Neurosurgery training in war-torn countries: A perspective from Iraq and Syria

Hoz, Shmaryahu; Tamer, Wardan A; Al-Awadi, Osama M.; Al-Sharshahi, Zahraa F.; Dolachee, Ali A.

doi:10.25259/sni_513_2020

Cited by 8 publications

(8 citation statements)

References 6 publications

(3 reference statements)

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“…Neurosurgical workforce data were obtained for 210 nations through 42 included sources ( Supplemental Digital Content 2, Supplemental Table 1 , http://links.lww.com/NEU/E46). 1,17,18,22-61 A world map denoting total neurosurgeons per capita is shown in Figure 1. The color scale denotes countries in green if they have at least 1 neurosurgeon per 200 000 population as this has been described as the minimum requirement for essential neurosurgical workforce to address neurotrauma in low- and middle-income countries.…”

Section: Resultsmentioning

confidence: 99%

Women Neurosurgeons Worldwide: Characterizing the Global Female Neurosurgical Workforce

Vaca,

Theologitis,

Zygourakis

2023

Neurosurgery

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BACKGROUND AND OBJECTIVES: As the global neurosurgical workforce expands, so do the contributions of women neurosurgeons. Recent studies highlighted pioneering women leaders in neurosurgery and provided invaluable perspectives into the proportion of women neurosurgeons in regions across the world. To provide a broad perspective of global trends, this study aims to characterize the global female neurosurgical workforce and evaluate its association with countries' economic status, broader physician workforce, and global gender gap index (GGGI). METHODS: A literature search included studies dated 2016–2023 characterizing the neurosurgical workforce. Total neurosurgeons, neurosurgeons per capita, and percent of women neurosurgeons by country were collected or calculated from available data. Countries were stratified by World Health Organization (WHO) region, World Bank economic classification, WHO physician workforce, and GGGI. Poisson regressions and Spearman correlation tests were performed to evaluate the association between each country's percent of women neurosurgeons and their economic classification, WHO physician workforce, and GGGI. RESULTS: Neurosurgical workforce data were obtained for 210 nations; world maps were created demonstrating neurosurgeons per capita and proportion of women neurosurgeons. Africa had the fewest neurosurgeons (1296) yet highest percentage of women neurosurgeons (15%). A total of 94 of 210 (45%) countries met the minimum requirement of neurosurgeons needed to address neurotrauma. Compared with low-income countries, upper-middle–income and high-income countries had 27.5 times greater the rate of neurosurgeons per capita but only 1.02 and 2.57 times greater percentage of women neurosurgeons, respectively (P < .001). There was a statistically significant association between GGI and women neurosurgeons (P < .001) and a weak correlation between proportion of women in physician workforce and women neurosurgeons (P = .019, rho = 0.33). CONCLUSION: Much progress has been made in expanding the neurosurgical workforce and the proportion of women within it, but disparities remain. As we address the global neurosurgeon deficit, improving recruitment and retention of women neurosurgeons through mentorship, collaboration, and structural support is essential.

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Section: Resultsmentioning

confidence: 99%

Women Neurosurgeons Worldwide: Characterizing the Global Female Neurosurgical Workforce

Vaca,

Theologitis,

Zygourakis

2023

Neurosurgery

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“…First, in terms of attacks against MEHPT as a massively devastating negative impact of the conflict, the strategy of weaponisation of healthcare and MEHPT was reported heavily in the NGCAs,4 6 14–25 in which healthcare facilities and MEHPT campuses were attacked, workers were targeted, medical neutrality was obliterated, and international humanitarian laws were violated, to restrict or prevent access to care as a weapon of war. However, in the GCAs, the scale of attacks was limited to some bombings, missiles and arrests from within MEHPT campuses 26–28…”

Section: Resultsmentioning

confidence: 99%

Impact of armed conflict on health professionals’ education and training in Syria: a systematic review

et al. 2023

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ObjectivesTo provide an overview of the holistic impact of the armed conflict on medical education and health professionals’ training (MEHPT) in Syria.SettingSyria is a country which underwent an armed conflict for 10 years and suffered from the weaponisation of health.MethodsA mixed-methods systematic review including quantitative, qualitative, mixed-methods and textual literature between 2011 and 2021 including papers on the Syrian MEHPT undergraduate and postgraduate education and training personnel (including medicine, dentistry, pharmacy, nursing, midwifery and allied health professionals). The electronic search was conducted in October 2018 in Embase, Global Health, Medline, PsycINFO, Web of Science, PubMed, Scopus, CINAHL and grey literature. And an update to the search was conducted in August 2021 in PubMed, Google Scholar and Trip database.OutcomesThe impact of conflict on the MEHPT system, personnel, experiences, challenges and channels of support.ResultsOf the 5710 citations screened, 70 met the inclusion criteria (34 quantitative, 3 qualitative, 1 mixed-method, and 32 reports and opinion papers). The two major cross-cutting themes were attacks on MEHPT and innovations (present in 41% and 44% of the papers, respectively), followed by challenges facing the MEHPT sector and attitudes and knowledge of trainees and students, and lastly health system and policy issues, and narrating experiences.ConclusionConflict in Syria has politicised all aspects of MEHPT. Influenced by political control, the MEHPT system has been divided into two distinguished geopolitical contexts; government-controlled areas (GCAs) and non-GCAs (NGCAs), each having its characteristics and level of war impact. International and regional academic institutes collaboration and coordination efforts are needed to formulate educational platforms using innovative approaches (such as online/blended/store-and-forward/peer-training/online tutoring) to strengthen and build the capacity of the health workforce in conflict-affected areas.

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“…7 The few available neurosurgical workforce in these conflict-torn domiciles has too much neurosurgical sequela to mitigate, facilitating the prioritization of patient care over research endeavors. 7 Several studies have elucidated that collating accurate data in these war-inflicted nations is sometimes difficult. Confinement of home and hospital visits as well as unsafe conditions in most districts results in smaller sample sizes and potential sample bias.…”

mentioning

confidence: 99%

“…6 Iraq has only 1 licensed spinal surgeon, and Syria has none. 7 The few available neurosurgical workforce in these conflict-torn domiciles has too much neurosurgical sequela to mitigate, facilitating the prioritization of patient care over research endeavors. 7 Several studies have elucidated that collating accurate data in these war-inflicted nations is sometimes difficult.…”

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confidence: 99%

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Letter: Addressing Neurosurgery Research and Data Access Gaps in War-Inflicted Nations

et al. 2023

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Neurosurgery training in war-torn countries: A perspective from Iraq and Syria

Cited by 8 publications

References 6 publications

Women Neurosurgeons Worldwide: Characterizing the Global Female Neurosurgical Workforce

Women Neurosurgeons Worldwide: Characterizing the Global Female Neurosurgical Workforce

Impact of armed conflict on health professionals’ education and training in Syria: a systematic review

Letter: Addressing Neurosurgery Research and Data Access Gaps in War-Inflicted Nations

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