<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT04450823</url>
  </required_header>
  <id_info>
    <org_study_id>2020-01</org_study_id>
    <nct_id>NCT04450823</nct_id>
  </id_info>
  <brief_title>From Short-term Surgical Missions Towards Sustainable Partnerships</brief_title>
  <official_title>From Short-term Surgical Missions Towards Sustainable Partnerships. A Survey Among Members of Foreign Teams</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>Global Surgery Amsterdam</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
  </sponsors>
  <source>Global Surgery Amsterdam</source>
  <oversight_info>
    <has_dmc>No</has_dmc>
    <is_fda_regulated_drug>No</is_fda_regulated_drug>
    <is_fda_regulated_device>No</is_fda_regulated_device>
  </oversight_info>
  <brief_summary>
    <textblock>
      Introduction: Recently, the devastating consequences of neglected surgical care in global&#xD;
      health became apparent with an estimated five billion people lacking access to safe surgical&#xD;
      and anesthesia care. Traditionally, short-term surgical missions were the predominant&#xD;
      strategy how surgical care was supported in Low- and Middle-Income Countries. Although&#xD;
      surgical missions have been criticized in recent literature they are still being performed on&#xD;
      a large scale. The aim of this study is to provide recommendations for persons and&#xD;
      organizations involved in surgical mission on how to strengthen surgical care in LMICs in the&#xD;
      future.&#xD;
&#xD;
      Method: An online survey was developed for members of foreign teams. Data was collected on 5&#xD;
      topics, consisting of: 1) basic characteristics of the missions, 2) main activities, 2)&#xD;
      follow-up and reporting, 3) the local registration process for foreign teams and 4)&#xD;
      collaboration with local stakeholders.&#xD;
    </textblock>
  </brief_summary>
  <overall_status>Completed</overall_status>
  <start_date type="Actual">June 1, 2019</start_date>
  <completion_date type="Actual">October 30, 2019</completion_date>
  <primary_completion_date type="Actual">October 30, 2019</primary_completion_date>
  <study_type>Observational</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <observational_model>Other</observational_model>
    <time_perspective>Cross-Sectional</time_perspective>
  </study_design_info>
  <primary_outcome>
    <measure>Q7: Country Where the Last Mission Took Place</measure>
    <time_frame>approximately 20 minutes</time_frame>
    <description>Answer on the question: What was the country where your last mission took place?</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Q8: Name of the Place and Hospital Where the Last Mission Took Place</measure>
    <time_frame>approximately 20 minutes</time_frame>
    <description>List with names of the places and hospitals where the last mission took place</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Q9: Number of Participants Per Organization</measure>
    <time_frame>approximately 20 minutes</time_frame>
    <description>Name of the organization that supported the last mission of the participant</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Q10: Countries Where the NGOs Are Based</measure>
    <time_frame>approximately 20 minutes</time_frame>
    <description>List of countries where the supporting NGOs of the last mission are based</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Q11: Importance of Potential Activities</measure>
    <time_frame>approximately 20 minutes</time_frame>
    <description>Points provided (1-4) for four potential activities of a visiting team (more points = more important activity) The points provided by all participants are summed per specific activity and the total scores are compared&#xD;
The four potential activities are:&#xD;
Treat patients yourself&#xD;
Provide surgical equipment and consumables for the local team&#xD;
Provide free treatment&#xD;
Facilitate teaching of local staff&#xD;
Scale with importance of potential activities. Maximum score: 4x58 = 232</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Q12: Activities That Where Missing in Question 11.</measure>
    <time_frame>approximately 20 minutes</time_frame>
    <description>Respondents that were missing this activity as an option in question 11&#xD;
Total number of respondents that were missing an activity: 29&#xD;
Activities that were missing:&#xD;
Financial collaboration&#xD;
Advocacy&#xD;
Academic collaboration&#xD;
Sustainability&#xD;
Collaboration with local staff&#xD;
Follow-up</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Q13. Medical Registration is Required in the Host Country</measure>
    <time_frame>approximately 20 minutes</time_frame>
    <description>Medical registration in the host country is required for specialists performing short-term reconstructive missions&#xD;
Participants of the survey were asked what they think of this statement:&#xD;
Strongly agree&#xD;
Agree&#xD;
Neither agree nor disagree&#xD;
Disagree&#xD;
Strongly disagree</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Q14: The Process of Obtaining Medical Registration Was Straightforward</measure>
    <time_frame>approximately 20 minutes</time_frame>
    <description>The Process of Obtaining Medical Registration Was Straightforward&#xD;
Participants of the survey were asked what they think of this statement:&#xD;
Strongly agree&#xD;
Agree&#xD;
Neither agree nor disagree&#xD;
Disagree&#xD;
Strongly disagree</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Q15: Collaboration</measure>
    <time_frame>approximately 20 minutes</time_frame>
    <description>What can you say about the collaboration between authorities in LMICs and visiting surgical teams?&#xD;
Participants of the survey were asked to choose one of the following answers on this question:&#xD;
collaboration is present but improvement is needed&#xD;
there is no collaboration and it should be developed as a priority&#xD;
collaboration has no benefits nor disadvantages&#xD;
collaboration will likely be more harmful than beneficial for the mission</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Q16. What Should Have a Higher Priority in the Hospital of Your Last Mission?</measure>
    <time_frame>approximately 20 minutes</time_frame>
    <description>What should have a higher priority in the hospital of your last mission ?&#xD;
Respondents were asked to choose on the these two answers:&#xD;
Teaching in anesthesia care or teaching in surgical care</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Q17. A Structured Follow-up Strategy is Required</measure>
    <time_frame>approximately 20 minutes</time_frame>
    <description>A structured follow-up strategy (&gt;6 months) of patients is required for short-term reconstructive surgical missions.&#xD;
Participants of the survey were asked what they think of this statement:&#xD;
Strongly agree&#xD;
Agree&#xD;
Neither agree nor disagree&#xD;
Disagree&#xD;
Strongly disagree</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Q18. One Month After the Mission, an Official Report is Recommended</measure>
    <time_frame>approximately 20 minutes</time_frame>
    <description>One month after the mission, an official report on the outcome including all complications encountered is recommended for all missions.&#xD;
Participants of the survey were asked what they think of this statement:&#xD;
Strongly agree&#xD;
Agree&#xD;
Neither agree nor disagree&#xD;
Disagree&#xD;
Strongly disagree</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Q19. A Written Long-term Strategy is Recommended at the Start of a New Project.</measure>
    <time_frame>approximately 20 minutes</time_frame>
    <description>A written long-term strategy (&gt;5 years) with clear goals, developed by the visiting team and the local actors together, is recommended at the start of a new project.&#xD;
Participants of the survey were asked what they think of this statement:&#xD;
Strongly agree&#xD;
Agree&#xD;
Neither agree nor disagree&#xD;
Disagree&#xD;
Strongly disagree</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Q20. Suggestions to Improve the Impact of Short Term Reconstructive Missions.</measure>
    <time_frame>approximately 20 minutes</time_frame>
    <description>What would you suggest to improve the impact of short term reconstructive missions?&#xD;
The answers were categorized and the three most mentioned categories are:&#xD;
Teaching of local staff&#xD;
Follow-up&#xD;
Building sustainable partnerships&#xD;
The three activities were mentioned in total 68 times in the comments The distribution among the three categories is shown below</description>
  </primary_outcome>
