Background
In Uganda, there is a critical shortage of anaesthesia providers, and 70% of the government posts for anaesthesia providers in the country are empty. Underlying chronic problems such as pay, career progression, and limited training capacity lead to perpetual shortages and attrition of the anaesthesia workforce. Currently Uganda has only <1 anaesthesia provider per 100,000 people, well short of the goal to have at least 5-10 anaesthesia providers per 100,00 by the year 2030. This goal is based on evidence demonstrating significant reductions in maternal mortality and improved perioperative outcomes. Each 10 unit increase in the number of surgeons, anesthesiologists and obstetricians per 100,000 decreases mortality by 13%.
Uganda’s Health Sector Development Plan 2015-2020 has explicitly targeted increasing anaesthesia training capacity, yet existing training capacity for Ugandan anaesthesia providers (5 institutions) cannot meet current demands or match population growth. At the present rate, Uganda will not come close to achieving the 2030 anaesthesia workforce goals established by the Lancet Commission on Global Surgery and the World Health Organization.
The AAU National Anaesthesia Workforce Strategy will achieve 2030 workforce goals to increase access to safe anaesthesia services. The strategy includes targeted strategies for rural workforce retention, career progression, continuing professional development, timely absorption of graduates
Bachelors of Science in Anaesthesia (BScA)
The Department of Anaesthesia at the Faculty of Health Sciences, Busitema University, together with the Association of Anaesthesiologists of Uganda (AAU) has developed a novel training programme in anaesthesia to complement the existing anaesthesia training programmes in Uganda. The Bachelor of Science in Anaesthesia (BScA) is a competency-based training programme and is designed to address the critical shortage of anaesthesia providers while actively addressing the chronic deterrents to the practice of anaesthesia in Uganda. These Anaesthetic Officers (Bachelors) will be competent to provide other essential services including critical care, pain management, resuscitation, emergency medicine and patient transfers.
How will the BScA integrate with the current anaesthesia provider types in Uganda?
- It will provide opportunities for career and pay progression for not only for the new BSc graduates but also for existing anaesthetic officers.
- It will create a cadre of anaesthesia provider who can provide support supervision at lower level health facilities.
- It completes the link between Health Centre IVs, District Hospitals and specialist anaesthesia and critical care at a regional/national level.
- As illustrated below, the BSc Anaesthesia provider will fill a much needed gap between current Anaesthetic Officers (Diploma Level) and the physician anaesthestiologists (MMed)
BScA Programme Structure
The BScA is a 4-year university academic program. Key characteristics of this physician-led programme include integration with MBChB curriculum, a problem-based approach and a competency-based assessment process.
Admission criteria for the BScA are equivalent to those for the MBChB program. Mature entry diploma holders, current anaesthetic officers (higher diploma) and advanced level (UACE) school leavers are eligible for entry into the course. Students will spend the first two years learning basic sciences (MBChB) before completing two years of anaesthesia, critical care and pain management training. Graduates will hold a Bachelors Degree in Anaesthesia and will be known as Anaesthetic Officers (BScA). Any holder of the BScA will have an opportunity to further their career by joining medical school in the 3rd year of the MBChB programme (candidates may be required to complete mandatory clinical service after completing the BSc and before re-entering the MBChB program).
Roadmap
The BScA will commence at Busitema University in September 2017. A scale-up plan has been developed that would see 44 faculty recruited into 5 universities across Uganda training in 12 government hospitals over the next 10 years. This plan is being finalized and implemented with the input and partnership of multiple stakeholders and collaborating institutions.