• Janet Martin, Goa Tau, Meena Nathan Cherian, Jennifer Vergel de Dios, David Mills, Jane Fitzpatrick, William Adu-Krow, and Davy Cheng.
• Department of Anesthesia & Perioperative Medicine, Medical Evidence, Decision Integrity & Clinical Impact (MEDICI) Centre, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada Department of Epidemiology & Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.
• BMJ Open. 2015 Dec 16; 5 (12): e009841.

ObjectiveTo assess capacity to provide essential surgical services including emergency, obstetric and anaesthesia care in Papua New Guinea (PNG) in order to support planning for relevant post-2015 sustainable development goals for PNG.DesignCross-sectional survey.SettingHospitals and health facilities in PNG.Participants21 facilities including 3 national/provincial hospitals, 11 district/rural hospitals, and 7 health centres.Outcome MeasuresThe WHO Situational Analysis Tool to Assess Emergency and Essential Surgical Care (WHO-SAT) was used to measure each participating facility's capacity to deliver essential surgery and anaesthesia services, including 108 items related to relevant infrastructure, human resources, interventions and equipment.ResultsWhile major surgical procedures were provided at each hospital, fewer than 30% had uninterrupted access to oxygen, and 57% had uninterrupted access to resuscitation bag and mask. Most hospitals reported capacity to provide general anaesthesia, though few hospitals reported having at least one certified surgeon, obstetrician and anaesthesiologist. Access to anaesthetic machines, pulse oximetry and blood bank was severely limited. Many non-hospital health centres providing basic surgical procedures, but almost none had uninterrupted access to electricity, running water, oxygen and basic supplies for resuscitation, airway management and obstetric services.ConclusionsCapacity for essential surgery and anaesthesia services is severely limited in PNG due to shortfalls in physical infrastructure, human resources, and basic equipment and supplies. Achieving post-2015 sustainable development goals, including universal healthcare, will require significant investment in surgery and anaesthesia capacity in PNG.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

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