  <enrollment type="Actual">61</enrollment>
  <condition>Global Surgery</condition>
  <condition>Medical Missions</condition>
  <intervention>
    <intervention_type>Other</intervention_type>
    <intervention_name>no intervention</intervention_name>
    <description>no intervention study, survey amongst health workers</description>
  </intervention>
  <eligibility>
    <study_pop>
      <textblock>
        An international group of members of foreign teams, that did participate in at least one&#xD;
        short-term surgical mission in a hospital in a LMIC&#xD;
      </textblock>
    </study_pop>
    <sampling_method>Non-Probability Sample</sampling_method>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
        Members of foreign teams, that did participate in at least one short-term surgical mission&#xD;
        in a hospital in a LMIC&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
        -&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>N/A</minimum_age>
    <maximum_age>N/A</maximum_age>
    <healthy_volunteers>Accepts Healthy Volunteers</healthy_volunteers>
  </eligibility>
  <location>
    <facility>
      <name>Global surgery amsterdam</name>
      <address>
        <city>Amsterdam</city>
        <state>Noord Holland</state>
        <zip>1105BD</zip>
        <country>Netherlands</country>
      </address>
    </facility>
  </location>
  <location_countries>
    <country>Netherlands</country>
  </location_countries>
  <verification_date>November 2020</verification_date>
  <study_first_submitted>June 20, 2020</study_first_submitted>
  <study_first_submitted_qc>June 29, 2020</study_first_submitted_qc>
  <study_first_posted type="Actual">June 30, 2020</study_first_posted>
  <results_first_submitted>July 2, 2020</results_first_submitted>
  <results_first_submitted_qc>August 3, 2020</results_first_submitted_qc>
  <results_first_posted type="Actual">August 5, 2020</results_first_posted>
  <last_update_submitted>November 25, 2020</last_update_submitted>
  <last_update_submitted_qc>November 25, 2020</last_update_submitted_qc>
  <last_update_posted type="Actual">December 19, 2020</last_update_posted>
  <responsible_party>
    <responsible_party_type>Principal Investigator</responsible_party_type>
    <investigator_affiliation>Global Surgery Amsterdam</investigator_affiliation>
    <investigator_full_name>Matthijs Botman</investigator_full_name>
    <investigator_title>Principal investigator</investigator_title>
  </responsible_party>
  <patient_data>
    <sharing_ipd>Yes</sharing_ipd>
    <ipd_description>Individual participant data will be shared anonymously on this platform as requested by the journal of submission (int,. journal of surgery)</ipd_description>
    <ipd_info_type>Study Protocol</ipd_info_type>
    <ipd_time_frame>ASAP</ipd_time_frame>
  </patient_data>
  <provided_document_section>
    <provided_document>
      <document_type>Study Protocol</document_type>
      <document_has_protocol>Yes</document_has_protocol>
      <document_has_icf>No</document_has_icf>
      <document_has_sap>No</document_has_sap>
      <document_date>May 15, 2019</document_date>
      <document_url>https://ClinicalTrials.gov/ProvidedDocs/23/NCT04450823/Prot_000.pdf</document_url>
    </provided_document>
  </provided_document_section>

  <clinical_results>

    <participant_flow>
      <recruitment_details>Recruitment was June through October of 2019</recruitment_details>
      <group_list>
        <group group_id="P1">
          <title>Experts</title>
          <description>Included were English speaking experienced members of foreign teams and local team members from LMIC, that did participate in at least one short-term surgical mission in a hospital in a LMIC.</description>
        </group>
      </group_list>
      <period_list>
        <period>
          <title>Overall Study</title>
          <milestone_list>
            <milestone>
              <title>STARTED</title>
              <participants_list>
                <participants group_id="P1" count="61"/>
              </participants_list>
            </milestone>
            <milestone>
              <title>COMPLETED</title>
              <participants_list>
                <participants group_id="P1" count="58"/>
              </participants_list>
            </milestone>
            <milestone>
              <title>NOT COMPLETED</title>
              <participants_list>
                <participants group_id="P1" count="3"/>
              </participants_list>
            </milestone>
          </milestone_list>
        </period>
      </period_list>
    </participant_flow>

    <baseline>
      <group_list>
        <group group_id="B1">
          <title>All Participants of the Study</title>
          <description>Included were English speaking experienced members of foreign teams and local team members from LMIC, that did participate in at least one short-term surgical mission in a hospital in a LMIC.</description>
        </group>
      </group_list>
      <analyzed_list>
        <analyzed>
          <units>Participants</units>
          <scope>Overall</scope>
          <count_list>
            <count group_id="B1" value="58"/>
          </count_list>
        </analyzed>
      </analyzed_list>
      <measure_list>
        <measure>
          <title>Age</title>
          <units>years</units>
          <param>Median</param>
          <dispersion>Inter-Quartile Range</dispersion>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="B1" value="43" lower_limit="32" upper_limit="55"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <measure>
          <title>Sex: Female, Male</title>
          <units>Participants</units>
          <param>Count of Participants</param>
          <class_list>
            <class>
              <category_list>
                <category>
                  <title>Female</title>
                  <measurement_list>
                    <measurement group_id="B1" value="20"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Male</title>
                  <measurement_list>
                    <measurement group_id="B1" value="38"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <measure>
          <title>Race (NIH/OMB)</title>
          <description>We did not register Race as a variable in this study</description>
          <units>Participants</units>
          <param>Count of Participants</param>
          <class_list>
            <class>
              <category_list>
                <category>
                  <title>American Indian or Alaska Native</title>
                  <measurement_list>
                    <measurement group_id="B1" value="NA">not considered to be relevant in this study</measurement>
                  </measurement_list>
                </category>
                <category>
                  <title>Asian</title>
                  <measurement_list>
                    <measurement group_id="B1" value="NA">not considered to be relevant in this study</measurement>
                  </measurement_list>
                </category>
                <category>
                  <title>Native Hawaiian or Other Pacific Islander</title>
                  <measurement_list>
                    <measurement group_id="B1" value="NA">not considered to be relevant in this study</measurement>
                  </measurement_list>
                </category>
                <category>
                  <title>Black or African American</title>
                  <measurement_list>
                    <measurement group_id="B1" value="NA">not considered to be relevant in this study</measurement>
                  </measurement_list>
                </category>
                <category>
                  <title>White</title>
                  <measurement_list>
                    <measurement group_id="B1" value="NA">not considered to be relevant in this study</measurement>
                  </measurement_list>
                </category>
                <category>
                  <title>More than one race</title>
                  <measurement_list>
                    <measurement group_id="B1" value="NA">not considered to be relevant in this study</measurement>
                  </measurement_list>
                </category>
                <category>
                  <title>Unknown or Not Reported</title>
                  <measurement_list>
                    <measurement group_id="B1" value="NA">not considered to be relevant in this study</measurement>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <measure>
          <title>Nationality</title>
          <description>in the survey provided answer on the question what is your nationality:</description>
          <units>Participants</units>
