SECURITE EN ANESTHESIE AU SUD ET A L'EST DE LA RD CONGO : Etat de lieu et Perception communautaire

Objective: To assess the current anaesthesia safety situation in the south and east of the DemocraticRepublic of Congo, with a view to reducing anaesthesia-related morbidity and mortality, and to evaluate theperception of safety within the local community.Methodology: This is a descriptive cross-sectional study with an analytical component, using a mixedprospective approach (qualitative and quantitative) in 10 health facilities in the South and East of the DRCongo (CliniquesUniversitaires de Lubumashi, Centre MédicalDiamant, Hôpital SENDWE, PolycliniqueSaint-Luc, Hôpital DACO, HGR de Mwangeji, HôpitalMéthodiste, HôpitalGénéral de Kadutu,HôpitalSkyborne and HPGR de Kalemie) located respectively in the towns of Lubumbashi (4 facilities),Likasi (1 facility), Kolwezi (2 facilities), Kalemie (1 facility) and Bukavu (2 facilities) during the periodfrom September 2024 to February 2025 (approximately 6 months) on anaesthesia safety in the South andEast of DR Congo: State of play and community perception. Safety in anaesthesia is captured through anevaluation of post-anaesthetic complications, patient satisfaction with care, the level of confidence expressedby the patient in anaesthetic care, and the willingness of patients to recommend others in the healthestablishments where they receive care. In addition, the variables of safety according to WHOrecommendations are taken into account and include, among others, the qualification of the health care staff,the use of the checklist, the availability of and access to monitoring equipment and medicines, and thequality of the health care infrastructure meeting the standards. The level of community perception is capturedthrough an analysis of expectations, attitudes and perception itself in relation to anaesthesia care. Sampling isprobability based and determined by the Schwartz formula. A survey was conducted among 313 patients, 313carers and 37 providers in this region in a resource-limited setting. Data were collected using a digital questionnaire via Kobo Collect, then cleaned with Excel before analysis with EPI Info software. Frequencyanalysis and percentage calculations were used for description, while the Chi-square test and Odss Ratio (95%CI) calculations were applied to establish the association between the occurrence of complications and theother variables.Results: Fewer than 60% of the target facilities applied the WHO-recommended safety protocols, such as thesurgical checklist. Post-anaesthetic complications were significantly associated with the absence ofpostoperative follow-up.Conclusion: Our study shows that the community's perception of anaesthesia remains negative overall and isinfluenced by safety levels. This is because patients who have had a negative experience with anaesthesiaperceive it as a threat to their health, which makes them negative customers who pose a public danger.Conversely, a positive experience of anaesthesia promotes community outreach based on its benefits andreassures potential surgical patients that their safety is guaranteed by trusting anaesthesia professionals. Thisstudy calls for an integrated clinical and community approach to make anaesthesia everyone's business,involving decision-makers, anaesthesia professionals and care recipients. This can be achieved byinstitutionalising the use of the checklist in all facilities and adapting it to the realities and context ofresource-limited areas. Continuing education for anaesthesia practitioners should be reinforced, and astandardised monitoring and evaluation system should be implemented in this sector to guarantee success.