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The WFSA Global Anesthesia Workforce Survey

Kempthorne, Peter MBChB, FANZCA*†; Morriss, Wayne W. MBChB, FANZCA†‡; Mellin-Olsen, Jannicke MD, DPH†§; Gore-Booth, Julian MA

doi: 10.1213/ANE.0000000000002258
Global Health: Original Clinical Research Report

BACKGROUND: Safe anesthesia and surgical care are not available when needed for 5 billion of the world’s 7 billion people. There are major deficiencies in the specialist surgical workforce in many parts of the world, and specific data on the anesthesia workforce are lacking.

METHODS: The World Federation of Societies of Anaesthesiologists conducted a workforce survey during 2015 and 2016. The aim of the survey was to collect detailed information on physician anesthesia provider (PAP) and non-physician anesthesia provider (NPAP) numbers, distribution, and training. Data were categorized according to World Health Organization regional groups and World Bank income groups.

RESULTS: We obtained information for 153 of 197 countries, representing 97.5% of the world’s population. There were marked differences in the density of PAPs between World Health Organization regions and between World Bank income groups, ranging from 0 to over 20 PAP per 100,000 population. Seventy-seven countries reported a PAP density of <5, with particularly low densities in the African and South-East Asia regions. NPAPs make up a large part of the global anesthesia workforce, especially in countries with limited resources. Even when NPAPs are included, 70 countries had a total anesthesia provider density of <5 per 100,000. Using current population data, over 136,000 additional PAPs would be needed immediately to achieve a minimum density of 5 per 100,000 population in all countries.

CONCLUSIONS: The World Federation of Societies of Anaesthesiologists Global Anesthesia Workforce Survey is the most comprehensive study of the global anesthesia workforce to date. It is the first step in a process of ongoing data collection and longitudinal follow-up. The authors recommend an interim goal of at least 5 specialist physician anesthesia providers (anesthesiologists) per 100,000 population. A marked increase in training of PAPs and NPAPs will need to occur if we are to have any hope of achieving safe anesthesia for all by 2030.

From the *Christchurch Hospital, Christchurch, New Zealand; World Federation of Societies of Anaesthesiologists, London, United Kingdom; Department of Anaesthesia, University of Otago, Christchurch, New Zealand; and §Baerum Hospital, Sandvika, Norway.

Accepted for publication April 18, 2017.

Funding: None.

The authors declare no conflicts of interest.

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Address correspondence to Wayne W. Morriss, MBChB, FANZCA, Department of Anaesthesia, Christchurch Hospital, Private Bag 4710, Christchurch 8140, New Zealand. Address e-mail to

© 2017 International Anesthesia Research Society