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National Surgical, Obstetric and Anaesthesia Plans (NSOAPs)

In 2015, the World Health Assembly unanimously adopted Resolution 68.15, calling for the strengthening of emergency and essential surgical and anaesthesia services as a part of universal health coverage. The passing of this resolution sent a clear message: surgery is an indispensable part of health care and there is now global recognition that health systems planning is incomplete if the surgical system is left unaddressed.

In order to solve the current crisis in surgical care that has left 5 billion people without safe and affordable surgery and anaesthesia when needed, national governments must commit significant resources to improve the availability, quality and affordability of anaesthesia and surgery within their countries. These resources, and a full scale-up plan, should be laid out in a national surgical, obstetric and anaesthesia plan (NSOAP), and integrated into the national health policy.

WHO has compiled a document entitled Surgical Care Systems Strengthening: Developing national surgical, obstetric and anaesthesia plans to help enable countries to develop their specific plans. However, it is important to note that each country will require a specific plan designed for their individual context.

WFSA has developed an online questionnaire on anaesthesia capacity based on the international standards in order to gather data about anaesthesia workforce, equipment, medicines and practices at facility level. If you would prefer to complete the questionnaire in Microsoft Word, please download it here and send it back to programmes@wfsahq.org.

WFSA is also able to assist our Member Societies in compiling a National Anaesthesia Plan and can help engage governments, Ministries of Health, and the wider medical community in the importance of a National Anaesthesia Plan for public health as a whole. To find out more about the assistance we can offer please email comms@wfsahq.org.

Case study: Zambia

Zambia was the first Sub-Saharan country to create a national surgical care health policy document entitled The Zambian National Surgical, Obstetric and Anaesthesia Strategic Plan. This was a year-long process involving extensive review of the published literature, stakeholder engagement, facility visits, committee meetings to develop priorities, and ultimately drafting and budgeting for the plan at all levels of Zambian governance.

The Zambian National Surgical, Obstetric and Anaesthesia Strategic Plan was written into the National Health Strategic Plan for 2017-2021.

Case Study: Nigeria

The National Surgical, Obstetrics, Anaesthesia and Nursing Plan (NSOANP) 2019 – 2023 was developed by Nigeria’s Federal Ministry of Health. The NSOANP outlines in the form of the Strategic Priorities for Surgical Care (StraPS), an assessment and situational analysis of the state of surgical care in Nigeria. The plan provides a road map for implementation, as well as ongoing monitoring and evaluation with feedback mechanisms. Nigeria is the very first country to specifically including children and adolescents in its surgical plan.

The NSOANP is integrated into the National Strategic Health Development Plan and National Child Health Policy.

Case study: Madagascar

Madagascar is currently working towards creating a National Surgical, Obstetric and Anaesthesia Plan. In 2017 Anesthesia & Analgesia (A&A) published Observational Assessment of Anesthesia Capacity in Madagascar as a Prerequisite to the Development of a National Surgical Plan which found that capacity assessment is a useful first step that helps enable progress to be tracked against specific targets. Data from the study was presented to the Ministry of Health for inclusion in the development of the National Plan, together with recommendations for the needed improvements in the delivery of anesthesia.