Supplement 1: Survey questionnaire sent to all practicing neurosurgeons in Ethiopia.
Question Response Options Type
Demographics Age a) 20-30
b) 30-40 c) 40-50 d) 50-60 e) 60-70
Single Choice
Gender a) Female
b) Male
Single Choice
Education &
Training
Medical School Free text
Residency Institution a) Addis Ababa University Program (Black Lion) b) St. Paul Millennium College Program
c) Mekelle University Program d) Other (specify)
Single Choice &
Free text
Please indicate how many years ago you finished neurosurgery residency?
a) 1-2 b) 3-5 c) 6-8 d) 8-10
e) Over 10 years What is your primary subspeciality? If you do not
have a primary subspecialty, choose “General.”
a) General b) Spine
c) Cerebrovascular d) Neuro-oncology e) Trauma
f) Epilepsy g) Pediatrics
h) Functional/ Stereotactic
Single Choice
If you do not have a primary subspecialty but you aspire to have one, please indicate your
subspecialty of interest?
a) Spine
b) Cerebrovascular c) Neuro-oncology
Single Choice
d) Trauma e) Epilepsy f) Pediatrics
g) Functional/ Stereotactic
Hospital &
Practice Details
Which city do you primarily practice in? a) Addis Ababa b) Adama c) Assela d) Bahir Dar e) Dessie f) Gonder g) Haromaya h) Hawassa i) Jijiga j) Mekelle k) Werabe l) Other
Multiple choice
& free-text if
“other” is selected
What setting do you primarily practice in? a) Academic hospital b) Non-academic hospital c) Private practice
Single Choice
Do you work for a private hospital/clinic part-time? a) Yes b) No
Single Choice
If you answered “yes” to the previous question, please indicate how many hours you work at the private institution per week?
a) < 5 hours b) 5-15 hours c) 15-25 hours
d) More than 25 hours
Single Choice
Which of the following best describes your work
setting? a) National (tertiary) referral hospital
b) Regional (second -level) hospital, c) District (first-level) hospital
Single Choice
What is your academic rank? a) Instructor/ Lecturer b) Assistant Professor c) Associate Professor
Single Choice
d) Professor If you hold an academic title, please choose the
following choices?
a) Department Chair b) Department Vice Chair
c) Neurosurgery Program Director
d) Neurosurgery Program Assistant Director e) Other (specify)
Single Choice &
Free text
How many neurosurgical procedures are annually performed at your institution?
a) < 250 b) 250-500 c) 501-750 d) 751-1000 e) 1001-1250 f) Over 1250
Single Choice
Approximately how many neurosurgical surgeries do you typically perform annually?
a) <10 b) 11-50 c) 50-100 d) 101-150 e) 151-200
f) Over 200 operations
Single Choice
Which best describes your time distribution as a neurosurgeon?
a) Primarily clinical with some administrative tasks
b) Primarily administrative with some clinical tasks
c) Entirely clinical tasks
a) Entirely administrative or research
Single Choice
What percentage of your weekly work schedule is devoted to research-related tasks?
a) <10 % b) 10-25%
c) 25-50%
d) 50-75%
e) Over 75%
Single Choice
What percentage of your weekly work schedule is devoted to supervising and educating residents?
a) <10 % b) 10-25%
c) 25-50%
d) 50-75%
Single Choice
e) Over 75%
How many hours do you typically work per week, on average?
a) ≤ 40 hrs/ week b) 41-60 hrs/ week c) 61-80 hrs/weel d) 81-100 hrs/week e) Over 100 hrs/week
Single Choice
Which of the following essential procedures are commonly performed at your institution?
(choose all that apply)
a) Shunt for hydrocephalus b) Myelomeningocele closure c) Burr holes for hemorrhage d) Trauma craniotomy
e) Urgent/Emergency external ventricular drainage
f) Endoscopic third ventriculostomy g) Cerebral abscess evacuation/aspiration h) Spinal cord detethering
i) Posterior fossa craniotomy for tumor resection j) Repair of complex spinal dysraphism
k) Fixation of unstable spine fracture l) Surgery for refractory epilepsy m) Craniofacial reconstruction
n) Foramen magnum decompression with/without duraplasty
o) Surgery for spasticity p) Other
Multiple choice
& free-text if
“other” is selected
Which of the following neurological conditions are in the top 25% of the most frequent cases?
