Background
Methods
Country | Author | Cadre name | Preservice training | Specialized training | Surgical roles/procedures | Regulation system | Geographic location |
---|---|---|---|---|---|---|---|
Eastern Africa | |||||||
Kenya | Kakande et al. [6] | Clinical officer | 3-year diploma in clinical medicine + 1-year internship | 1–1.5-year higher diploma course | Ear, nose, and throat; ophthalmology, anesthesia, orthopedics, minor surgery (e.g., circumcision) | Training and practice regulated by the clinical officers council, act of parliament in place to define roles | Mainly rural |
Tanzania | Assistant medical officer | 3-year training in clinical medicine + 1-year internship | 2-year training for advanced diploma | Emergency obstetric surgery, anesthesia, hernia, abdominal surgery including laparotomy, hydrocelectomy, prostatectomy | Diploma award, accreditation and registration by Tanganyika Medical Council | Urban, rural | |
Sudan | Kakande et al. [6] | Clinical officer | 3-year clinical training | Minor surgery, emergency obstetric surgery, anesthesia | |||
Uganda | Clinical officer | 3-year diploma in clinical medicine + 1-year internship | 1–1.5-year higher diploma course | Orthopedics, anesthesia | |||
Ethiopia | Gessessew et al. [35] | Integrated emergency surgical officer | 3–4-year training in clinical medicine, public health, healthcare management | 6–9-month training in emergency obstetric care | Emergency obstetric surgery, laparotomy, uterine evacuation, hysterectomy, ophthalmology, anesthesia | ||
Burundi | McAuliffe et al. [10] | Nurse anesthetist | 2-year training program | ||||
Djibouti | McAuliffe et al. [10] | Nurse anesthetist [7] | |||||
Malawi | Clinical officer | 2-year training and 4-year clinical experience as medical assistant | 18-month formal training in surgery | Orthopedic, ophthalmology, emergency obstetric surgery, laparotomy | Registration by the Malawi Medical Council, | Urban, rural | |
Mozambique | Surgical technicians Anesthesia technicians | 2-year training in clinical medicine as an assistant medical officer + 2–3-year clinical experience | 2-year surgical training + 1-year internship for a specialized diploma | Emergency obstetric surgery, orthopedic, general surgery including craniotomy, bowel resection, colostomy, anesthesia | Accreditation by Ministry of Health | Mainly rural | |
Zambia | Kakande et al. [6] | Medical licentiates | 3-year training as clinical officer + 2-year clinical experience | 3-year training for a bachelor’s degree in surgery | Anesthesia, orthopedics, emergency obstetric care | Accredited by University of Zambia Regulated by Medical Council of Zambia | Mainly rural |
Central Africa | |||||||
Cameroon | McAuliffe et al. [10] | Nurse anesthetist | 3-year training as registered nurse + 2-year pf experience as intensive care unit nurse | 2-year anesthesia training program | |||
Chad, Angola | McAuliffe et al. [10] | Nurse anesthetist | |||||
West Africa | |||||||
Guinea-Bissau | Mullan et al. [8] | Clinical officer | 3-year training | N/A | Minor surgery, anesthesia | Mainly rural | |
Ghana | Mullan et al. [8] | Medical assistant | 3-year training + 1-year internship | Minor surgery, emergency obstetric surgery, anesthesia | Mainly rural | ||
Togo | Mullan et al. [8] | Medical assistant | Minor surgery, ophthalmology | ||||
Senegal | Mullan et al. [8] | Health officer | 2-year clinical training + 6-month internship | Minor surgery, anesthesia | |||
Sierra Leone | Mullan et al. [8] | Community health officer Nurse anesthetist | 3-year training in community health sciences to earn a higher national diploma in community health sciences | Trainees receive 6 months of surgical training at a central hospital then 6-month rotation to a partner hospital | Cesarean section, laparotomy, hernia repair, hydrocelectomy, appendectomy, tubal ligation, anesthesia | ||
Burkina Faso | Hounton et al. [20] | Clinical officer | 3-year training in clinical medicine and surgery | None | Minor surgery, Cesarean section, ophthalmology | Rural, urban | |
Côte d’Ivoire | McAuliffe et al. [10] | Nurse anesthetist | 2-year training program | ||||
Gabon | Mullan et al. [8] McAuliffe et al. [10] | Nurse anesthetist | Registered nurse with 2-year clinical experience | 2-year training program | |||
Nigeria, Mali, Benin | McAuliffe et al. [10] | Nurse anesthetist | |||||
Southern Africa | |||||||
Botswana, Swaziland, Lesotho, Zimbabwe | McAuliffe et al. [10] | Nurse anesthetist | |||||
Central America | |||||||
Haiti | Rosseel et al. [26] | Certified nurse | 2-year training as a nurse | 15–18-month program offered by Medicines San Frontieres (1998–2003) and Partners in Health (2007–) | General anesthesia, spinal anesthesia | ||
Asia | |||||||
Bhutan | Mavalankar et al. [13] | Nurse anesthetist | 2-year training as clinical nurse | 14-month training combined in Bhutan and Bangkok | General anesthesia, spinal anesthesia | ||
Afghanistan | Mavalankar et al. [13] | Nurse anesthetist | 2-year training as clinical nurse | 1 year of training in anesthesia | General anesthesia | ||
Nepal | Mavalankar et al. [11] | Anesthesia assistant | 6-month training | None | General anesthesia | ||
Cambodia, Laos | Mavalankar et al. [11] McAuliffe et al. [12] | Nurse anesthetist | 2-year training | ||||
Philippines, Indonesia, Vietnam, Myanmar, India | McAuliffe et al. [10] Mavalankar et al. [11] | Nurse anesthetist |
Surgical specialty area | Orthopedics [25] | Ophthalmology [35] | Ear, nose, throat/otolaryngology [6] | Neuro surgery [4] | Plastic surgery [6] | ||
---|---|---|---|---|---|---|---|
Procedures performed | • C-section • Repair of ruptured uterus • Hysterectomy • Ectopic pregnancy • Tubal ligation • Dilatation and curettage • Manual vacuum aspiration | • Exploratory laparotomy • Inguinal hernia repair • Hydrocelectomy • Appendectomy • Prostatectomy • Bowel surgery (resection, colostomy) • Circumcision • Incision and drainage of abscess • Surgical repair of traumatic wounds | • Debridement of open fractures • External fixation of fractures • Closed fracture manipulation • Joint dislocation • Acute pyogenic musculoskeletal infections • Limb amputation • Management of club foot | • Cataract surgery • Evisceration of the globe • Management of acute eye emergencies • Management of refractive errors [3] | • Ear/nasal foreign body removal • Tonsillectomy • Excision of nasal soft tissue | • Craniotomy • V-P shunting for hydrocephalus | • Management of burn injuries • Skin grafting |