Ghana’s critical shortage of physician anesthesiologists threatens surgical safety — GHS Director General

Ghana’s healthcare system is facing an alarming shortage of physician anaesthesiologists, a situation the Director-General of the Ghana Health Service (GHS), Dr. Samuel Kaba Akoriyea, has described as requiring immediate and coordinated national intervention to safeguard safe surgical care across the country.

Speaking as the Special Guest of Honour at the 30th-anniversary celebration of the Ghana Society of Anaesthesiologists (GAS) in Accra, Dr. Akoriyea warned that the country’s specialist workforce remains critically inadequate despite growing healthcare demands. Describing anaesthesia as “the backbone of modern medicine and safe surgery,” he stressed that no modern health system can function effectively without a strong and well-distributed anaesthesia workforce.

Only 200 Specialists for the Entire Nation

The Director-General disclosed that Ghana currently has approximately 200 physician anaesthesiologists serving the country’s entire population, a figure he described as “grossly inadequate” considering the nation’s population and increasing surgical needs.

According to the Ministry of Health, a minimum of four specialist anaesthetists per 100,000 population is recommended to achieve a reasonable standard of healthcare at the country level. Based on this benchmark, Ghana would need a minimum of 1,232 specialist physician anaesthetists to provide a reasonable standard of anaesthesia service delivery. The current shortfall therefore exceeds 1,000 specialists.

While acknowledging the contribution of more than 636 Certified Registered Nurse Anaesthetists who have helped bridge the gap, Dr. Akoriyea explained that their efforts alone cannot replace the specialised expertise provided by physician anaesthesiologists.

“They have helped bridge the gap, but their numbers alone cannot substitute for the equitable training, deployment, supervision, and subspecialisation needed to improve surgical outcomes, maternal health, and the overall quality of care across the country,” he said.

Disparities in Access to Surgical Care

The Director-General observed that many health facilities, particularly those outside major cities, continue to struggle with limited access to specialist anaesthesia services, creating significant disparities in surgical care across the country. Research indicates that about 42 per cent of Ghana’s doctors are based in the Greater Accra Region, while a combined 57.2 per cent serve within the Greater Accra and Ashanti regions alone, leaving rural and underserved areas severely understaffed.

The shortage of anaesthesia providers extends beyond numbers, affecting the quality, supervision, training, and equitable delivery of anaesthesia services nationwide.

Four-Point Action Plan to Address the Crisis

To tackle the shortage, Dr. Akoriyea proposed four immediate actions that could significantly increase the number of physician anaesthesiologists within the Ghana Health Service:

1. National Strategic Plan for Anaesthesia: The development and implementation of a comprehensive national framework to guide workforce development, improve planning, and support long-term investment in specialist anaesthesia services.
2. Expanded Telemedicine and Consultant Outreach: Strengthening supervision of anaesthesia services, especially in underserved communities where specialist support remains limited.
3. Study Leave with Pay: Immediate provision of study leave with pay for Ghana Health Service doctors who choose to specialise in anaesthesiology, creating incentives to encourage more physicians to enter the specialty.
4. Stronger Collaboration: Closer collaboration between physician anaesthesiologists and Certified Registered Nurse Anaesthetists to improve professional practice and enhance service delivery throughout the health system.

“Together, these measures could begin to close the gap between the demand for and supply of anaesthesia care in Ghana,” Dr. Akoriyea said.

A Legacy of Excellence Amidst Challenges

In his address, Dr. Akoriyea paid tribute to generations of physician anaesthesiologists whose dedication has strengthened healthcare delivery throughout Ghana. He gave special recognition to Dr. Wulf, Dr. Sarpong, and the multidisciplinary team that worked for nearly two years on the successful separation of Ghana’s craniopagus conjoined twins – an achievement he described as evidence that Ghanaian doctors can deliver world-class care when provided with the necessary tools and support.

Reflecting on the country’s healthcare journey, the Director-General honoured pioneering health professionals who served in remote communities under difficult conditions, often without electricity, telecommunications, or adequate infrastructure. While acknowledging significant progress in healthcare over the past three decades, he noted that life expectancy in Ghana remains below the global average, highlighting the need for sustained investment in quality care.

Calling for unity across the health sector, Dr. Akoriyea reminded participants that every Ghanaian is a potential patient, including health workers, and that every child or mother safely brought through surgery represents an investment in Ghana’s future.

Broader Context of Healthcare Workforce Challenges

The anaesthesiologist shortage is part of a wider specialist deficit plaguing Ghana’s health system. The Ghana College of Physicians and Surgeons has indicated that the country requires about 4,000 additional specialists to meet current and future healthcare demands. By 2030, the country will need at least 6,200 additional specialists to meet its national healthcare needs.

Currently, Ghana is performing only 30 per cent of all surgical operations required across the country, mainly due to under-tooling, inaccessibility, inadequate human resources, and the cost of care. The World Health Assembly recommends a minimum of 20 SOTA (Surgery, Obstetrics, Trauma, and Anaesthesia) physicians per 100,000 people, but Ghana is currently managing with only six.

The situation has been exacerbated by the emigration of skilled professionals. The Ghana Association of Certified Registered Anaesthetists reported that over 30 per cent of its members left the country for greener pastures in 2023 alone, citing lack of career progression, poor conditions of service, and regulatory challenges as contributing factors.

Government Response

The Ministry of Health has launched the National Surgical, Obstetric and Anaesthesia Plan (NSOAP 2025-2029), a five-year strategy aimed at strengthening the country’s surgical, obstetric, and anaesthesia care services. The US$503 million plan places Ghana among countries with a SOTA strategy in line with the World Health Assembly Resolution 68.15, adopted in 2015 to strengthen emergency and essential surgical care as a critical component of achieving universal health coverage by 2030.

The plan focuses on reducing gaps in access to SOTA care through targeted investments in infrastructure at primary, district, secondary, regional, and tertiary or teaching-level hospitals.

Challenging members of the Ghana Society of Anaesthesiologists to lead the transformation of the specialty over the next thirty years, Dr. Akoriyea urged them to build a lasting legacy so that future generations would remember this era as the period that fundamentally changed anaesthesia care in Ghana.