Fuller Anthony T, Butler Elissa K, Tran Tu M, Makumbi Fredrick, Luboga Samuel, Muhumza Christine, Chipman Jeffrey G, Groen Reinou S, Gupta Shailvi, Kushner Adam L, Galukande Moses, Haglund Michael M
Duke University School of Medicine, Durham, NC, USA.
Duke University Global Health Institute, Durham, NC, USA.
World J Surg. 2015 Dec;39(12):2900-7. doi: 10.1007/s00268-015-3191-5.
The first step in improving surgical care delivery in low- and middle-income countries (LMICs) is quantifying surgical need. The Surgeons OverSeas Assessment of Surgical Need (SOSAS) is a validated household survey that has been previously implemented in three LMICs with great success. We implemented the SOSAS survey in Uganda, a medium-sized country with comparatively more language and ethnic group diversity.
The investigators partnered with the Performance Monitoring and Accountability 2020 (PMA2020) Uganda to access a data collection platform sampling 2520 households in 105 randomly selected enumeration areas. Due to geographic size consideration and language diversity, SOSAS's methodology was updated in three significant dimensions (1) technology, (2) staff management, and (3) questionnaire adaptations.
The SOSAS survey was successfully implemented with non-medically trained but field proven research assistants. We sampled 2315 of 2402 eligible households (response rate 96.4 %) and 4248 of 4374 eligible individual respondents (response rate 97.1 %). The female-to-male ratio was 51.1-48.9 %. Total survey cost was USD 73,145 and data collection occurred in 14 days.
SOSAS Uganda has demonstrated that non-medically trained, but university-educated, experienced researchers supervised by academic surgeons can successfully perform accurate data collection of SOSAS. SOSAS can be successfully implemented within larger and more diverse LMICs using existing national survey platforms, and SOSAS Uganda provides insights on how SOSAS can be executed specifically within other PMA2020 program countries.
在低收入和中等收入国家（LMICs）改善外科护理服务的第一步是量化手术需求。海外外科医生手术需求评估（SOSAS）是一项经过验证的家庭调查，此前已在三个低收入和中等收入国家成功实施。我们在乌干达开展了SOSAS调查，乌干达是一个中等规模的国家，语言和族群多样性相对较多。
研究人员与乌干达2020年绩效监测与问责制（PMA2020）合作，以使用一个数据收集平台，该平台在105个随机选择的普查区域对2520户家庭进行抽样。由于地理面积和语言多样性的考虑，SOSAS的方法在三个重要方面进行了更新：（1）技术，（2）人员管理，以及（3）问卷调整。
SOSAS调查由未经医学培训但经验证的实地研究助理成功实施。我们从2402户符合条件的家庭中抽取了2315户（回复率96.4%），从4374名符合条件的个体受访者中抽取了4248名（回复率97.1%）。男女比例为51.1%-48.9%。调查总费用为73145美元，数据收集在14天内完成。
乌干达的SOSAS表明，由学术外科医生监督的未经医学培训但受过大学教育的有经验的研究人员能够成功地准确收集SOSAS数据。利用现有的国家调查平台，SOSAS可以在更大且更多样化的低收入和中等收入国家成功实施，乌干达的SOSAS为SOSAS如何在其他PMA2020项目国家具体实施提供了见解。
