title: Assessing unmet anaesthesia need in Sierra Leone: a secondary analysis of a cluster-randomized, cross-sectional, countrywide survey.
abstract: OBJECTIVE
  To determine the unmet anaesthesia need in a low resource region.
  
  
  BACKGROUND
  Surgery and anæsthesia services in low- and middle-income countries (LMICs) are under-equipped, under-staffed, and unable to meet current surgical need. There is little objective measure as to the true extent and nature of unmet need. Without such an understanding it is impossible to formulate solutions. Therefore, we re-examined Surgeons OverSeas (SOSAS) unmet surgical need data to extrapolate unmet anaesthesia need.
  
  
  METHODS
  For the untreated surgical conditions identified by SOSAS, we assigned anaesthetic technique required to carry out the procedure. The chosen anaesthetic was based on common practice in the region. Procedures were categorized into minimal anaesthesia, spinal anæsthesia, regional anaesthesia, ketamine/monitored anaesthesia care (MAC), and general endotracheal anæsthesia (GETA).
  
  
  CONCLUSIONS
  Ninety-two per cent (687 of 745) of untreated surgical conditions in Sierra Leone would require some form of anaesthesia. Seventeen per cent (125 of 745) would require MAC, 22% (167 of 745) would require spinal anaesthesia, and 53% (395 of 745) would require GETA.
  
  
  CONCLUSIONS
  Analyses such as this can provide guidance as to the rational and efficient production and distribution of personnel, drugs and equipment.
authors.affiliation: Department of Anesthesiology (Rm 3C444), University of Utah Medical Center Salt Lake City, USA.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Harris
authors.affiliation: Department of Surgery, Connaught Hospital Freetown, Sierra Leone.
authors.forename: Thaim B
authors.initials: TB
authors.lastname: Kamara
authors.affiliation: Department of Anæsthesiology Connaught Hospital Freetown, Sierra Leone.
authors.forename: Eva
authors.initials: E
authors.lastname: Hanciles
authors.affiliation: Department of Anesthesiology (Rm 3C444), University of Utah Medical Center Salt Lake City, USA.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Newberry
authors.affiliation: Department of Anesthesiology (Rm 3C444), University of Utah Medical Center Salt Lake City, USA.
authors.forename: Scott R
authors.initials: SR
authors.lastname: Junkins
authors.affiliation: Department of Anesthesiology (Rm 3C444), University of Utah Medical Center Salt Lake City, USA.
authors.forename: Nathan L
authors.initials: NL
authors.lastname: Pace
mesh_terms: D000758:Anesthesia; D016000:Cluster Analysis; D003430:Cross-Sectional Studies; D003906:Developing Countries; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D020380:Needs Assessment; D016032:Randomized Controlled Trials as Topic; D012807:Sierra Leone
keywords: cluster-randomized; countrywide survey; cross-sectional; unmet anaesthesia