Introduction: To improve and maintain quality and safety in anesthesia, standards
have been proposed regarding human resources, facilities and equipment, medica-
tions and intravenous fluids, monitoring, and the conduct of anesthesia. Compliance
with these standards remains a challenge in French-­ speaking sub-­ Saharan Africa (SSA)
and results in high morbidity and mortality particularly in children.
This aim of this study was to assess the progress made in improving the pediatric an-
esthesia infrastructures, human resources, education, medications, and equipment in
French-­ speaking SSA over the past 10 years (2013–2022).
Methods: This is a descriptive, multicenter, cross-­ sectional study with retrospective
data collection, conducted from September 1 to November 5, 2023. Comparative
data from 2012 to 2022 were collected through an online survey. Descriptive statis-
tics were used to summarize data.
Results: Data were obtained from 12 countries out of 14. The number of hospitals pro-
viding pediatric surgery and anesthesia rose from 94 in 2012 to 142 in 2022 (+51%).
The total number of physician anesthesiologists rose from 293 (0.1 physician anesthe-
siologists/100 000 inhabitants) in 2012 to 597 (0.2 physician anesthesiologists/100 000
inhabitants) in 2022 (+103.7%). Five (0.006 physician anesthesiologists/100 000 chil-
dren) had completed a fellowship in pediatric anesthesia and intensive care in 2012, and
15 (0.01 physician anesthesiologists/100 000 children) in 2022 (+200%). Five physician
anesthesiologists had an exclusive pediatric anesthesia practice in 2012, whereas they
were 32 in 2022 (+540%). There is no specialized training in pediatric anesthesia and
intensive care in any of these countries. Halothane was always available in 81.5% of
the hospitals in 2012, and in 50.4% of the hospitals in 2022. Sevoflurane was always
available in 5% of the hospitals in 2012, and in 36.2% in 2022. Morphine was always
available in 32.2% in 2012, whereas it was available in 52.9% of them in 2022. Pediatric
pulse oximeter sensors were available in 36% of the hospitals in 2012, and in 63.4% in
2022. Capnography was available in 5.3% of the hospitals in 2012, and in 48% in 2022.
Conclusion: Progress have been made over the last 10 years in French-­ speaking SSA
to improve infrastructures, human resources, education, medications, and equipment
for pediatric anesthesia in French-­ speaking SSA. However, major efforts must be con-
tinued. Standards adapted to the local context should be formulated.

pediatric anesthesia, advances, French-­ speaking, sub-­ Saharan Africa