Survey of the capacity for essential surgery and anaesthesia services in Papua New Guinea

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. DESIGN Cross-sectional survey. SETTING Hospitals and health facilities in PNG. PARTICIPANTS 21 facilities including 3 national/provincial hospitals, 11 district/rural hospitals, and 7 health centres. OUTCOME MEASURES 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.