Elie Sader1, Philip Yee1, Mojgan Hodaie2. 1. Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. 2. Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Division of Neurosurgery, Toronto Western Hospital, Toronto, Ontario, Canada. Electronic address: mojgan.hodaie@uhn.ca.
Abstract
BACKGROUND: Quantitative estimates of surgical capacity and infrastructure and perceived care limitations in low-resource countries are essential baseline measures that can provide strategies for improving access to surgical care. Information about these barriers in Africa is scarce, particularly with respect to neurosurgery. We conducted a survey to better understand the unmet surgical need and resources available for the care of neurosurgery patients in Sub-Saharan Africa. METHODS: Using SurveyMonkey, we administered a neurosurgery-specific survey to neurosurgery attending surgeons and residents in Sub-Saharan African countries. Key outcome measures included workforce, access to imaging modalities and instruments, volume and breakdown of neurosurgical cases, and perceived limitations of care. RESULTS: We obtained a 41% survey response (129/314 sent). In addition to the expected large gap in workforce between low- and high-income countries, we found a dramatic paucity of neurosurgical resources in Central Africa, whereas specific pockets in West and South Africa have better neurosurgical care. Access to neuroimaging was not a major limitation in Sub-Saharan African countries. The most commonly perceived limitations of care included infrastructure, anesthesia/nursing availability, wait times, and strength of training. CONCLUSIONS: This large survey defines important self-perceived limitations to care within neurosurgery and highlights the importance of infrastructure and allied professions in this role. A clear understanding of areas of focus will enable a more efficient and sustainable response to the limitations in surgical care in low-resource areas.
BACKGROUND: Quantitative estimates of surgical capacity and infrastructure and perceived care limitations in low-resource countries are essential baseline measures that can provide strategies for improving access to surgical care. Information about these barriers in Africa is scarce, particularly with respect to neurosurgery. We conducted a survey to better understand the unmet surgical need and resources available for the care of neurosurgery patients in Sub-Saharan Africa. METHODS: Using SurveyMonkey, we administered a neurosurgery-specific survey to neurosurgery attending surgeons and residents in Sub-Saharan African countries. Key outcome measures included workforce, access to imaging modalities and instruments, volume and breakdown of neurosurgical cases, and perceived limitations of care. RESULTS: We obtained a 41% survey response (129/314 sent). In addition to the expected large gap in workforce between low- and high-income countries, we found a dramatic paucity of neurosurgical resources in Central Africa, whereas specific pockets in West and South Africa have better neurosurgical care. Access to neuroimaging was not a major limitation in Sub-Saharan African countries. The most commonly perceived limitations of care included infrastructure, anesthesia/nursing availability, wait times, and strength of training. CONCLUSIONS: This large survey defines important self-perceived limitations to care within neurosurgery and highlights the importance of infrastructure and allied professions in this role. A clear understanding of areas of focus will enable a more efficient and sustainable response to the limitations in surgical care in low-resource areas.
Authors: Faizal A Haji; Jacob R Lepard; Matthew C Davis; Nguyen Duc Lien; Dang Do Thanh Can; Cao Vu Hung; Le Nam Thang; Brandon G Rocque; James M Johnston Journal: Childs Nerv Syst Date: 2020-07-27 Impact factor: 1.475
Authors: Keng Siang Lee; John J Y Zhang; Vincent Nguyen; Julian Han; Jeremiah N Johnson; Ramez Kirollos; Mario Teo Journal: Neurosurg Rev Date: 2021-04-23 Impact factor: 2.800