title: Surgeons OverSeas Assessment of Surgical Need (SOSAS) Uganda: Update for Household Survey.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors: Duke University School of Medicine, Durham, NC, USA.|Duke University Global Health Institute, Durham, NC, USA.
authors: Anthony T
authors: AT
authors: Fuller
authors: University of Minnesota Medical School, Minneapolis, MN, USA.
authors: Elissa K
authors: EK
authors: Butler
authors: Duke University Global Health Institute, Durham, NC, USA. tu.tran@duke.edu.
authors: Tu M
authors: TM
authors: Tran
authors: Makerere University School of Public Health, Kampala, Uganda.
authors: Fredrick
authors: F
authors: Makumbi
authors: Department of Anatomy, Makerere University School of Medicine, Kampala, Uganda.
authors: Samuel
authors: S
authors: Luboga
authors: Makerere University School of Public Health, Kampala, Uganda.
authors: Christine
authors: C
authors: Muhumza
authors: Department of Surgery, University of Minnesota, Minneapolis, MN, USA.
authors: Jeffrey G
authors: JG
authors: Chipman
authors: Department of Gynecology and Obstetrics, Johns Hopkins Hospital, Baltimore, MD, USA.
authors: Reinou S
authors: RS
authors: Groen
authors: Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors: Shailvi
authors: S
authors: Gupta
authors: Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors: Adam L
authors: AL
authors: Kushner
authors: Department of Surgery, Makerere University College of Health Sciences, Kampala, Uganda.
authors: Moses
authors: M
authors: Galukande
authors: Duke University Global Health Institute, Durham, NC, USA. michael.haglund@dm.duke.edu.|Department of Neurosurgery, Duke University, 4508 Hospital South, Durham, NC, 27710, USA. michael.haglund@dm.duke.edu.
authors: Michael M
authors: MM
authors: Haglund
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003365:Costs and Cost Analysis; D003625:Data Collection / Q000379:methods*; D005006:Ethnicity; D005260:Female; D005843:Geography; D006290:Health Planning Technical Assistance; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D011203:Poverty; D066231:Surgeons; D011795:Surveys and Questionnaires; D014454:Uganda; D014495:Universities; D055815:Young Adult