          <param>Count of Participants</param>
          <class_list>
            <class>
              <category_list>
                <category>
                  <title>Dutch</title>
                  <measurement_list>
                    <measurement group_id="B1" value="33"/>
                  </measurement_list>
                </category>
                <category>
                  <title>German</title>
                  <measurement_list>
                    <measurement group_id="B1" value="5"/>
                  </measurement_list>
                </category>
                <category>
                  <title>British</title>
                  <measurement_list>
                    <measurement group_id="B1" value="4"/>
                  </measurement_list>
                </category>
                <category>
                  <title>American</title>
                  <measurement_list>
                    <measurement group_id="B1" value="4"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Australian</title>
                  <measurement_list>
                    <measurement group_id="B1" value="2"/>
                  </measurement_list>
                </category>
                <category>
                  <title>South African</title>
                  <measurement_list>
                    <measurement group_id="B1" value="2"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Tanzanian</title>
                  <measurement_list>
                    <measurement group_id="B1" value="1"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Lebanese</title>
                  <measurement_list>
                    <measurement group_id="B1" value="1"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Nigerian</title>
                  <measurement_list>
                    <measurement group_id="B1" value="1"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Danish</title>
                  <measurement_list>
                    <measurement group_id="B1" value="1"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Indian</title>
                  <measurement_list>
                    <measurement group_id="B1" value="1"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Haitian</title>
                  <measurement_list>
                    <measurement group_id="B1" value="1"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Ethiopian</title>
                  <measurement_list>
                    <measurement group_id="B1" value="2"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <measure>
          <title>Profession</title>
          <units>Participants</units>
          <param>Count of Participants</param>
          <class_list>
            <class>
              <category_list>
                <category>
                  <title>plastic surgeons</title>
                  <measurement_list>
                    <measurement group_id="B1" value="23"/>
                  </measurement_list>
                </category>
                <category>
                  <title>orthopedic surgeons</title>
                  <measurement_list>
                    <measurement group_id="B1" value="9"/>
                  </measurement_list>
                </category>
                <category>
                  <title>general surgeons</title>
                  <measurement_list>
                    <measurement group_id="B1" value="4"/>
                  </measurement_list>
                </category>
                <category>
                  <title>local doctors/surgeons in training</title>
                  <measurement_list>
                    <measurement group_id="B1" value="12"/>
                  </measurement_list>
                </category>
                <category>
                  <title>anaesthetists</title>
                  <measurement_list>
                    <measurement group_id="B1" value="5"/>
                  </measurement_list>
                </category>
                <category>
                  <title>nurses</title>
                  <measurement_list>
                    <measurement group_id="B1" value="2"/>
                  </measurement_list>
                </category>
                <category>
                  <title>physiotherapists</title>
                  <measurement_list>
                    <measurement group_id="B1" value="2"/>
                  </measurement_list>
                </category>
                <category>
                  <title>NGO executive officer</title>
                  <measurement_list>
                    <measurement group_id="B1" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <measure>
          <title>Number of missions performed</title>
          <description>by the respondent provided number of surgical missions performed in the past by the respondent him- or herself</description>
          <units>missions</units>
          <param>Mean</param>
          <dispersion>Full Range</dispersion>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="B1" value="6" lower_limit="3" upper_limit="15"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </measure_list>
    </baseline>

    <outcome_list>
      <outcome>
        <type>Primary</type>
        <title>Q7: Country Where the Last Mission Took Place</title>
        <description>Answer on the question: What was the country where your last mission took place?</description>
        <time_frame>approximately 20 minutes</time_frame>
        <group_list>
          <group group_id="O1">
            <title>All Included Participants of the Study</title>
            <description>Included were English speaking experienced members of foreign teams and local team members from LMIC, that did participate in at least one short-term surgical mission in a hospital in a LMIC.</description>
          </group>
        </group_list>
        <measure>
          <title>Q7: Country Where the Last Mission Took Place</title>
          <description>Answer on the question: What was the country where your last mission took place?</description>
          <units>Participants</units>
          <param>Count of Participants</param>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="58"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <title>Burkino fase</title>
                  <measurement_list>
                    <measurement group_id="O1" value="2"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Bangladesh</title>
                  <measurement_list>
                    <measurement group_id="O1" value="2"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Cambodia</title>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Ecuador</title>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Ethiopia</title>
                  <measurement_list>
                    <measurement group_id="O1" value="3"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Gaza</title>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Guinea</title>
                  <measurement_list>
                    <measurement group_id="O1" value="9"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Guinee Bissau</title>
                  <measurement_list>
                    <measurement group_id="O1" value="2"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Haiti</title>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Indonesia</title>
                  <measurement_list>
                    <measurement group_id="O1" value="2"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Laos</title>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Lebanon</title>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Malawi</title>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Morocco</title>
                  <measurement_list>
                    <measurement group_id="O1" value="2"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Nigeria</title>
                  <measurement_list>
                    <measurement group_id="O1" value="3"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Peru</title>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Rwanda</title>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Senegal</title>
                  <measurement_list>
                    <measurement group_id="O1" value="2"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Sierra Leone</title>
                  <measurement_list>
                    <measurement group_id="O1" value="3"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Sri LAnka</title>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Tanzania</title>
                  <measurement_list>
                    <measurement group_id="O1" value="13"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Uganda</title>
