• Fauzia A Khan, Saeeda Haider, Nighat Abbas, Navaid Akhtar, Nur Ul Haq, M Saleh Khaskheli, Younis Khatri, Nadeem Munir, Hamid Raza, Maqsood Ahmed Siddiqui, Ahmed Uddin Soomro, and Safia Zafar Siddiqui.
• From the Department of Anaesthesiology, Aga Khan University, Karachi, Pakistan.
• Anesth. Analg. 2022 Mar 1; 134 (3): 653660653-660.

BackgroundPakistan is a lower middle-income country located in South Asia with a population of nearly 208 million. Sindh is its second largest province. The aim of this survey was to identify the current setup of pediatric services, staffing, equipment, and training infrastructure in the teaching hospitals of Sindh.MethodsThe survey was conducted between June 2018 and September 2018. A questionnaire was designed with input from experts and pretested. One faculty coordinator from each of 12 of the 13 teaching hospitals (7 government and 5 private) completed the form. Information was exported into Statistical Package for the Social Sciences (SPSS) version 22. Frequency and percentages were computed for all variables. Confidentiality was ensured by anonymizing the data.ResultsAnesthesia services are provided by consultants with either membership or fellowship in anesthesia of the College of Physicians and Surgeons of Pakistan (CPSP). All drugs on the World Health Organization (WHO) essential medication list were available, although narcotic supply was often inconsistent. Weak areas identified were absence of standardization of practice regarding premedication, preoperative laboratory testing, pain assessment, and management. No national practice guidelines exist. Pulse oximeters and capnometers were available in all private hospitals but in only 86% and 44% of the government hospitals, respectively. Some training centers were not providing the training as outlined by the CPSP criteria.ConclusionsSeveral gaps have been identified in the practice and training infrastructure of pediatric anesthesia. There is a need for national guidelines, standardization of protocols, provision of basic equipment, and improved supervision of trainees. One suggestion is to have combined residency programs between private and government hospitals to take advantage of the strengths of both. Recommendations by this group have been shared with all teaching hospitals and training bodies.Copyright © 2021 International Anesthesia Research Society.

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