Claire Karekezi1, Abdeslam El Khamlichi2, Abdessamad El Ouahabi3, Najia El Abbadi4, Semevo Alidegnon Ahokpossi5, Kodjo Mensah Hobli Ahanogbe6, Ibrahima Berete7, Soueilem Mohamed Bouya8, Oumar Coulibaly9, Ibrahim Dao10, Ben Ousmanou Djoubairou11, Agbeko Achille Komlan Doleagbenou6, Komi Prosper Egu12, Hugues Brieux Ekouele Mbaki13, Sinclair Brice Kinata-Bambino13, Laminou Mahamane Habibou14, Adio Nabil Mousse15, Trésor Ngamasata16, Jeff Ntalaja17, Justin Onen18, Kisito Quenum19, Diawara Seylan7, Youssouf Sogoba20, Franco Servadei21, Isabelle M Germano22. 1. 1Department of Neurosurgery, Rwanda Military Hospital, Kigali, Rwanda. 2. 2National Center for Rehabilitation and Neurosciences, Hôpital des Spécialités de Rabat. 3. 3Department of Neurosurgery, Hôpital des Spécialités ONO, Rabat Medical School. 4. 4Department of Neurosurgery, Cheikh Zaid International Hospital, Abulcasis International University of Health Sciences, Rabat, Morocco. 5. 5Neurosurgery Department, Hôpital Bethesda, Cotonou, Benin Republic. 6. 6Neurosurgery Department, CHU Sylvanus Olympio, University of Lome, Republic of Togo. 7. 7Department of Neurosurgery, Medical School at University Gamal Abdel Nasser of Conakry, Guinea. 8. 8Department of Neurosurgery, Military Hospital of Nouakchott, Mauritania. 9. 9Department of Neurosurgery, Hôpital du Mali, Bamako, Mali. 10. 10Department of Neurosurgery, University Hospital Yalgafo Ouedraogo and Military Camp General Sangoule Lamizana, University Nazi Boni, Bobo-Dioulasso, Burkina Faso. 11. 11Department of Neurosurgery, Military Hospital of Yaoundé, Cameroon. 12. 12Polyclinique Saint Joseph, Lome, Republic of Togo. 13. 13Division of Neurosurgery, University Hospital Center of Brazzaville, Marien Ngouabi University, Brazzaville, Republic of Congo. 14. 14General Reference Hospital of Niamey, Niger. 15. 15Clinique Mahouena, Cotonou, Benin Republic. 16. 16Hopital General Provincial de Kinshasa. 17. 17Hopital Ngaliema, Kinshasa, Democratic Republic of Congo. 18. 18CURE Children's Hospital of Uganda, Mbale, Uganda. 19. 19Neurosurgery Department of Parakou University, Parakou, Benin Republic. 20. 20Gabriel Toure Teaching Hospital, Bamako, Mali. 21. 21Department of Neurosurgery, Humanitas Clinical and Research Hospital and Humanitas University, Milan, Italy; and. 22. 22Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, New York.
Abstract
OBJECTIVE: Sub-Saharan Africa (SSA) represents 17% of the world's land, 14% of the population, and 1% of the gross domestic product. Previous reports have indicated that 81/500 African neurosurgeons (16.2%) worked in SSA-i.e., 1 neurosurgeon per 6 million inhabitants. Over the past decades, efforts have been made to improve neurosurgery availability in SSA. In this study, the authors provide an update by means of the polling of neurosurgeons who trained in North Africa and went back to practice in SSA. METHODS: Neurosurgeons who had full training at the World Federation of Neurosurgical Societies (WFNS) Rabat Training Center (RTC) over the past 16 years were polled with an 18-question survey focused on demographics, practice/case types, and operating room equipment availability. RESULTS: Data collected from all 21 (100%) WFNS RTC graduates showed that all neurosurgeons returned to work to SSA in 12 different countries, 90% working in low-income and 10% in lower-middle-income countries, defined by the World Bank as a Gross National Income per capita of ≤ US$995 and US$996-$3895, respectively. The cumulative population in the geographical areas in which they practice is 267 million, with a total of 102 neurosurgeons reported, resulting in 1 neurosurgeon per 2.62 million inhabitants. Upon return to SSA, WFNS RTC graduates were employed in public/private hospitals (62%), military hospitals (14.3%), academic centers (14.3%), and private practice (9.5%). The majority reported an even split between spine and cranial and between trauma and elective; 71% performed between 50 and more than 100 neurosurgical procedures/year. Equipment available varied across the cohort. A CT scanner was available to 86%, MRI to 38%, surgical microscope to 33%, endoscope to 19.1%, and neuronavigation to 0%. Three (14.3%) neurosurgeons had access to none of the above. CONCLUSIONS: Neurosurgery availability in SSA has significantly improved over the past decade thanks to the dedication of senior African neurosurgeons, organizations, and volunteers who believed in forming the new neurosurgery generation in the same continent where they practice. Challenges include limited resources and the need to continue expanding efforts in local neurosurgery training and continuing medical education. Focus on affordable and low-maintenance technology is needed.