                  <measurement_list>
                    <measurement group_id="O1" value="4"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Vietnam</title>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Q8: Name of the Place and Hospital Where the Last Mission Took Place</title>
        <description>List with names of the places and hospitals where the last mission took place</description>
        <time_frame>approximately 20 minutes</time_frame>
        <group_list>
          <group group_id="O1">
            <title>All Included Participants of the Study</title>
            <description>Included were English speaking experienced members of foreign teams and local team members from LMIC, that did participate in at least one short-term surgical mission in a hospital in a LMIC.</description>
          </group>
        </group_list>
        <measure>
          <title>Q8: Name of the Place and Hospital Where the Last Mission Took Place</title>
          <description>List with names of the places and hospitals where the last mission took place</description>
          <units>Participants</units>
          <param>Count of Participants</param>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="58"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <title>Paul VI, Ouaga</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Sekou Toure Regional Referral hospital</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Harapan, pematang Siantar, Sumatera Bissau Hospita</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Haydom Lutheran Hospital, Haydom</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="9"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>St Josephs, Kitgum</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Comprehensive Health Centre, totoro Abeokuta.</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Sengerema hospital, sengerema</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="3"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Masanga Hospital</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="3"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Pius VI, Ouagadougou</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>St Francis hospital Mutolere</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Pemantang siantar, rumah sakit harapan</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Virgen de la puerta</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Gatagara</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Rach Gia</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Yekatit 12 hospital, Addis Ababa</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Guercif, Morocco;</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Munshiganj, Bangladesh</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Ambroseli Hospital Kalongo</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="2"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Conakry, Port. Mercy Ships</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Mahossot Hospiatl Vientiane</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Vavuniya General Hospital</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Guayaquil</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Bekhazi Medical Center, Beirut</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Bissau teaching hospital</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Conakry</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="5"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Malamulo Hospital</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Dhaka Medical College Hospital, Dhaka</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Yekatit 12</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>CSC, Phnom Penh</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Africa Mercy</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Mercships</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Hopital National Donka, Conakry</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Africa Mercy, Conakry</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Exeter</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Mangu Hospital, Mangu Plateau state</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Cocin, Mangu</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>University Hospital Basel, Switzerland</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Yekatit 12 Hospital, Addis Ababa</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Shifa Hospital, Gaza City</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>MSF burn hospital in Port-au-Prince, Haiti</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Q9: Number of Participants Per Organization</title>
        <description>Name of the organization that supported the last mission of the participant</description>
        <time_frame>approximately 20 minutes</time_frame>
        <group_list>
          <group group_id="O1">
            <title>All Included Participants of the Study</title>
            <description>Included were English speaking experienced members of foreign teams and local team members from LMIC, that did participate in at least one short-term surgical mission in a hospital in a LMIC.</description>
          </group>
        </group_list>
        <measure>
          <title>Q9: Number of Participants Per Organization</title>
          <description>Name of the organization that supported the last mission of the participant</description>
          <units>Participants</units>
          <param>Count of Participants</param>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="58"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <title>Bridge the Gap Foundation</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>B-first</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Doctors of the World</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="11"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Global Smile Foundation</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="3"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Harapan Jaya</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="2"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Ka Dounia Dia</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="2"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>MAP</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Mercy Ships</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="12"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Mission Restore</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>MSF</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Njokuti</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="3"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Operation Hernia</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Orthopaedic Outreach</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Pan-African Academy of Christian Surgeons</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Project Harar</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="2"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Resurge</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Interplast Holland</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="6"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Simba Health</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="2"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Stichting 'Op Gelijke Voet'</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Trinitas Health Care Partners</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Mission without a supporting NGO</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="4"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Q10: Countries Where the NGOs Are Based</title>
        <description>List of countries where the supporting NGOs of the last mission are based</description>
        <time_frame>approximately 20 minutes</time_frame>
        <group_list>
          <group group_id="O1">
            <title>All Included Participants of the Study</title>
            <description>Included were English speaking experienced members of foreign teams and local team members from LMIC, that did participate in at least one short-term surgical mission in a hospital in a LMIC.</description>
          </group>
        </group_list>
        <measure>
          <title>Q10: Countries Where the NGOs Are Based</title>
          <description>List of countries where the supporting NGOs of the last mission are based</description>
          <units>Participants</units>
