Challenges and Factors Affecting Safe Anaesthesia Provision in Hospitals of the Adamawa Region (Cameroon): A Cross-Sectional Study
Défis et Facteurs Influant sur la Sécurité de la Pratique de l'Anesthésie dans les Hôpitaux de la Région de l'Adamaoua (Cameroun) : Une Etude Transversale
DOI:
https://doi.org/10.67260/hra.v4i8.7926Keywords:
Safe Anaesthesia, Challenges, Limited Resources, Adamawa, CameroonAbstract
ABSTRACT Background. Improving perioperative safety is a global priority, yet adherence to international anaesthesia standards remains poorly documented in sub Saharan Africa. Cameroon faces major service delivery challenges, but regional data are lacking. This study assessed anaesthesia resources and barriers to safe care in the Adamawa Region. Materials and methods. We conducted a cross sectional study (February–June 2025) in 12 hospitals across seven health districts. We used the WHO WFSA checklist, a provider questionnaire, and a standardised form review. Compliance scores were calculated; inter facility differences were tested with Kruskal Wallis; form reliability used Cronbach’s alpha (≥0.70). Completeness was defined as ≥75% of 64 items. Results. Eighteen providers participated (mean age 38.0±5.1 years; 83.3% male); 72.2% were nurse anaesthetists; no physician anaesthesiologist was found. Overall provider to population ratio was 1:67,137; three districts had none. Primary facilities had the lowest compliance (highly recommended 61.6%, recommended 25.8%, suggested 14.9%; p=0.043 for suggested). Only 41.7% had functioning anaesthesia machines; 50% had PACUs. Main challenges were shortages of anaesthetic agents (66.7%), lack of specialised skills (61.1%), paediatric/geriatric expertise (55.6%), and equipment failure (50.0%). Among 77 pre anaesthesia forms, only 28.6% were complete, though internal consistency was good (α=0.882). Barriers included absence of standardised forms (58.3%), unavailable labs (58.3%), and no dedicated space (50.0%). Conclusion. Severe shortages of drugs, equipment, and trained staff critically impair safe anaesthesia in the Adamawa Region. Preoperative assessment is underused and incomplete. Urgent investment in workforce, infrastructure, and supply chains is needed to improve perioperative safety. RÉSUMÉ Introduction. L'amélioration de la sécurité périopératoire est une priorité mondiale, mais le respect des normes internationales d'anesthésie reste mal documenté en Afrique subsaharienne. Le Cameroun est confronté à des défis majeurs dans la prestation des services, mais les données régionales font défaut. Cette étude a évalué les ressources en anesthésie et les obstacles aux soins sécurisés dans la région de l'Adamaoua. Matériels et méthodes. Nous avons mené une étude transversale (février-juin 2025) dans 12 hôpitaux de sept districts sanitaires. Nous avons utilisé la liste de contrôle OMS-FMSA, un questionnaire destiné aux prestataires et une revue standardisée des formulaires. Des scores de conformité ont été calculés ; les différences entre établissements ont été testées par Kruskal-Wallis ; la fiabilité des formulaires a utilisé l'alpha de Cronbach (≥0,70). L'exhaustivité a été définie comme ≥75 % des 64 éléments. Résultats. Dix-huit prestataires ont participé (âge moyen 38,0±5,1 ans ; 83,3 % d'hommes) ; 72,2 % étaient des infirmiers anesthésistes ; aucun médecin anesthésiste-réanimateur n'a été trouvé. Le ratio global prestataire-population était de 1:67 137 ; trois districts n'en comptaient aucun. Les établissements de premier niveau présentaient la conformité la plus faible (hautement recommandé 61,6 %, recommandé 25,8 %, suggéré 14,9 % ; p=0,043 pour les équipements suggérés). Seulement 41,7 % disposaient d'appareils d'anesthésie fonctionnels ; 50 % avaient des unités de soins post-interventionnels. Les principaux défis étaient les pénuries d'agents anesthésiques (66,7 %), le manque de compétences spécialisées (61,1 %), l'expertise en anesthésie pédiatrique/gériatrique (55,6 %) et les pannes d'équipement (50,0 %). Sur 77 formulaires pré-anesthésiques, seulement 28,6 % étaient complets, bien que la cohérence interne fût bonne (α=0,882). Les obstacles incluaient l'absence de formulaires standardisés (58,3 %), les examens de laboratoire indisponibles (58,3 %) et l'absence d'espace dédié (50,0 %). Conclusion. Des pénuries sévères de médicaments, d'équipements et de personnel formé compromettent gravement la sécurité anesthésique dans la région de l'Adamaoua. L'évaluation préopératoire est sous-utilisée et incomplète. Des investissements urgents dans les effectifs, les infrastructures et les chaînes d'approvisionnement sont nécessaires pour améliorer la sécurité périopératoire.References
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Copyright (c) 2026 Verla Vincent Siysi, Dzetse William Ngwayi, Tanue Elvis Asangbeng, Tchuisseu Ngapjang Christian Damien, Ngomba Divine Martin Mokake
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