Table 2. Summary of Data Sources and Participants .

Data Sources	Timing	Sample	Participants	Focus Areas
DLHs surveys	Jul-Sep 2017 and Mar 2019	22 DLHs	Surgical providers, anaesthesia providers and theatre nurses part of DLH surgical teams	Referral links across hospitals, referral practices (including communication and feedback) and resource availability at DLHs
Interviews with DLH staff	Jul-Sep 2017	12 interviews at 9 DLHs	Surgical providers, anaesthesia providers and theatre nurses part of DLH surgical teams	Key reasons for referrals and further details on referral practices, including unnecessary referrals
Database of incoming surgical cases received at the sentinel RHs	Nov-Dec 2017-Apr/May 2018	2 RHs	QECH, Zomba CH	Referral flows, including case details, type of referral, place of origin, transport mode and referral documentation
Interviews with RH staff	Oct 2018-Jul 2019	8 interviews at 3 RHs	Surgical interns, registrars, non-physician clinicians and the specialists supervising and coordinating them	Type of incoming referrals, appropriateness and quality of incoming referrals (communication, documentation, pre-referral management and stabilisation, transport), feedback practices at the RH

Abbreviations: QECH, Queen Elizabeth Central Hospital; Zomba CH, Zomba Central Hospital; DLHs, district level hospitals; RH, referral hospital.