          <param>Count of Participants</param>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="58"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <title>Netherlands</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="29"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>USA</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="17"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>No supporting NGO</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="4"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>UK</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="4"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Australia</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>France</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Nigeria</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Sierra Leone</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Q11: Importance of Potential Activities</title>
        <description>Points provided (1-4) for four potential activities of a visiting team (more points = more important activity) The points provided by all participants are summed per specific activity and the total scores are compared&#xD;
The four potential activities are:&#xD;
Treat patients yourself&#xD;
Provide surgical equipment and consumables for the local team&#xD;
Provide free treatment&#xD;
Facilitate teaching of local staff&#xD;
Scale with importance of potential activities. Maximum score: 4x58 = 232</description>
        <time_frame>approximately 20 minutes</time_frame>
        <group_list>
          <group group_id="O1">
            <title>All Included Participants of the Study</title>
            <description>Included were English speaking experienced members of foreign teams and local team members from LMIC, that did participate in at least one short-term surgical mission in a hospital in a LMIC.</description>
          </group>
        </group_list>
        <measure>
          <title>Q11: Importance of Potential Activities</title>
          <description>Points provided (1-4) for four potential activities of a visiting team (more points = more important activity) The points provided by all participants are summed per specific activity and the total scores are compared&#xD;
The four potential activities are:&#xD;
Treat patients yourself&#xD;
Provide surgical equipment and consumables for the local team&#xD;
Provide free treatment&#xD;
Facilitate teaching of local staff&#xD;
Scale with importance of potential activities. Maximum score: 4x58 = 232</description>
          <units>score on a scale</units>
          <param>Number</param>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="58"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <title>Treat patients yourself</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="157"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Provide surgical equipment and consumables for the</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="153"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Provide free treatment</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="175"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Facilitate teaching of local staff</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="210"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Q12: Activities That Where Missing in Question 11.</title>
        <description>Respondents that were missing this activity as an option in question 11&#xD;
Total number of respondents that were missing an activity: 29&#xD;
Activities that were missing:&#xD;
Financial collaboration&#xD;
Advocacy&#xD;
Academic collaboration&#xD;
Sustainability&#xD;
Collaboration with local staff&#xD;
Follow-up</description>
        <time_frame>approximately 20 minutes</time_frame>
        <population>Question 12 was asked to all participants but only 29 stated that an activity was missing in question 11</population>
        <group_list>
          <group group_id="O1">
            <title>All Included Participants of the Study</title>
            <description>Included were English speaking experienced members of foreign teams and local team members from LMIC, that did participate in at least one short-term surgical mission in a hospital in a LMIC.</description>
          </group>
        </group_list>
        <measure>
          <title>Q12: Activities That Where Missing in Question 11.</title>
          <description>Respondents that were missing this activity as an option in question 11&#xD;
Total number of respondents that were missing an activity: 29&#xD;
Activities that were missing:&#xD;
Financial collaboration&#xD;
Advocacy&#xD;
Academic collaboration&#xD;
Sustainability&#xD;
Collaboration with local staff&#xD;
Follow-up</description>
          <population>Question 12 was asked to all participants but only 29 stated that an activity was missing in question 11</population>
          <units>Participants</units>
          <param>Count of Participants</param>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="29"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <title>Financial collaboration</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Advocacy</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="2"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Academic collaboration</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="4"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Sustainability</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="5"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Collaboration with local staff</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="8"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Follow up</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="9"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Q13. Medical Registration is Required in the Host Country</title>
        <description>Medical registration in the host country is required for specialists performing short-term reconstructive missions&#xD;
Participants of the survey were asked what they think of this statement:&#xD;
Strongly agree&#xD;
Agree&#xD;
Neither agree nor disagree&#xD;
Disagree&#xD;
Strongly disagree</description>
        <time_frame>approximately 20 minutes</time_frame>
        <group_list>
          <group group_id="O1">
            <title>All Included Participants of the Study</title>
            <description>Included were English speaking experienced members of foreign teams and local team members from LMIC, that did participate in at least one short-term surgical mission in a hospital in a LMIC.</description>
          </group>
        </group_list>
        <measure>
          <title>Q13. Medical Registration is Required in the Host Country</title>
          <description>Medical registration in the host country is required for specialists performing short-term reconstructive missions&#xD;
Participants of the survey were asked what they think of this statement:&#xD;
Strongly agree&#xD;
Agree&#xD;
Neither agree nor disagree&#xD;
Disagree&#xD;
Strongly disagree</description>
          <units>Participants</units>
          <param>Count of Participants</param>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="58"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <title>Strongly agree</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="28"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Agree</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="16"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Neither agree nor disagree</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="7"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Disagree</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="7"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Strongly disagree</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="0"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Q14: The Process of Obtaining Medical Registration Was Straightforward</title>
        <description>The Process of Obtaining Medical Registration Was Straightforward&#xD;
Participants of the survey were asked what they think of this statement:&#xD;
Strongly agree&#xD;
Agree&#xD;
Neither agree nor disagree&#xD;
Disagree&#xD;
Strongly disagree</description>
        <time_frame>approximately 20 minutes</time_frame>
        <group_list>
          <group group_id="O1">
            <title>All Included Participants of the Study</title>
            <description>Included were English speaking experienced members of foreign teams and local team members from LMIC, that did participate in at least one short-term surgical mission in a hospital in a LMIC.</description>
          </group>
        </group_list>
        <measure>
          <title>Q14: The Process of Obtaining Medical Registration Was Straightforward</title>
