Surgical Assessment Tool for Ethiopia National Policy Monitoring & Evaluation

NCT04276103 | Completed

• 1 other identifier: IJS-D-19-00363R1
• Study Type: observational
• Target: 14
• Locations: 0 countries
• Sites: N/A

Brief Summary

Introduction: A baseline assessment of surgical capacity is recommended as a first-step to inform national policy on surgical system strengthening. In Ethiopia, the World Health Organization's Situational Analysis Tool (WHO SAT) was adapted to assess surgical capacity as part of a national initiative: Saving Lives Through Safe Surgery (SaLTS). This study describes the process of adapting this tool and initial results. Methods: The new tool was used to evaluate fourteen hospitals in the Southern Nations, Nationalities, and People's Region of Ethiopia between February and March 2017. Two analytic methods were employed. To compare this data to international metrics, the WHO Service Availability and Readiness Assessment (SARA) framework was used. To assess congruence with national policy, data was evaluated against Ethiopian SaLTS targets.

Conditions

Global Surgery; Health System; Health Planning; Global Anesthesia; Public Health

Outcome Measures

Primary Outcomes (3)

• General service readiness

  Measured by the number of hospital beds, major operating rooms, surgical/anesthesia/and obstetric providers, and basic infrastructure availability

  Cross-Sectional, assesses availability of this infrastructure within the past year in general

• Basic surgery readiness

  Readiness for surgical services was assessed based on the presence of tracer items identified by WHO/USAID Service Availability and Readiness Assessment (SARA) as particularly important for providing basic surgical services. The service specific readiness score is defined as the mean availability of service specific tracer items in three domains (staff and training, equipment, and medicines and commodities).

  Cross-Sectional, assesses availability of tracer items within the past year in general

• Comprehensive surgery readiness

  Readiness for surgical services was assessed based on the presence of additional tracer items identified by WHO/USAID Service Availability and Readiness Assessment (SARA) as necessary to provide comprehensive surgical services, beyond those needed for basic surgery.

  Cross-Sectional, assesses availability of tracer items within the past year in general

Eligibility Criteria

• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

The Southern Nations, Nationalities and Peoples' (SNNP) Region is one of Ethiopia's eleven regions, occupying the southwest portion of the country. Public hospitals serve the region's population in this area within three tiers - primary, general, and specialized hospitals. An average of four providers were interviewed per facility and participants included hospital leadership (CEOs, medical directors, and matrons), surgeons, integrated emergency surgical officers, obstetrician-gynecologists, mid-level anesthesia providers, and operating room nurses.

You may qualify if:

• Fourteen public hospitals (11 primary, 1 general, and 2 specialized) chosen by the regional health bureau
• Hospital staff with willingness to participate in study
• Hospital staff with availability to participate in study

You may not qualify if:

• Hospital staff which did not volunteer to participate or refused to participate were excluded.
• Hospital staff not available at the time of visit
• Hospitals not chosen by the regional health bureau

Sponsors & Collaborators

• Harvard Medical School (HMS and HSDM): lead
• General Electric: collaborator
• Federal Minstry of Health of Ethiopia: collaborator
• Jhpiego: collaborator

Study Officials

• John G Meara, MD, DMD, MBA

  Harvard Medical School & Boston Children's Hospital

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: ECOLOGIC OR COMMUNITY
• Time Perspective: CROSS SECTIONAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Director Program in Global Surgery and Social Change

Study Record Dates

• First Submitted: January 21, 2020
• First Posted: February 19, 2020
• Study Start: November 1, 2016
• Primary Completion: February 23, 2019
• Study Completion: February 23, 2019
• Last Updated: February 19, 2020

Record last verified: 2020-02

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, CSR
• Time Frame: Once the original study is published, de-identified results will be available by request to the authors.
• Access Criteria: Original data may be provided upon request to the authors with consensus approval from all co-authors.