Provision of anaesthesia services for emergency obstetric care through task shifting in South Asia
Provision of anaesthesia services for emergency obstetric care through task shifting in South Asia
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DOI：
10.1016/s0968-8080(09)33433-3
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发表时间：
2009-05-01
影响因子：
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通讯作者：
Sriram, Veena
中科院分区：
文献类型：
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作者：
Mavalankar, Dileep;Sriram, Veena
在产科急诊中，某些手术需要麻醉，如剖腹产和破裂子宫的修复。近年来，由于麻醉师严重短缺，南亚的公共部门农村医院实行了提供麻醉的任务转移，但对这一问题的研究有限。本文回顾了关于这一主题的文献，并记录了南亚将麻醉服务任务转移到中级提供者以增加获得紧急产科护理和降低孕产妇死亡率的现有方案。我们发现，麻醉服务任务转移在扩大南亚的覆盖面和获得护理方面是有效的，但大多数方案没有作为整体人力资源战略的一个港口系统地实施。全面的方法，以尽量扩大这些方案的效益，呼吁各国任命一名名义上的或国家一级的主任，负责在农村地区提供麻醉服务;提供法律的保护，由主管当局颁发许可证，并进行登记，以提供麻醉服务，包括开具麻醉药品处方;支助性管理安排、基于能力的培训、监测和评价;业绩奖励、职业结构和工作明确性;充足的设备和用品;麻醉专科医生的支持和安全质量保证（C）2009年生殖健康事项。All rights reserved.
Anaesthesia is required for certain procedures in emergency obstetric core, such as caesarean section and the repair of ruptured uterus. Task shifting for provision of anaesthesia has been implemented in public sector rural hospitals of South Asia in recent years because of significant shortages of anaesthetists, but there has been limited research on this issue. This paper reviews the literature on this topic and documents existing programmes for task shifting anaesthesia services to mid-level providers in South Asia to increase access to emergency obstetric care and reduce maternal mortality we found that task shifting of anaesthesia services has been effective in expanding coverage and access to care in South Asia, but most programmes hove not been implemented systematically as port of an overall human resources strategy A comprehensive approach, to maximise the benefits of these programmes, calls for countries to appoint a director at notional or state level who is responsible for the availability of anaesthesia services in rural areas; legal protections, licensing by a competent authority and registration to perform anaesthesia services, including prescription of anaesthesia drugs; supportive managerial arrangements, competency-based training, monitoring and evaluation; performance rewards, career structure and job clarity; adequate equipment and supplies; support from specialist anaesthetists and quality assurance for safety (C) 2009 Reproductive Health Matters. All rights reserved.