          <description>The Process of Obtaining Medical Registration Was Straightforward&#xD;
Participants of the survey were asked what they think of this statement:&#xD;
Strongly agree&#xD;
Agree&#xD;
Neither agree nor disagree&#xD;
Disagree&#xD;
Strongly disagree</description>
          <units>Participants</units>
          <param>Count of Participants</param>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="58"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <title>Strongly agree</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="8"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Agree</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="19"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Neither agree nor disagree</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="16"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Disagree</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="10"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Strongly disagree</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="5"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Q15: Collaboration</title>
        <description>What can you say about the collaboration between authorities in LMICs and visiting surgical teams?&#xD;
Participants of the survey were asked to choose one of the following answers on this question:&#xD;
collaboration is present but improvement is needed&#xD;
there is no collaboration and it should be developed as a priority&#xD;
collaboration has no benefits nor disadvantages&#xD;
collaboration will likely be more harmful than beneficial for the mission</description>
        <time_frame>approximately 20 minutes</time_frame>
        <group_list>
          <group group_id="O1">
            <title>All Included Participants of the Study</title>
            <description>Included were English speaking experienced members of foreign teams and local team members from LMIC, that did participate in at least one short-term surgical mission in a hospital in a LMIC.</description>
          </group>
        </group_list>
        <measure>
          <title>Q15: Collaboration</title>
          <description>What can you say about the collaboration between authorities in LMICs and visiting surgical teams?&#xD;
Participants of the survey were asked to choose one of the following answers on this question:&#xD;
collaboration is present but improvement is needed&#xD;
there is no collaboration and it should be developed as a priority&#xD;
collaboration has no benefits nor disadvantages&#xD;
collaboration will likely be more harmful than beneficial for the mission</description>
          <units>Participants</units>
          <param>Count of Participants</param>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="58"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <title>collaboration is present but improvement is neede</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="39"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>there is no collaboration and it should be develop</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="16"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>collaboration has no benefits nor disadvantages</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="3"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>-collaboration has no benefits nor disadvantages</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Q16. What Should Have a Higher Priority in the Hospital of Your Last Mission?</title>
        <description>What should have a higher priority in the hospital of your last mission ?&#xD;
Respondents were asked to choose on the these two answers:&#xD;
Teaching in anesthesia care or teaching in surgical care</description>
        <time_frame>approximately 20 minutes</time_frame>
        <population>5 respondents did't make a choice In the comments section 9 respondents declared that preferable both should be equally addressed</population>
        <group_list>
          <group group_id="O1">
            <title>All Included Participants of the Study</title>
            <description>Included were English speaking experienced members of foreign teams and local team members from LMIC, that did participate in at least one short-term surgical mission in a hospital in a LMIC.</description>
          </group>
        </group_list>
        <measure>
          <title>Q16. What Should Have a Higher Priority in the Hospital of Your Last Mission?</title>
          <description>What should have a higher priority in the hospital of your last mission ?&#xD;
Respondents were asked to choose on the these two answers:&#xD;
Teaching in anesthesia care or teaching in surgical care</description>
          <population>5 respondents did't make a choice In the comments section 9 respondents declared that preferable both should be equally addressed</population>
          <units>Participants</units>
          <param>Count of Participants</param>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="53"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <title>Surgical care</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="31"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Anaesthesia care</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="22"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Q17. A Structured Follow-up Strategy is Required</title>
        <description>A structured follow-up strategy (&gt;6 months) of patients is required for short-term reconstructive surgical missions.&#xD;
Participants of the survey were asked what they think of this statement:&#xD;
Strongly agree&#xD;
Agree&#xD;
Neither agree nor disagree&#xD;
Disagree&#xD;
Strongly disagree</description>
        <time_frame>approximately 20 minutes</time_frame>
        <group_list>
          <group group_id="O1">
            <title>All Included Participants of the Study</title>
            <description>Included were English speaking experienced members of foreign teams and local team members from LMIC, that did participate in at least one short-term surgical mission in a hospital in a LMIC.</description>
          </group>
        </group_list>
        <measure>
          <title>Q17. A Structured Follow-up Strategy is Required</title>
          <description>A structured follow-up strategy (&gt;6 months) of patients is required for short-term reconstructive surgical missions.&#xD;
Participants of the survey were asked what they think of this statement:&#xD;
Strongly agree&#xD;
Agree&#xD;
Neither agree nor disagree&#xD;
Disagree&#xD;
Strongly disagree</description>
          <units>Participants</units>
          <param>Count of Participants</param>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="58"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <title>Strongly agree</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="37"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Agree</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="17"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Neither agree nor disagree</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="4"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Disagree</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="0"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Strongly disagree</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="0"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Q18. One Month After the Mission, an Official Report is Recommended</title>
        <description>One month after the mission, an official report on the outcome including all complications encountered is recommended for all missions.&#xD;
Participants of the survey were asked what they think of this statement:&#xD;
Strongly agree&#xD;
Agree&#xD;
Neither agree nor disagree&#xD;
Disagree&#xD;
Strongly disagree</description>
        <time_frame>approximately 20 minutes</time_frame>
        <group_list>
          <group group_id="O1">
            <title>All Included Participants of the Study</title>
            <description>Included were English speaking experienced members of foreign teams and local team members from LMIC, that did participate in at least one short-term surgical mission in a hospital in a LMIC.</description>
          </group>
        </group_list>
        <measure>
          <title>Q18. One Month After the Mission, an Official Report is Recommended</title>
          <description>One month after the mission, an official report on the outcome including all complications encountered is recommended for all missions.&#xD;
Participants of the survey were asked what they think of this statement:&#xD;
Strongly agree&#xD;
Agree&#xD;
Neither agree nor disagree&#xD;
