Professional Obstacles to Anaesthesiology Practice in Punjab, Pakistan: Qualitative Study of Consultant Anaesthesiologists’ Perspectives

Sumbal Shahbaz, Rubeena Zakar, Florian Fischer () and Natasha Howard
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Sumbal Shahbaz: Department of Public Health, University of the Punjab, Lahore 54590, Pakistan
Rubeena Zakar: Department of Public Health, University of the Punjab, Lahore 54590, Pakistan
Florian Fischer: Institute of Public Health, Charité—Universitätsmedizin Berlin, 10117 Berlin, Germany
Natasha Howard: Saw Swee Hock School of Public Health, National University of Singapore, Singapore 119077, Singapore

IJERPH, 2022, vol. 19, issue 20, 1-12

Abstract: Limitations in the global anaesthesia workforce contribute to the emigration of skilled anaesthesiologists from lower-income to higher-income countries, jeopardizing workforce balance and patient outcomes in Pakistan. This study aimed to explore the challenges experienced by anaesthesiologists in Punjab, Pakistan’s most populous province, and the potential changes to encourage their retention. We conducted a qualitative study, conducting semi-structured interviews with 25 purposively sampled consultant anaesthesiologists working in Punjab and analysing data thematically. Reported professional challenges and reasons consultant anaesthesiologists chose to work abroad differed between public and private sectors, each sector providing distinct challenges that compromised anaesthesia workforce numbers and quality. Key concerns were security, promotion/incentive structures, and gender inequalities in public hospitals versus inadequate salary and facilities, surgeon dependency, and the lack of out-of-theatre practice in private hospitals that minimized the scope and earnings of anaesthesiologists within Pakistan. Our findings help contextualise Pakistan’s anaesthesia workforce crisis, indicating public-sector improvements could include increasing security in hospital premises, performance-based incentives, and qualification-dependent promotion, while private-sector improvements could include decreasing surgeon dependency, fixing salary percentages by surgical case, and encouraging direct patient-anaesthesiologist relationships. National and subnational interventions to promote anaesthesiology, along with public awareness campaigns, could additionally raise its profile and encourage retention.

Keywords: anaesthesia; workforce challenges; qualitative research; Pakistan (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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