(choose all that apply)
a) Brain tumors
b) Traumatic brain injury c) Hydrocephalus
d) Degenerative spine disease e) Congenital malformations f) Traumatic spinal injury g) Vascular anomalies h) Stroke
i) Spinal tumors
Multiple choice
& free-text if
“other” is selected
j) Epilepsy k) Pain disorders
l) Movement disorders m) Other
Which of the following neurological conditions are in the bottom 25% of the most frequent cases?
(choose all that apply)
a) Brain tumors
b) Traumatic brain injury c) Hydrocephalus
d) Degenerative spine disease e) Congenital malformations f) Traumatic spinal injury g) Vascular anomalies; Stroke h) Spinal tumors
i) Epilepsy j) Pain disorders k) Movement disorders l) Other
Multiple choice
& free-text if
“other” is selected
Surgical workforce &
access to
neurosurgical care (5 questions)
For patients with emergency neurological cases estimate the percentage of patients who travel for more than 4 hours to seek your care?
a) < 10%
b) 10-25%
c) 26-50%
d) 51-75%
e) Over 75%
Single Choice
Estimate the percentage of your patients who come to the ED via ambulances.
a) < 10%
b) 10-25%
c) 26-50%
d) 51-75%
e) Over 75%
Single Choice
What is the principal method of travel for most of
your patients ? a) Public transport: taxis, buses, train
b) Private vehicles c) Cycling
d) Walking
e) Livestock: horses, mules, or donkeys
Single Choice
How many neurosurgeons work at your institution? a) 1-2 Single Choice
b) 3-5 c) 5-7 d) 7-10
e) Over 10 neurosurgeons In your opinion, how many more neurosurgeons are
needed to adequately treat the volume of neurosurgery patients in your principal site of practice?
a) 1-2 b) 3-5 c) 5-7 d) 7-10
e) Over 10 neurosurgeons
Single Choice
What percentage of cranial operations qualify as trauma cases?
a) < 10%
b) 10-25%
c) 25-50%
d) 50-75%
e) Over 75%
Single Choice
Quality of NS Care
(10 questions)
Are there ICU beds in your hospital? a) Yes b) No
Single Choice
If you answered “yes” to the previous question, how many ICU beds are available at your institution?
a) 1-3 b) 4-6 c) 7-10
d) More than 10 ICU beds
Single Choice
Are there mechanical ventilators in the ICU? a) Yes
b) No Single Choice
If you answered “yes” to the previous question, how many mechanical ventilators are available in the ICU?
a) 1-3 b) 4-6 c) 7-10
d) More than 10 mechanical ventilators
Single Choice
Is physical therapy available at your institution? a) Yes b) No
Single Choice
Do neurosurgery patients have access to post-
operative care at your institution? a) Yes
b) No Single Choice
Is there a standardized neurosurgical checklist completed prior to commencing surgery?
a) Yes b) No
Single Choice
Select the antibiotics you use for surgical prophylaxis.
a) Gentamicin b) Cefazolin c) Cephalexin d) Cloxacillin e) Metronidazol f) Vancomycin g) Other
Single Choice
Which of the following equipment is currently present and functional at your institution? (choose all that apply)
a) Manual drill b) Electric drill
c) Three point head fixer (Mayfield) d) Microscope,
e) Endoscope
f) Micro-instruments g) Shunt hardware h) Spinal implants i) CT scanner j) MRI scanner k) C-arm fluoroscope Which of the following equipment is currently
present at your institution but requires repair ? (choose all that apply)
a) Manual drill b) Electric drill
c) Three point head fixer (Mayfield) d) Microscope,
e) Endoscope
f) Micro-instruments g) Shunt hardware h) Spinal implants
i) CT scanner j) MRI scanner k) C-arm fluoroscope