Last week the Kenya Society of Anaesthesiologists (KSA) officially launched their National Anaesthesia Guidelines, a resource which gives recommendations for best practice and sets a number of minimum standards.
The guide covers recommendations for Minimum Facilities For Safe Administration of Anaesthesia in Operating Suites and Other Anaesthetizing Locations, Minimum Facilities For The Provision Of Obstetric Analgesia Services, Recommendations on Monitoring During Anaesthesia, Guidelines on The Provision of Obstetric Anaesthesia Services, Checking Anaesthetic Equipment Guidelines, Pre-Op Review Guidelines, and a Pre-Anaesthetic Machine Checklist Guideline Summary.
“The journey began in 2014 at our annual scientific conference,” Phoebe Khagame, KSA representative explained. “At the AGM a member who works outside the main urban centres expressed to members the challenges he was having, mostly in terms of equipment, support from the hospital and things like that. So it was found essential to have guidelines, from which we can enforce standards of anaesthesia and define the bare minimum, to ensure patient safety.”
The KSA worked on the guidelines, forming subcommittees between 2014 and 2015, passing the sub-committees’ findings at their 2015 AGM, and working with the Kenya Medical Practitioners and Dentists Board to gain approval for the guidelines in 2016.
The official launch of the National Anaesthesia Guidelines took place at the Radisson Blu Hotel, Nairobi, presented by Dr Annah Wamae, Head of Clinical Services, who serves under the Cabinet Secretary for Health. The event was attended by all types of anaesthesia provider as the guidelines will apply to physician anaesthetists, clinical officer anaesthetists, and nurse anaesthetists. The media was also present, as well as other partners and stakeholders including pharmaceutical companies and industry, as the KSA felt that it was important that they understand the standards in the country in which they are working.
Dr Louis Litswa, KSA Chairperson, remarked that the guidelines are “a great milestone in the recognition of safe provision of anaesthesia care across the country as being fundamental to attaining universal health care for Kenyans.”
“Thanks to the Government of Kenya, WFSA, the anaesthetic colleagues, and BBRAUN for their assistance in actualising the dream.”
In a letter to the KSA, Dr Gonzalo Barreiro expressed the WFSA’s support for the guidelines by saying:
“Safe anaesthesia is essential for safe surgery, a clear concept that is universally understood and accepted. The argument that poor quality anaesthesia “is better than nothing” risks compromising the whole surgical system, patient outcomes will be affected and lives will be lost.”
He added that: “Your National Anaesthesia guidelines, designed to achieve safe anaesthesia for your citizens, are not only a great achievement, but an example to other countries worldwide.”
The Guidelines Going Forward
The creation of the National Anaesthesia Guidelines are part of wider work that is being undertaken by the KSA to create a National Surgical & Anaesthesia Plan with the Ministry of Health to ensure there is suitable government support and funding to help facilities across Kenya meet the recommendations set out in the Anaesthesia Guidelines document, and to scale up anaesthesia and surgical care in the long term.
The KSA has printed copies of the National Anaesthesia Guidelines to disseminate, along with a letter of support from the Kenya Medical Practitioners and Dentists Board, to all of the consultant anaesthetists in the country. They are also working with the National Clinical Officer Association, as the majority of its members work in more rural areas whereas most physician anaesthetists work in urban areas, to ensure that every institution with an operating theatre will have the National Anaesthesia Guidelines booklet.
After the guidelines have been disseminated the KSA plans to conduct follow-up surveys of medical facilities to see whether there have been improvements, and if facilities have incorporated some of the recommendations that were made in the guidelines. There is already baseline data on facilities and equipment available in many institutions as a result of country-wide data collection undertaken by the WFSA/AAGBI SAFE (Safer Anaesthesia From Education) Fellow in 2016/17. The aim of the KSA is to conduct follow-up data collection on the availability of equipment and drugs just before the existing guidelines are updated every 2-3 years.
A copy of the National Anaesthesia Guidelines is available on the KSA website here.