Sepsis - Knowledge - Score

* Measured as the sum of correctly answered questions in the questionnaire. This results in a sepsis knowledge score of 0-47 points, with higher scores indicating better knowledge. * Assessed in two independent cross-sectional survey waves. * Calculated for all participants. * Serves as the main measure of clinical sepsis knowledge in partner countries across survey waves conducted before and after the implementation period of capacity-building activities

Baseline survey period (January 19, 2026 - April 30, 2026) and follow-up survey period (April 1, 2027 - July 31, 2027)

Domain-specific knowledge of sepsis

Domain-specific knowledge of sepsis is measured in five domains, to identify specific knowledge gaps. Domain-specific scores will be measured as the sum of correctly answered questions in the questionnaire in respective domain. Domains are: 1. definitions of sepsis and septic shock (0-8 points, with higher points indicating higher knowledge) 2. sepsis risk groups (0-6 points, with higher points indicating higher knowledge), 3. causes of sepsis (0-6 points, with higher points indicating higher knowledge), 4. sepsis symptoms (0-6 points, with higher points indicating higher knowledge), 5. management of sepsis (0-21 points, with higher points indicating higher knowledge). All domains together sum up to the overall sepsis knowledge score (primary outcome).

Baseline survey period (January 19, 2026 - April 30, 2026), and follow-up survey period (April 1, 2027 - July 31, 2027)

Analysis of sepsis knowledge scores and domain-specific scores by professional role

* Correlations between sepsis knowledge scores and professional roles and different levels of education within professional groups (nurses, doctors, and midwifes). * Regression-based predictors of overall sepsis knowledge scores and domain-specific scores by professional roles and different levels of education within the professional groups of nurses, doctors, and midwifes

Baseline survey period (January 19, 2026 - April 30, 2026), and follow-up survey period (April 1, 2027 - July 31, 2027)

Country comparison

• Between group comparison in sepsis knowledge scores and domain-specific sepsis knowledge between different countries (Uganda, Ethiopia, the Demoratic Republic of the Congo, Mozambique, Ghana, Sierra Leone, Nigeria, (potentially other countries in case of spill-over).

Baseline survey period (January 19, 2026 - April 30, 2026), and follow-up survey period (April 1, 2027 - July 31, 2027)

Second survey wave only: Change in sepsis knowledge scores between survey waves

\- Difference in average knowledge score in repeated survey. * Between-wave comparison of sepsis knowledge scores and domain specific sepsis knowledge scores in a comparison between baseline assessment and after implementation of STAIRS capacity building measures * Comparisons between survey waves will be conducted using appropriate parametric or non-parametric tests

Follow-up survey period (April 1, 2027 - July 31, 2027)

Comparison of sepsis knowledge scores by self-reported participation in capacity-building measures

* Comparison of sepsis knowledge scores and domain-specific scores between respondents who report participation in capacity-building activities and those who do not * If possible, assessment of correlations and adjusted relationships between participation in capacity-building activities and sepsis knowledge scores

Follow-up survey period (April 1, 2027 - July 31, 2027)

Baseline survey only: Self-assessment of perceived training needs

* Exploratory analysis of self-reported sepsis training needs, and preferred formats (virtual vs. in-person) * Self-reported perception of the importance of sepsis as a training subject

Baseline survey period (January 19, 2026 - April 30, 2026)

Vignette-based sepsis knowledge score (sum of correct responses to predefined vignette items)

* Calculated as the sum of correct responses (0-9 points) to predefined items across four clinical case vignettes * Analyzed separately from the primary sepsis knowledge score * Analyzed descriptively and compared between groups and survey waves using appropriate statistical tests

Baseline survey period (January 19, 2026 - April 30, 2026), and follow-up survey period (April 1, 2027 - July 31, 2027)