Disagree&#xD;
Strongly disagree</description>
          <units>Participants</units>
          <param>Count of Participants</param>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="58"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <title>Strongly agree</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="39"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Agree</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="16"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Neither agree nor disagree</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="2"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Disagree</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Strongly disagree</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="0"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Q19. A Written Long-term Strategy is Recommended at the Start of a New Project.</title>
        <description>A written long-term strategy (&gt;5 years) with clear goals, developed by the visiting team and the local actors together, is recommended at the start of a new project.&#xD;
Participants of the survey were asked what they think of this statement:&#xD;
Strongly agree&#xD;
Agree&#xD;
Neither agree nor disagree&#xD;
Disagree&#xD;
Strongly disagree</description>
        <time_frame>approximately 20 minutes</time_frame>
        <group_list>
          <group group_id="O1">
            <title>All Included Participants of the Study</title>
            <description>Included were English speaking experienced members of foreign teams and local team members from LMIC, that did participate in at least one short-term surgical mission in a hospital in a LMIC.</description>
          </group>
        </group_list>
        <measure>
          <title>Q19. A Written Long-term Strategy is Recommended at the Start of a New Project.</title>
          <description>A written long-term strategy (&gt;5 years) with clear goals, developed by the visiting team and the local actors together, is recommended at the start of a new project.&#xD;
Participants of the survey were asked what they think of this statement:&#xD;
Strongly agree&#xD;
Agree&#xD;
Neither agree nor disagree&#xD;
Disagree&#xD;
Strongly disagree</description>
          <units>Participants</units>
          <param>Count of Participants</param>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="58"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <title>Strongly agree</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="37"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Agree</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="17"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Neither agree nor disagree</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="4"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Disagree</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="0"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Strongly disagree</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="0"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Q20. Suggestions to Improve the Impact of Short Term Reconstructive Missions.</title>
        <description>What would you suggest to improve the impact of short term reconstructive missions?&#xD;
The answers were categorized and the three most mentioned categories are:&#xD;
Teaching of local staff&#xD;
Follow-up&#xD;
Building sustainable partnerships&#xD;
The three activities were mentioned in total 68 times in the comments The distribution among the three categories is shown below</description>
        <time_frame>approximately 20 minutes</time_frame>
        <population>the 58 participants mentioned the top three activities 68 times</population>
        <group_list>
          <group group_id="O1">
            <title>All Included Participants of the Study</title>
            <description>Included were English speaking experienced members of foreign teams and local team members from LMIC, that did participate in at least one short-term surgical mission in a hospital in a LMIC.</description>
          </group>
        </group_list>
        <measure>
          <title>Q20. Suggestions to Improve the Impact of Short Term Reconstructive Missions.</title>
          <description>What would you suggest to improve the impact of short term reconstructive missions?&#xD;
The answers were categorized and the three most mentioned categories are:&#xD;
Teaching of local staff&#xD;
Follow-up&#xD;
Building sustainable partnerships&#xD;
The three activities were mentioned in total 68 times in the comments The distribution among the three categories is shown below</description>
          <population>the 58 participants mentioned the top three activities 68 times</population>
          <units>answers mentioning this activity</units>
          <param>Number</param>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="58"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <title>Teaching of local staff</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="24"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Follow-up</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="10"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Building sustainable partnerships</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="34"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
    </outcome_list>

    <reported_events>
      <time_frame>5 months</time_frame>
      <desc>Adverse Events data was not collected.&#xD;
Because this study is a survey, there is no intervention group</desc>
      <group_list>
        <group group_id="E1">
          <title>Experts</title>
          <description>Included were English speaking experienced members of foreign teams and local team members from LMIC, that did participate in at least one short-term surgical mission in a hospital in a LMIC.</description>
        </group>
      </group_list>
      <serious_events>
        <category_list>
          <category>
            <title>Total</title>
            <event_list>
              <event>
                <sub_title>Total, all-cause mortality</sub_title>
                <counts group_id="E1" subjects_affected="0" subjects_at_risk="0"/>
              </event>
              <event>
                <sub_title>Total, serious adverse events</sub_title>
                <counts group_id="E1" subjects_affected="0" subjects_at_risk="0"/>
              </event>
            </event_list>
          </category>
        </category_list>
      </serious_events>
      <other_events>
        <frequency_threshold>0</frequency_threshold>
        <category_list>
          <category>
            <title>Total</title>
            <event_list>
              <event>
                <sub_title>Total, other adverse events</sub_title>
                <counts group_id="E1" subjects_affected="0" subjects_at_risk="0"/>
              </event>
            </event_list>
          </category>
        </category_list>
      </other_events>
    </reported_events>

    <certain_agreements>
      <pi_employee>Principal Investigators are NOT employed by the organization sponsoring the study.</pi_employee>
      <restrictive_agreement>There is NOT an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed. </restrictive_agreement>
    </certain_agreements>
    <limitations_and_caveats>An important limitation of this study is that most of the respondents are medical doctors from HICs.&#xD;
Another possible 'selection bias' that could have occurred concerns (over-) representation of experts from the Netherlands.</limitations_and_caveats>
    <point_of_contact>
      <name_or_title>Dr Matthijs Botman</name_or_title>
      <organization>Global Surgery Amsterdam</organization>
      <phone>0031648073683</phone>
      <email>matthijsbotman@gmail.com</email>
    </point_of_contact>
  </clinical_results>
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT04450823
org study id: 2020-01
nct id: NCT04450823
lead sponsor: 
has dmc: No
is fda regulated drug: No
is fda regulated device: No
Introduction: Recently, the devastating consequences of neglected surgical care in global
      health became apparent with an estimated five billion people lacking access to safe surgical
      and anesthesia care. Traditionally, short-term surgical missions were the predominant
      strategy how surgical care was supported in Low- and Middle-Income Countries. Although
      surgical missions have been criticized in recent literature they are still being performed on
      a large scale. The aim of this study is to provide recommendations for persons and
      organizations involved in surgical mission on how to strengthen surgical care in LMICs in the
      future.

