A framework for advancing sustainable magnetic resonance imaging access in Africa

Abstract

Magnetic resonance imaging (MRI) technology has profoundly transformed current healthcare systems globally, owing to advances in hardware and software research innovations. Despite these advances, MRI remains largely inaccessible to clinicians, patients, and researchers in low‐resource areas, such as Africa. The rapidly growing burden of noncommunicable diseases in Africa underscores the importance of improving access to MRI equipment as well as training and research opportunities on the continent. The Consortium for Advancement of MRI Education and Research in Africa (CAMERA) is a network of African biomedical imaging experts and global partners, implementing novel strategies to advance MRI access and research in Africa. Upon its inception in 2019, CAMERA sets out to identify challenges to MRI usage and provide a framework for addressing MRI needs in the region. To this end, CAMERA conducted a needs assessment survey (NAS) and a series of symposia at international MRI society meetings over a 2‐year period. The 68‐question NAS was distributed to MRI users in Africa and was completed by 157 clinicians and scientists from across Sub‐Saharan Africa (SSA). On average, the number of MRI scanners per million people remained at less than one, of which 39% were obsolete low‐field systems but still in use to meet daily clinical needs. The feasibility of coupling stable energy supplies from various sources has contributed to the growing number of higher‐field (1.5 T) MRI scanners in the region. However, these systems are underutilized, with only 8% of facilities reporting clinical scans of 15 or more patients per day, per scanner. The most frequently reported MRI scans were neurological and musculoskeletal. The CAMERA NAS combined with the World Health Organization and International Atomic Energy Agency data provides the most up‐to‐date data on MRI density in Africa and offers a unique insight into Africa's MRI needs. Reported gaps in training, maintenance, and research capacity indicate ongoing challenges in providing sustainable high‐value MRI access in SSA. Findings from the NAS and focused discussions at international MRI society meetings provided the basis for the framework presented here for advancing MRI capacity in SSA. While these findings pertain to SSA, the framework provides a model for advancing imaging needs in other low‐resource settings.

Impact of Magnetic Resonance Imaging on Healthcare in Low- and Middle-Income Countries

“…However, despite a generally positive trend in the dissemination of MRI technology, its accessibility and use are limited in places with limited resources, such as Africa and Asia, due to high acquisition and maintenance costs, restricted access to infrastructure, a lack of expertise required to operate and maintain the equipment, and other region-specific factors [ 13 , 14 ]. More than 370 million people in West Africa were covered by only 84 MRI facilities in 2016, with more than two-thirds of those units located in Nigeria [ 15 ]. The African region had the lowest number of MRI scanners per million people in 2017 (0.7), followed by the South-East Asian region (1.1), the Eastern Mediterranean region (2.8), and the region of the Americas (4.1).…”

Dementia and cognitive impairment in French-speaking Sub-Saharan Africa: a comprehensive review on moving out of the shadows of neglect

“…SSA is faced with underdiagnosis of cases of dementia due to untimely clinical diagnosis and limited structural MRI centers for prompt management [9]. The Consortium for Advancement of MRI Education & Research in Africa (CAMERA) identi ed challenges to MRI usage ranging from scant MRI per unit population to obsolete low-eld sub-standard systems to meet clinical needs and under-usage of MRI scans [133]. Although reported gaps in training, maintenance, and research capacity indicate ongoing challenges in providing sustainable high-value MRI access in SSA, the consortium advanced a framework to address MRI needs, including the feasibility of coupling stable energy supplies from various sources for higher-eld (1.5T) MRI scanners in the region [133].…”

On‐site construction of a point‐of‐care low‐field MRI system in Africa

“…The lack of MRI facilities, both clinical and research, in the African continent has been highlighted in several recent articles 1–3 . A recent publication both outlines the current situation and proposes plans for improving this situation in the future 2 .…”

“…The lack of MRI facilities, both clinical and research, in the African continent has been highlighted in several recent articles. [1][2][3] A recent publication both outlines the current situation and proposes plans for improving this situation in the future. 2 Four crucial challenges were highlighted: access and availability, personnel training and education, research capacity and sustainable technology.…”

“…[1][2][3] A recent publication both outlines the current situation and proposes plans for improving this situation in the future. 2 Four crucial challenges were highlighted: access and availability, personnel training and education, research capacity and sustainable technology. One approach that can potentially address many of these recommendations is low-field MRI.…”