Authors: Daniel J Olivieri; William Harkness; Benjamin Warf, MD; Michael Dewan (Providence, RI)
To evaluate the presence, extent and timing of neurosurgical partnerships between countries, in order to understand the efforts of individuals, institutions and NGOs to address LMICs neurosurgical deficiencies.
A literature and web-based media review was conducted to identify surgeons, healthcare institutions, foundations, or non-profits from HICs participating in neurosurgical delivery and/or capacity building with LMICs from 2010 - 2018. Neurosurgical partnership was defined as a HIC representative supporting a LMIC actor through clinical activities, education and training, and/or research support. Descriptive data on current neurosurgical partnerships was collected from various sources: published reports, reports from academic institutions, and information on stakeholder webpages. Partnerships were classified according to the extent of ‘Training’ and ‘Engagement’ based on pre-specified criteria. Data was analyzed using descriptive statistics and geospatially depicted on ArcMap GIS software.
104 unique HIC-LIC neurosurgical partnerships were described. The geospatial data illustrated trends in partnerships, and demonstrated relative disparities in South America, the Eastern Mediterranean, and parts of South-East Asia. 71% (74/104) and 15% (16/104) of HIC partnership representation is derived from North America and Europe, respectively. The most common LMIC partners were from Africa (38%, [40/104]), South America (18%), and South-East Asia (17%). The majority of partnerships provided services in pediatric neurosurgery (88%), and a majority provided combined adult-pediatric services (65%). The most frequent “Engagement” classifications were E2 (36%), closely followed by E1 (34%). For “Training”, T1 and T2 were the most common (36%).
A robust network of HIC-LIC partnerships exists with varying degrees of engagement and training activities. Geospatial disparities suggest several regions particularly suitable for growth and development. Collaboration and information exchange between individuals, institutions, and NGOs can enhance efficiency and promote equitable resource distribution.