Knowledge, Resources, and Barriers in Surgical Data Collection in Ethiopia

Introduction: The Saving Lives Through Safe Surgery (SaLTS) initiative in Ethiopia in 2015, a national policy to improve surgical care, included efforts to enhance quality of surgical data collection. Five years after its implementation, this study examines the knowledge of surgical key performance indicators (KPIs), resources for data collection, and barriers to quality metrics in Sidama and Amhara regions. Methods: A mixed-methods survey was administered to 51 participants across 10 hospitals and 2 regional health bureaus from July-August 2022. Participants included hospital providers, data officers, and regional health bureau personnel. Questions were based on prior studies regarding the initiation of the surgical KPIs and elicited perspectives on data feasibility and quality through Likert-scale, multiple choice, and open responses. Data was collected in REDCap and descriptive statistics were performed using Microsoft Excel. Results: Of all responders, 27.5% (14/51) reported receiving training on surgical KPIs, while 78.4% (40/51) believe there is insufficient training on surgical KPIs. About half (50.9%, 26/51) of the participants reported that the registries available were adequate. However, 54.9% (28/51) reported incomplete data as a barrier to their data system. Open-ended responses often mentioned surgical site infections (4 participants) as one of the indicators with unclear mechanisms for data collection. Conclusion: Five years after the initiation of a national surgical data system in Ethiopia, there remains persistent challenges to KPI quality. Many participants lacked adequate training on surgical KPIs, and the registry data elements were often incomplete. Improving surgical indicator quality will require consistent training and establishing a standard protocol for data entry.