Identifying Information Gaps in a Surgical Capacity Assessment Tool for Developing Countries: A Methodological...

Area of Science:

• Global Health
• Surgical Systems Research
• Health Services Research

Background:

• Assessing surgical capacity in low- and middle-income countries (LMICs) presents significant challenges.
• The Personnel Infrastructure Procedure Equipment and Supplies (PIPES) survey tool was developed to address these assessment challenges.
• Gaps in the veracity and contextual appropriateness of PIPES tool data require examination.

Purpose of the Study:

• To evaluate the effectiveness of the PIPES survey tool in assessing surgical capacity in LMICs.
• To identify limitations of the PIPES tool in capturing the realities of surgical care delivery.
• To propose improvements for surgical capacity assessment methodologies in resource-limited settings.

Main Methods:

• Methodological triangulation was employed to compare PIPES tool data with other data collection methods.
• Data were collected simultaneously using the PIPES tool, time and motion studies (T&M), provider focus group discussions (FGDs), and retrospective hospital record reviews.

Main Results:

• The PIPES survey, in its original form, does not account for non-physician clinicians vital to surgical care in LMICs.
• Focus group discussions and time and motion studies provided a more comprehensive capture of the surgical workforce.
• The PIPES tool may overlook essential improvisations used to expand surgical capacity within resource-constrained environments.

Conclusions:

• The PIPES tool captures essential surgical capacity data but has identifiable gaps.
• Modifying the PIPES tool and integrating ancillary methodologies can address these limitations.
• Future modifications should be guided by researcher interests and local stakeholder perspectives to enhance contextual appropriateness.