Development of a Surgical Data Availability and Transferability Assessment Tool and Its Use in Evaluating Mozambique's Surgical Data Ecosystem.

BACKGROUND

In 2015, the Lancet Commission on Global Surgery promoted the adoption of six perioperative care indicators and increased their visibility in national health policies. However, regular reporting of these surgical indicators remains limited due to challenges with data infrastructure and workforce capacity. This study defines the surgical data ecosystem in a low-income country and develops a tool for harmonizing national data ecosystems with validated global indicators.

METHODS

This exploratory, mixed-methods study examined the scope of Mozambique's surgical data ecosystem in 2023. Data were obtained in three phases: qualitative interviews with health data stakeholders, analysis of data instruments from four purposively selected public hospitals, and review of aggregate Ministry of Health reports used for surgical system monitoring and evaluation. These data were organized by domains and compared with international reporting standards, informing development of the Surgical Data Availability and Transferability Assessment (S-DATA) tool for evaluating surgical data availability, transferability, and usability for global benchmarking.

RESULTS

Metadata and data instruments were inconsistent across hospitals, which carried into aggregate reports. Facility-level data elements and national reports did not align with national and international guidelines, respectively. Processes for aggregating data varied between data managers, leading to loss of information in summary reports. The flow of surgical data from facility to national reports revealed multiple parallel data streams. These findings informed development and pilot application of the S-DATA tool, with variable data ecosystem performance at the facility level, ranging from fair to poor, yet excellent metadata availability at the highest levels of aggregation.

CONCLUSIONS

This study represents the first structured evaluation of a surgical data ecosystem in Mozambique and the development of a novel framework for benchmarking surgical data availability against international standards. Data management analysis revealed gaps, redundancies, and inefficiencies at each level of aggregation. Standardized data instruments and reporting processes may facilitate monitoring and evaluation of surgical systems. Future studies are necessary to validate the S-DATA tool in additional settings.