      Method: An online survey was developed for members of foreign teams. Data was collected on 5
      topics, consisting of: 1) basic characteristics of the missions, 2) main activities, 2)
      follow-up and reporting, 3) the local registration process for foreign teams and 4)
      collaboration with local stakeholders.
observational model: Other
time perspective: Cross-Sectional
measure: Q7: Country Where the Last Mission Took Place
time frame: approximately 20 minutes
description: Answer on the question: What was the country where your last mission took place?
measure: Q8: Name of the Place and Hospital Where the Last Mission Took Place
time frame: approximately 20 minutes
description: List with names of the places and hospitals where the last mission took place
measure: Q9: Number of Participants Per Organization
time frame: approximately 20 minutes
description: Name of the organization that supported the last mission of the participant
measure: Q10: Countries Where the NGOs Are Based
time frame: approximately 20 minutes
description: List of countries where the supporting NGOs of the last mission are based
measure: Q11: Importance of Potential Activities
time frame: approximately 20 minutes
description: Points provided (1-4) for four potential activities of a visiting team (more points = more important activity) The points provided by all participants are summed per specific activity and the total scores are compared
The four potential activities are:
Treat patients yourself
Provide surgical equipment and consumables for the local team
Provide free treatment
Facilitate teaching of local staff
Scale with importance of potential activities. Maximum score: 4x58 = 232
measure: Q12: Activities That Where Missing in Question 11.
time frame: approximately 20 minutes
description: Respondents that were missing this activity as an option in question 11
Total number of respondents that were missing an activity: 29
Activities that were missing:
Financial collaboration
Advocacy
Academic collaboration
Sustainability
Collaboration with local staff
Follow-up
measure: Q13. Medical Registration is Required in the Host Country
time frame: approximately 20 minutes
description: Medical registration in the host country is required for specialists performing short-term reconstructive missions
Participants of the survey were asked what they think of this statement:
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree
measure: Q14: The Process of Obtaining Medical Registration Was Straightforward
time frame: approximately 20 minutes
description: The Process of Obtaining Medical Registration Was Straightforward
Participants of the survey were asked what they think of this statement:
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree
measure: Q15: Collaboration
time frame: approximately 20 minutes
description: What can you say about the collaboration between authorities in LMICs and visiting surgical teams?
Participants of the survey were asked to choose one of the following answers on this question:
collaboration is present but improvement is needed
there is no collaboration and it should be developed as a priority
collaboration has no benefits nor disadvantages
collaboration will likely be more harmful than beneficial for the mission
measure: Q16. What Should Have a Higher Priority in the Hospital of Your Last Mission?
time frame: approximately 20 minutes
description: What should have a higher priority in the hospital of your last mission ?
Respondents were asked to choose on the these two answers:
Teaching in anesthesia care or teaching in surgical care
measure: Q17. A Structured Follow-up Strategy is Required
time frame: approximately 20 minutes
description: A structured follow-up strategy (>6 months) of patients is required for short-term reconstructive surgical missions.
Participants of the survey were asked what they think of this statement:
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree
measure: Q18. One Month After the Mission, an Official Report is Recommended
time frame: approximately 20 minutes
description: One month after the mission, an official report on the outcome including all complications encountered is recommended for all missions.
Participants of the survey were asked what they think of this statement:
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree
measure: Q19. A Written Long-term Strategy is Recommended at the Start of a New Project.
time frame: approximately 20 minutes
description: A written long-term strategy (>5 years) with clear goals, developed by the visiting team and the local actors together, is recommended at the start of a new project.
Participants of the survey were asked what they think of this statement:
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree
measure: Q20. Suggestions to Improve the Impact of Short Term Reconstructive Missions.
time frame: approximately 20 minutes
description: What would you suggest to improve the impact of short term reconstructive missions?
The answers were categorized and the three most mentioned categories are:
Teaching of local staff
Follow-up
Building sustainable partnerships
The three activities were mentioned in total 68 times in the comments The distribution among the three categories is shown below
intervention type: Other
intervention name: no intervention
description: no intervention study, survey amongst health workers
study pop: 
sampling method: Non-Probability Sample
criteria: 
gender: All
minimum age: N/A
maximum age: N/A
healthy volunteers: Accepts Healthy Volunteers
facility: 
country: Netherlands
responsible party type: Principal Investigator
investigator affiliation: Global Surgery Amsterdam
investigator full name: Matthijs Botman
investigator title: Principal investigator
sharing ipd: Yes
ipd description: Individual participant data will be shared anonymously on this platform as requested by the journal of submission (int,. journal of surgery)
ipd info type: Study Protocol
ipd time frame: ASAP
provided document: 
participant flow: 
baseline: 
outcome list: 
reported events: 
certain agreements: 
limitations and caveats: An important limitation of this study is that most of the respondents are medical doctors from HICs.
Another possible 'selection bias' that could have occurred concerns (over-) representation of experts from the Netherlands.
point of contact: 