Introduction: A baseline assessment of surgical capacity is recommended as a first-step to inform national policy on surgical system strengthening. In Ethiopia, the World Health Organization's Situational Analysis Tool (WHO SAT) was adapted to assess surgical capacity as part of a national initiative: Saving Lives Through Safe Surgery (SaLTS). This study describes the process of adapting this tool and initial results.

Methods: The new tool was used to evaluate fourteen hospitals in the Southern Nations, Nationalities, and People's Region of Ethiopia between February and March 2017. Two analytic methods were employed. To compare this data to international metrics, the WHO Service Availability and Readiness Assessment (SARA) framework was used. To assess congruence with national policy, data was evaluated against Ethiopian SaLTS targets.

Inclusion Criteria:

• Fourteen public hospitals (11 primary, 1 general, and 2 specialized) chosen by the regional health bureau
• Hospital staff with willingness to participate in study
• Hospital staff with availability to participate in study

Exclusion Criteria:

• Hospital staff which did not volunteer to participate or refused to participate were excluded.
• Hospital staff not available at the time of visit
• Hospitals not chosen by the regional health bureau

The Southern Nations, Nationalities and Peoples' (SNNP) Region is one of Ethiopia's eleven regions, occupying the southwest portion of the country. Public hospitals serve the region's population in this area within three tiers - primary, general, and specialized hospitals. An average of four providers were interviewed per facility and participants included hospital leadership (CEOs, medical directors, and matrons), surgeons, integrated emergency surgical officers, obstetrician-gynecologists, mid-level anesthesia providers, and operating room nurses.

Raw data from the survey is available in the study and appendices planned for publication. Additionally, the original source data without identification of the specific hospitals, is available upon request with author consensus.

Once the original study is published, de-identified results will be available by request to the authors.

Original data may be provided upon request to the authors with consensus approval from all co-authors.