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A1.3 Safe paediatric anaesthesia project: scaling-up paediatric anaesthesia training in east and central africa
  1. E Sharkey1,
  2. N Boyd2,
  3. Z Burton3,
  4. J Tumukunde4,
  5. M Nabukenya5,
  6. N Sipuka6,
  7. M Zyambo6,
  8. S Nabulindo7,
  9. G Rodney8,
  10. S Mndolo9,
  11. TB Gemechu10,
  12. D Bould11,
  13. F Evans12,
  14. J Kiwanuka13,
  15. A Ahmed14,
  16. M White2,
  17. I Walker2,
  18. the Safer Anaesthesia From Education (SAFE) Paediatric Anaesthesia group
  1. 1Royal Free Hospital NHS Foundation Trust, London, UK
  2. 2Great Ormond Street Hospital NHS Foundation Trust, UK
  3. 3Sheffield Children’s NHS Foundation Trust, UK
  4. 4Red Cross Children’s Hospital, Cape Town, South Africa
  5. 5Mulago National Referral Hospital, Uganda
  6. 6University Teaching Hospital, Zambia
  7. 7Kenyatta National Referral Hospital, Kenya
  8. 8Ninewells Hospital, Dundee, UK
  9. 9Queen Elizabeth Central Hospital, Blantyre
  10. 10Jimma University Teaching Hospital, Ethiopia
  11. 11Children’s Hospital of Eastern Ontario, Canada
  12. 12Boston Children’s Hospital, Boston, US
  13. 13Mbarara Regional Referral Hospital, Mbarara, Uganda
  14. 14World Federation of Societies of Anaesthesiologists, London, UK


Background The burden of treatable surgical diseases in children in low- and middle-income countries (LMICs) is greater than that of malaria, HIV/AIDS and TB combined. World Health Organisation member states are required to scale up access to emergency and essential surgery for children by 2030 as part of universal health coverage. There is a critical shortage of anaesthetists trained to look after children in LMICs. The aim of this project was to deliver the Safer Anaesthesia From Education (SAFE) Paediatric course in East and Central Africa, and to evaluate the impact of this training programme.

Methods The SAFE Paediatric anaesthesia course is a three-day short course developed by GOSH paediatric anaesthetists in collaboration with the Association of Anaesthetists of Great Britain and Ireland (AAGBI), World Federation of Societies of Anaesthesiologists (WFSA) and Association of Anaesthesiologists of Uganda (AAU). It focuses on common paediatric surgical conditions encountered in LMICs. A one-day Train-The-Trainer (TTT) course was also established to train future SAFE faculty.

Results A total of nine SAFE courses were delivered. ‘SAFE fellows’ conducted follow-up interviews in Uganda, Zambia and Malawi. 46/57 (81%) faculty members who completed the TTT course taught on a subsequent SAFE course. 381 delegates completed the course. Mean MCQ scores increased from 37.6/50 pre-course to 43.4/50 post-course and skills scores increased from 5.8/10 to 8/10 (p<0.001).

Follow-up showed significantly higher mean MCQ (pre-course 37.6/50, follow-up 41.5/50) and skills test scores (pre-course(5.8/10), follow-up(8.2/10)). All interviewed delegates reported increased confidence in providing paediatric anaesthesia.

Conclusion The SAFE paediatric anaesthesia course provides high quality education for anaesthetists in LMICs. Knowledge and skills improve and are retained at follow-up. SAFE course training results in changes in paediatric anaesthesia practice and improved patient outcomes. Delivery of the SAFE training through UK/LMIC anaesthesia health partnerships builds links between paediatric anaesthetists internationally.

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