Abstract
South Africa has a physician anaesthesia provider ratio of 3.3 per 100 000 people, which is below the World Federation of Societies of Anaesthesiologists’ (WFSA)
recommended target of five anaesthesiologists per 100 000 people. Limited access to healthcare services, partly due to a shortage of anaesthesia providers, impacts
patients' welfare, their human rights, and increases the risk of preventable anaesthesia-related deaths. The challenges facing the healthcare system in South Africa need to compel authorities to seek and implement sustainable solutions to deliver quality and cost-effective healthcare services to underserved areas. A solution to the anaesthesia provider shortage partly requires the involvement of the anaesthesiology community. The anaesthesiologist’s engagement is founded on the premise that, to accomplish global surgery, which is the implementation of evidencebased solutions to expand access to surgical care, solutions must be locally relevant and driven. Therefore, the purpose of this study was to gain an in-depth understanding of anaesthesiologists’ perspectives of the need for nurse anaesthetists in South Africa, and offer recommendations for the potential development of nurse anaesthetists’ practice. This study used a qualitative research design which was explorative, descriptive, and contextual in nature. The study population was anaesthesiologists
who meet the inclusion criteria. Purposive and snowball sampling methods were used to select 13 participants until data saturation was reached. Data were collected through audio-recorded, in-depth, individual, semi-structured interviews (face-to-face and online) and field notes. The data analysis was done using the seven-step Colaizzi method. The findings varied from views welcoming independent, well-trained nurse anaesthetists practising under supervision or as assistants to the anaesthesiologists, to views completely opposing and resisting nurse anaesthetists administering anaesthesia. It was also emphasised that the specialist fraternity should compile the nurse anaesthetists' scope of practice and the nurse anaesthetist profession should be regulated. The nurse anaesthetists' training should be at the same level as
diplomate anaesthetists' training and should be led by specialist anaesthesiologists
with the support of nursing lecturers. Recommendations included pilot training programmes, curriculum aligned with international standards, and building the capacity of nursing educators. Regulatory frameworks, collaboration with anaesthesiologists, clear supervision protocols, and infrastructure development in remote areas were furthermore recommended. Public awareness campaigns and
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open dialogue within the medical community were emphasised, along with dedicated resources for continuous research and feasibility studies. Trustworthiness was
ensured by adopting Lincoln and Guba’s criteria for evaluating qualitative research. Moreover, the participants’ rights were protected by adhering to the principles of respect for persons, beneficence and non-maleficence, and justice. This study is
significant as it is among the pioneering efforts within the South African context, involving an in-depth exploration of the perspectives of the anaesthesiology
community on the need for nurse anaesthetists.
Keywords: Nurse anaesthetists, Anaesthesiologists, Need, Perspectives.