Training needs analysis of surgical teams in Somaliland
Gerard McKnight1,2,3,4, Hassan Ali Daoud5, Rocco Friebel4,6
1School of Medicine, Cardiff University, Heath Park, Cardiff, UK.
The British Journal of Surgery
|December 10, 2025
Summary
A training needs analysis (TNA) tool was adapted for surgical teams in Somaliland, identifying priority areas like emergency airway management and highlighting the need for both training and improved work conditions for better surgical systems.
Area of Science:
- Global Surgery
- Health Systems Strengthening
- Medical Education
Background:
- Low-income countries face challenges in optimizing surgical systems due to resource limitations.
- Validated tools for needs assessment in surgical contexts are scarce.
- This study adapted a training needs analysis (TNA) tool for a low-resource surgical setting.
Purpose of the Study:
- To assess the feasibility and utility of applying a training needs analysis (TNA) tool in a low-income country's surgical context.
- To identify specific training and professional development needs of surgical and anesthesia providers in Somaliland.
- To inform resource prioritization for improving surgical care.
Main Methods:
- A mixed-methods online survey was developed using the Hennessy-Hicks training needs analysis (HHTNA) Questionnaire.
- Data collection involved quantitative and qualitative responses from anesthesia providers (APs) and surgical providers (SPs) in Somaliland.
- Collaborating organizations facilitated the survey distribution.
Main Results:
- Response rates varied: 59% for APs, 33% for surgeons, and 21% for obstetricians.
- Emergency front of neck access (cricothyroidotomy) was identified as a high-priority intervention for APs.
- Regional anesthesia, comorbidity management, and geriatric anesthesia were noted as performance outliers requiring intervention.
- Respondents indicated a need for mixed interventions, combining training with improvements to the work environment.
Conclusions:
- Conducting a pragmatic TNA is feasible in low-resource surgical settings like Somaliland.
- The TNA generated valuable data to guide targeted training and professional development initiatives.
- This approach can effectively inform resource allocation for surgical system improvement.