OBJECTIVE: Sub-Saharan Africa (SSA) represents 17% of the world's land, 14% of the population, and 1% of the gross domestic product. Previous reports have indicated that 81/500 African neurosurgeons (16.2%) worked in SSA-i.e., 1 neurosurgeon per 6 million inhabitants. Over the past decades, efforts have been made to improve neurosurgery availability in SSA. In this study, the authors provide an update by means of the polling of neurosurgeons who trained in North Africa and went back to practice in SSA. METHODS: Neurosurgeons who had full training at the World Federation of Neurosurgical Societies (WFNS) Rabat Training Center (RTC) over the past 16 years were polled with an 18-question survey focused on demographics, practice/case types, and operating room equipment availability. RESULTS: Data collected from all 21 (100%) WFNS RTC graduates showed that all neurosurgeons returned to work to SSA in 12 different countries, 90% working in low-income and 10% in lower-middle-income countries, defined by the World Bank as a Gross National Income per capita of ≤ US$995 and US$996-$3895, respectively. The cumulative population in the geographical areas in which they practice is 267 million, with a total of 102 neurosurgeons reported, resulting in 1 neurosurgeon per 2.62 million inhabitants. Upon return to SSA, WFNS RTC graduates were employed in public/private hospitals (62%), military hospitals (14.3%), academic centers (14.3%), and private practice (9.5%). The majority reported an even split between spine and cranial and between trauma and elective; 71% performed between 50 and more than 100 neurosurgical procedures/year. Equipment available varied across the cohort. A CT scanner was available to 86%, MRI to 38%, surgical microscope to 33%, endoscope to 19.1%, and neuronavigation to 0%. Three (14.3%) neurosurgeons had access to none of the above. CONCLUSIONS: Neurosurgery availability in SSA has significantly improved over the past decade thanks to the dedication of senior African neurosurgeons, organizations, and volunteers who believed in forming the new neurosurgery generation in the same continent where they practice. Challenges include limited resources and the need to continue expanding efforts in local neurosurgery training and continuing medical education. Focus on affordable and low-maintenance technology is needed.
Entities:
Keywords:
CME = continuing medical education; DRC = Democratic Republic of Congo; GNI = Gross National Income; LMIC; LMIC = low- and middle-income countries; RTC = Rabat Training Center; SSA = sub-Saharan Africa; WFNS = World Federation of Neurosurgical Societies; global neurosurgery; low- and middle-income countries; neurosurgery training; sub-Saharan Africa
Authors: Jose A Canseco; Gregory D Schroeder; Parthik D Patel; Giovanni Grasso; Michael Chang; Frank Kandziora; Emiliano N Vialle; F Cumhur Oner; Klaus J Schnake; Marcel F Dvorak; Jens R Chapman; Lorin M Benneker; Shanmuganathan Rajasekaran; Christopher K Kepler; Alexander R Vaccaro Journal: Eur Spine J Date: 2020-07-22 Impact factor: 3.134
Authors: Dawin Sichimba; Soham Bandyopadhyay; Ana Catinca Ciuculete; Joshua Erhabor; Jay Kotecha; Abdullah Egiz; Nourou Dine Adeniran Bankole; George Higginbotham; David Ulrich Dalle; Ulrick Sidney Kanmounye Journal: Front Surg Date: 2022-01-20