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Ki BK, Onajin-Obembe B, Adekola O, Baele PL, Binam F, Daddy H, Diouf E, Fanou L, Gathuya ZN, Igaga EN, Jeque E, Mawandza P, Nabukenya MT, Nabulindo SM, Nicole Rakotoarison RC, Robert AR, Schwalbach T, Uwambazimana JD, Vilasco B, Zomahoun L. Women Anesthesiologists in Sub-Saharan Africa in the Pre-COVID Era: A Multinational Demographic Study. Anesth Analg 2024; 139:4-14. [PMID: 38300845 PMCID: PMC11155285 DOI: 10.1213/ane.0000000000006868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2023] [Indexed: 02/03/2024]
Abstract
BACKGROUND Gender imbalance and poor representation of women complicate the anesthesiology workforce crisis in sub-Saharan Africa (SSA). This study was performed to obtain a better understanding of gender disparity among medical graduates and anesthesiologists in SSA. METHODS Using a quantitative, participatory, insider research study, led by female anesthesiologists as the national coordinators in SSA, we collected data from academic or national health authorities and agencies. National coordinators were nominees of anesthesiology societies that responded to our email invitations. Data gathered from 13 countries included information on medical graduates, anesthesiologists graduating between 1998 and 2021, and number of anesthesiologists licensed to practice in 2018. We compared data between Francophone and Anglophone countries, and between countries in East Africa and West Africa/Central Africa. We calculated anesthesiology workforce densities and compared representation of women among graduating anesthesiologists and medical graduates.Data analysis was performed using linear regression. We used F-tests on regression slopes to assess the trends in representation of women over the years and the differences between the slopes. A value of P < .050 was considered statistically significant. RESULTS Over a 20-year period, the representation of female medical graduates in SSA increased from 29% (1998) to 41% (2017), whereas representation of female anesthesiologists was inconsistent, with an average of 25%, and lagged behind. Growth and gender disparity patterns were different between West Africa/Central Africa and East Africa. Representation of female anesthesiologists was higher in East Africa (39.4%) than West Africa/Central Africa (19.7%); and the representation of female medical graduates in East Africa (42.5%) was also higher that West Africa/Central Africa (33.1%). CONCLUSIONS On average, in SSA, female medical graduates (36.9%), female anesthesiologists (24.9%), and female anesthesiology residents projected to graduate between 2018 and 2022 (25.2%) were underrepresented when compared to their male counterparts. Women were underrepresented in SSA, despite evidence that their representation in medicine and anesthesiology in East African countries was rising.
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Affiliation(s)
- Bertille K. Ki
- From the Service d’Anesthésie-Réanimation, CHU Pédiatrique Charles de Gaulle, Université Joseph Ki-Zerbo, Ouagadougou, Burkina Faso
| | - Bisola Onajin-Obembe
- Department of Anaesthesiology, Faculty of Clinical Sciences, College of Health Sciences, University of Port Harcourt, Port Harcourt, Rivers State, Nigeria
| | - Oyebola Adekola
- Department of Anaesthesia, College of Medicine University of Lagos, Lagos, Nigeria
| | - Philippe L. Baele
- Department of Anesthesiology, Faculty of Medicine, Catholic University of Louvain (UCLouvain), Ottignies-Louvain-la-Neuve, Belgium
| | - Fidele Binam
- Department of Anaesthesia, Yaoundé Faculty of Medicine and Biomedical Sciences, Yaoundé, Cameroon
| | - Hadjara Daddy
- Faculté des sciences de la santé, Université Abdou Moumouni, Niamey, Niger
| | - Elizabeth Diouf
- Service d’Anesthésie-Réanimation, Faculté de Médecine, Université Cheikh Anta Diop de Dakar, Dakar, Senegal
| | - Lionelle Fanou
- Hôpital d’instruction des armées, Centre hospitalier universitaire de Cotonou, Université d’Abomey-Calavi, Abomey-Calavi, Benin
| | | | - Elizabeth N. Igaga
- Uganda Heart Institute, Department of Anaesthesia and Critical care, Division of Cardiac Anaesthesia, Kampala, Uganda
| | - Emilia Jeque
- Faculdade de Medicina da Universidade Eduardo Mondlane, Maputo, Moçambique
| | - Peggy Mawandza
- Faculté des Sciences de la Santé - Université Marien Ngouabi, Brazzaville, Congo
| | - Mary T. Nabukenya
- Uganda Heart Institute, Department of Anaesthesia and Critical care, Division of Cardiac Anaesthesia, Kampala, Uganda
| | | | | | - Annie R. Robert
- Department of Epidemiology & Biostatistics, IREC EPID UCLouvain, Brussels, Belgium
| | - Teresa Schwalbach
- Faculdade de Medicina da Universidade Eduardo Mondlane, Maputo, Moçambique
| | - Jeanne D’Arc Uwambazimana
- Department of Anaesthesia, College of Medicine and Health Sciences, School of Medicine and Pharmacy, University of Rwanda, Kigali, Rwanda
| | - Brigitte Vilasco
- Unité de Formation et de Recherche en Sciences Médicales, Université Félix Houphouët-Boigny d’Abidjan, Cocody, Côte D’ivoire
| | - Lidwine Zomahoun
- Faculté des Sciences de la Santé, CHU Mère-Enfant Lagune, Université d’Abomey-Calavi, Cotonou, Benin
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Leslie K, Wan YI, Wong CA. Diversity, inclusion, and equity at the British Journal of Anaesthesia: 100 years of progress. Br J Anaesth 2023; 131:977-980. [PMID: 37758621 DOI: 10.1016/j.bja.2023.08.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 08/06/2023] [Accepted: 08/28/2023] [Indexed: 09/29/2023] Open
Abstract
The past century, especially the past decade, has seen re-examination and evolution in our views about sex, gender, race, and ethnicity. The British Journal of Anaesthesia is part of an ongoing effort in research and medical publishing, and in health and education more generally, to improve diversity, inclusion, and equity. This editorial highlights the contributions and evolution of the Journal in these areas from its origin until today.
