The Current State of Neurosurgery in Afghanistan

Ammar, Adam; Nawabi, Noah; Hamzah, Radzi; Berger, Connor; Jaweed, Mohammad; Park, Kee B.; Rosseau, Gail; Khan, Tariq; Monawari, Sayed; Pirzad, Ahmad Fawad; Aziz-Sultan, Mohammad Ali

doi:10.1016/j.wneu.2022.10.048

Cited by 10 publications

(3 citation statements)

References 22 publications

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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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“…This qualitative study sought to unravel barriers to access to care in Afghanistan from the perspectives of HCWs and hospital directors, and if and how these barriers modified after the change of government in August 2021. Although Afghanistan has a unique social, political and economic context, the results of this study may be applicable to other fragile settings undergoing changes in their socio-political assets, including a decrease in active fighting and violence [ 21 ].…”

Section: Introductionmentioning

confidence: 99%

Exploring barriers to access to care following the 2021 socio-political changes in Afghanistan: a qualitative study

Lamberti-Castronuovo,

Valente,

Bocchini

et al. 2024

Confl Health

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Background Following the change of government in August 2021, the social and economic landscape of Afghanistan deteriorated into an economic and humanitarian crisis. Afghans continue to struggle to access basic healthcare services, making Universal Health Coverage (UHC) in the country a major challenge. The aim of this study was to perform a qualitative investigation into the main access to care challenges in Afghanistan and whether these challenges have been influenced by the recent socio-political developments, by examining the perspectives of health professionals and hospital directors working in the country. Methods Health professionals working in facilities run by an international non-government organisation, which has maintained continuous operations since 1999 and has become a key health reference point for the population, alongside the public health system, and hospital directors working in government hospitals were recruited to participate in an in-depth qualitative study using semi-structured interviews. Results A total of 43 participants from ten provinces were interviewed in this study. Four issues were identified as critical barriers to achieving UHC in Afghanistan: (1) the lack of quality human resources; (2) the suboptimal management of chronic diseases and trauma; (3) the inaccessibility of necessary health services due to financial hardship; (4) the unequal accessibility of care for different demographic groups. Conclusions Health professionals and hospital directors shed light on weaknesses in the Afghan health system highlighting chronic issues and issues that have deteriorated as a result of the 2021 socio-political changes. In order to improve access to care, future healthcare system reforms should consider the perspectives of Afghan professionals working in the country, who are in close contact with Afghan patients and communities.

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“…Even the war-torn countries that have published extensive neurosurgical articles are woefully inadequate, with huge disparities compared with other non-war-inflicted nations. For instance, Ammar et al 11 highlighted such disparity and scarcity of high-quality, comprehensive literature reflecting Afghanistan's neurosurgery capabilities. Only 15 articles were identified as relevant to neurosurgery and having a connection to Afghan neurosurgeons and/or patients across clinical trial sites.…”

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confidence: 99%

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

et al. 2023

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The Current State of Neurosurgery in Afghanistan

Cited by 10 publications

References 22 publications

Women Neurosurgeons Worldwide: Characterizing the Global Female Neurosurgical Workforce

Women Neurosurgeons Worldwide: Characterizing the Global Female Neurosurgical Workforce

Exploring barriers to access to care following the 2021 socio-political changes in Afghanistan: a qualitative study

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

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