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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.

Supplemental Digital Content is available in the text.

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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Reprints will not be available from the authors.

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