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Affiliation(s)
- Kate Leslie
- Department of Critical Care, University of Melbourne, Melbourne, VIC, Australia; Department of Anaesthesiology and Perioperative Medicine, Central Clinical School, Monash University, Melbourne, VIC, Australia; Department of Anaesthesia and Pain Management, Royal Melbourne Hospital, Melbourne, VIC, Australia.
| | - Yize I Wan
- Adult Critical Care Research Unit, William Harvey Research Institute, Queen Mary University of London, London, UK
| | - Cynthia A Wong
- Department of Anesthesia, University of Iowa Carver College of Medicine, Iowa City, IA, USA
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Gisselbaek M, Barreto Chang OL, Saxena S. Gender equity in anesthesia: is it time to rock the boat? BMC Anesthesiol 2023; 23:67. [PMID: 36882715 PMCID: PMC9991878 DOI: 10.1186/s12871-023-01987-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Affiliation(s)
- M Gisselbaek
- Department of Anesthesiology and Acute Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - O L Barreto Chang
- Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, CA, USA
| | - S Saxena
- Department of Anesthesia and Reanimation, AZ Sint-Jan Brugge Oostende AV, Brugge, Belgium.
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Paterson A, Maswime S, Hardy A, Pearse RM, Biccard BM. Postoperative outcomes associated with surgical care for women in Africa: an international risk-adjusted analysis of prospective observational cohorts. BJA OPEN 2022; 4:100100. [PMID: 37588786 PMCID: PMC10430807 DOI: 10.1016/j.bjao.2022.100100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 09/21/2022] [Indexed: 08/18/2023]
Abstract
Background Improving women's health is a critical component of the sustainable development goals. Although obstetric outcomes in Africa have received significant focus, non-obstetric surgical outcomes for women in Africa remain under-examined. Methods We did a secondary analysis of the African Surgical Outcomes Study (ASOS) and International Surgical Outcomes Study (ISOS), two 7-day prospective observational cohort studies of outcomes after adult inpatient surgery. This sub-study focuses specifically on the analysis of the female, elective, non-obstetric, non-gynaecological surgical data collected during these two large multicentre studies. The African data from both cohorts are compared with international (non-African) outcomes in a risk-adjusted logistic regression analysis using a generalised linear mixed-effects model. The primary outcome was severe postoperative complications including in-hospital mortality in Africa compared with non-African outcomes. Results A total of 1698 African participants and 18 449 international participants met the inclusion criteria. The African cohort were younger than the international cohort with a lower preoperative risk profile. Severe complications occurred in 48 (2.9%) of 1671, and 431 (2.3%) of 18 449 patients in the African and international cohorts, respectively, with in-hospital mortality after severe complications of 23/48 (47.9%) in Africa and 78/431 (18.1%) internationally. Women in Africa had an adjusted odds ratio of 2.06 (95% confidence interval, 1.17-3.62; P=0.012) of developing a severe postoperative complication after elective non-obstetric, non-gynaecological surgery, compared with the international cohort. Conclusions Women in Africa have double the risk adjusted odds of severe postoperative complications (including in-hospital mortality) after elective non-obstetric, non-gynaecological surgery compared with the international incidence.
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Affiliation(s)
- Amy Paterson
- Global Surgery Division, Department of Surgery, University of Cape Town, Cape Town, South Africa
- Global Surgery Group, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Salome Maswime
- Global Surgery Division, Department of Surgery, University of Cape Town, Cape Town, South Africa
| | - Anneli Hardy
- Department of Statistical Sciences, University of Cape Town, Cape Town, South Africa
| | - Rupert M. Pearse
- Critical Care and Perioperative Medicine Research Group, Queen Mary University of London, London, UK
| | - Bruce M. Biccard
- Global Surgery Division, Department of Surgery, University of Cape Town, Cape Town, South Africa
- Department of Anaesthesia and Perioperative Medicine, Groote Schuur Hospital, Cape Town, South Africa
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Dunn LK, Wong CA. Enough Talk, the Time Is Now for Gender Parity of Anesthesiology Journals' Editorial Boards. Anesth Analg 2022; 134:952-955. [PMID: 35427268 DOI: 10.1213/ane.0000000000005938] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Lauren K Dunn
- From the Department of Anesthesiology and Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia
| | - Cynthia A Wong
- Department of Anesthesia, University of Iowa Carver College of Medicine, Iowa City, Iowa
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Kurdi MS, Katikar MD, Ahuja V, Sharma R. Striding towards the pinnacles of professional growth, scientific epitome, and leadership: India's women anaesthesiologists. Indian J Anaesth 2020; 64:739-742. [PMID: 33162566 PMCID: PMC7641080 DOI: 10.4103/ija.ija_1116_20] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 08/21/2020] [Accepted: 08/21/2020] [Indexed: 11/07/2022] Open
Affiliation(s)
- Madhuri S Kurdi
- Department of Anaesthesiology, Karnataka Institute of Medical Sciences, Hubli, Karnataka, India. E-mail:
| | - Manisha D Katikar
- Department of Anaesthesiology and Critical Care, Balwant Institute of Neurosurgery and Intensive trauma Unit, Solapur, Maharashtra, India
| | - Vanita Ahuja
- Department of Anaesthesia and Intensive Care, Government Medical College and Hospital, Chandigarh, India
| | - Ridhima Sharma
- Department of Anaesthesiology, Superspeciality Paediatric hospital and Postgraduate teaching Institute, Noida, Uttar Pradesh, India
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