICS; Essential Surgery; GLOBAL HEALTH