Emerging Trends in the Neurosurgical Workforce of Low- and Middle-Income Countries: A Cross-Sectional Study

Kanmounye, Ulrick Sidney; Lartigue, Jean Wilguens; Sadler, Samantha; Ip, Ho Kei Yuki; Corley, Jacquelyn; Arráez, Miguel Ángel Escribano; Park, Kee

doi:10.1016/j.wneu.2020.07.067

Cited by 45 publications

(24 citation statements)

References 7 publications

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“…Five HIC and 3 LMIC neurosurgeons were interviewed. Five overarching themes were identified: ( 1 ) inequality of access to neurosurgical equipment, ( 2 ) identifying specific neurosurgical equipment needs, ( 3 ) importance of organisations, ( 4 ) partnerships between LMIC and HIC centres, and ( 5 ) donations are insufficient in isolation.…”

Section: Resultsmentioning

confidence: 99%

“…The World Federation of Neurosurgical Societies' Global Neurosurgery Committee (WFNS GNC) recommends countries should have at least 1 neurosurgeon per 200,000 inhabitants, universal health coverage for all neurosurgical emergencies, and universal 2-h access to a facility that provides basic macroneurosurgery ( 4 ). While there have been considerable improvements in neurosurgical workforce and universal health coverage for neurosurgical emergencies, most LMICs face significant infrastructural challenges ( 5 , 6 ). The WFNS GNC mapped global access to neurosurgical infrastructure using a three-tier categorisation and geographic information systems: Level 1 facilities have the resources to provide basic macroneurosurgery; especially emergency neurotrauma care; Level 2 facilities provide basic microneurosurgery in addition to macroneurosurgery; and Level 3 facilities provide advanced microneurosurgery in addition to basic microneurosurgery and macroneurosurgery ( 7 ).…”

Section: Introductionmentioning

confidence: 99%

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Neurosurgical Equipment Donations: A Qualitative Study

Sichimba

Bandyopadhyay²,

Ciuculete³

et al. 2022

Front. Surg.

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IntroductionNeurosurgical equipment donation from high-income countries (HICs) to low-and-middle income countries (LMICs) exists. However, there is currently no published literature on whether there is a need for neurosurgical equipment donations or how to design equipment donation programmes that meet the needs of LMIC neurosurgeons. The primary aims of this study were to explore: (1) the need for the donation of neurosurgical equipment from the UK and Ireland to LMICs within the African continent, and (2) the ways through which neurosurgical equipment donations could meet the needs of LMIC neurosurgeons.MethodsThis was a qualitative study using semi-structured, one-on-one, audio-recorded interviews. Purposive sampling was used to recruit and interview consultants or attending neurosurgeons from Ireland, the UK and LMICs in Africa in a continuous process until data saturation. Interviews were conducted by members of the Association of Future African Neurosurgeons during March 2021. Qualitative analysis used a thematic approach using open and axial coding.ResultsFive HIC and 3 LMIC neurosurgeons were interviewed. Five overarching themes were identified: (1) inequality of access to neurosurgical equipment, (2) identifying specific neurosurgical equipment needs, (3) importance of organisations, (4) partnerships between LMIC and HIC centres, and (5) donations are insufficient in isolation.ConclusionThere is a need for greater access to neurosurgical equipment in LMICs. It is unclear if neurosurgical equipment donations are the optimal solution to this issue. Other solutions that are not linked to dependency need to be explored and executed. Collaborative relationships between LMICs and HICs better ensures that neurosurgical equipment donations meet the needs of the recipients. These relationships may be best created within an organisation framework that has the logistical capabilities of coordinating international equipment donation and providing a quality control measure.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Neurosurgical Equipment Donations: A Qualitative Study

Sichimba

Bandyopadhyay²,

Ciuculete³

et al. 2022

Front. Surg.

