Nepal is a mountainous country of 27 million people where the widespread lack of access to operative services is a major cause of morbidity and mortality. One critical reason for this is the lack of trained, appropriately distributed anaesthesia providers. We discuss the evolution of the ‘anaesthesia assistant’ in Nepal, review the international literature concerning the development of non-doctor anaesthetists, and invite links with others working in this field.
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References
1.
Government of Nepal. Nepal Demographic and Health Survey, Calverton, USA: Macro International Inc, 2006
2.
Government of Nepal Ministry of Health/Population. Family Health Division Records, Kathmandu, Nepal: Safe Motherhood Newsletter, 2007
3.
HornbyP, GhimireR. Policies for the Development and Deployment of Medical Specialists in Nepal. Kathmandu, Nepal: Government of Nepal Health Ministry/HSSP-GTZ, 2003:17
4.
M + M Associates for Nepal Safer Motherhood Programme. Evaluation of Performance of Anaesthesia Assistants of Nepal, 2004
5.
McAuliffeMS, HenryB. Nurse anaesthesia practice and research – a worldwide need. CRNA2000;11:89–98
6.
HenryB, McAuliffeMS. Practice and education of nurse anaesthetists. Bull World Health Organ1999;77:267–70
7.
GunnIP. Health educational costs, provider mix, and healthcare reform: A case in point – nurse anesthetists and anesthesiologists. AANA J1996;64:48–52
8.
American Association of Nurse Anesthetists (AANA). Cost Effectiveness of Nurse Anesthetist practice. See http://www.aana.com/aboutaana.aspx?ucNavMenu_TSMenuTargetID=179&ucNavMenu_TSMenuTargetType=4&ucNavMenu_TSMenuID=6&id=458 (last checked 7 February, 2007)
9.
RosenbachML, CromwellJ. A profile of anaesthesia practice patterns. Health Aff1988;7:118–31
10.
SmithAF, KaneM, MilneR. Comparative effectiveness and safety of physician and nurse anaesthetists: a narrative systematic review. Br J Anaesth2004;93:540–45
11.
AbensteinJP, WarnerMA. Anaesthesia providers, patient outcomes, and costs. Anaesth Analg1996;82:1273–83
12.
SimonsonDC, AhernMM, HendryxMS. Anaesthesia staffing and anesthetic complications during caesarean delivery: a retrospective analysis. Nurs Res2007;56:9–17
13.
FentonPM, WhittyCJ, ReynoldsF. Caesarean section in Malawi: prospective study of early maternal and perinatal mortality. BMJ2003;327:587
14.
FreedmanL.P. Shifting visions: ‘Delegation’ policies and the building of a ‘rights-based’ approach to maternal mortality. JAMWA2002;57:154–8