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“…The neurosurgical workforce density is yet to meet the unmet burden of neurosurgical diseases, despite increasingly growing workforce density seen in many countries around the globe (14). Africa still has the lowest neurosurgical workforce density globally, yet there are no indicative initiatives that can fill this gap by 2030 (17). Moreover, an analysis on number of neurosurgeons in east Asian countries, conducted in 2019, found that LMICs such as Indonesia, Malaysia, and the Philippines have neurosurgeon to population ratios of 1 per 731,000, 1 per 210,000, and 1 per 807,000, respectively while high-income countries (HICs) such as Japan and Taiwan have ratios of 1 per 13,000 and 1 per 37,000, respectively (18).…”

Section: Current State Of Neurosurgical Care Around the World: Workforce Deficit And Lack Of Global Neurosurgery Capacity Building In Curmentioning

confidence: 99%

Emphasizing the Role of Neurosurgery Within Global Health and National Health Systems: A Call to Action

et al. 2021

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Background: Worldwide, neurological disorders are the leading cause of disability-adjusted life years lost and the second leading cause of death. Despite global health capacity-building efforts, each year, 22.6 million individuals worldwide require neurosurgeon's care due to diseases such as traumatic brain injury and hydrocephalus, and 13.8 million of these individuals require surgery. It is clear that neurosurgical care is indispensable in both national and international public health discussions. This study highlights the role neurosurgeons can play in supporting the global health agenda, national surgical plans, and health strengthening systems (HSS) interventions.Methods: Guided by a literature review, the authors discuss key topics such as the global burden of neurosurgical diseases, the current state of neurosurgical care around the world and the inherent benefits of strong neurosurgical capability for health systems.Results: Neurosurgical diseases make up an important part of the global burden of diseases. Many neurosurgeons possess the sustained passion, resilience, and leadership needed to advocate for improved neurosurgical care worldwide. Neurosurgical care has been linked to 14 of the 17 Sustainable Development Goals (SDGs), thus highlighting the tremendous impact neurosurgeons can have upon HSS initiatives.Conclusion: We recommend policymakers and global health actors to: (i) increase the involvement of neurosurgeons within the global health dialogue; (ii) involve neurosurgeons in the national surgical system strengthening process; (iii) integrate neurosurgical care within the global surgery movement; and (iv) promote the training and education of neurosurgeons, especially those residing in Low-and middle-income countries, in the field of global public health.

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“…Spine disorders affect about 50 million Africans each year, and almost 200 000 require neurosurgical management [ 1 , 2 ]. Although the African continent has the lowest prevalence of diagnosed spine disorders, much of the surgical disease remains untreated given the lack of resources to provide operative management [ [2] , [3] , [4] ]. One area in which Africa has a deficit is in infrastructure and equipment.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of spine surgery navigation techniques and availability in Africa: A cross-sectional study

Kanmounye¹,

Zolo

Robertson

et al. 2021

Annals of Medicine &Amp; Surgery

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Background Africa has a large burden of spine pathology but has limited and insufficient infrastructure to manage these spine disorders. Therefore, we conducted this e-survey to assess the prevalence and identify the determinants of the availability of spine surgery navigation techniques in Africa. Materials and methods A two-part questionnaire was disseminated amongst African neurological and orthopedic surgery consultants and trainees from January 24 to February 23, 2021. The Chi-Square, Fisher Exact, and Kruskal-Wallis tests were used to evaluate bivariable relationships, and a p-value <0.05 was considered statistically significant. Results We had 113 respondents from all regions of Africa. Most (86.7 %) participants who practiced or trained in public centers and centers had an annual median spine case surgery volume of 200 (IQR = 190) interventions. Fluoroscopy was the most prevalent spine surgery navigation technique (96.5 %), followed by freehand (55.8 %), stereotactic without intraoperative CT scan (31.9 %), robotic with intraoperative CT scan (29.2 %), stereotactic with intraoperative CT scan (8.8 %), and robotic without intraoperative CT scan (6.2 %). Cost of equipment (94.7 %), lack of trained staff to service (63.7 %), or run the equipment (60.2 %) were the most common barriers to the availability of spine instrumentation navigation. In addition, there were significant regional differences in access to trained staff to run and service the equipment (P = 0.001). Conclusion There is a need to increase access to more advanced navigation techniques, and we identified the determinants of availability.

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Emerging Trends in the Neurosurgical Workforce of Low- and Middle-Income Countries: A Cross-Sectional Study

Cited by 45 publications

References 7 publications

Neurosurgical Equipment Donations: A Qualitative Study

Neurosurgical Equipment Donations: A Qualitative Study

Emphasizing the Role of Neurosurgery Within Global Health and National Health Systems: A Call to Action

Prevalence of spine surgery navigation techniques and availability in Africa: A cross-sectional study

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