NAVIGATING NEUROSURGICAL CARE IN LOW- AND MIDDLE-INCOME COUNTRIES FROM AFRICA: UNVEILING BARRIERS AND STRENGHTENING FACILITATORS alexmwangi663@students.uonbi.ac.ke

 

NAVIGATING NEUROSURGICAL CARE IN LOW- AND MIDDLE-INCOME COUNTRIES FROM AFRICA: UNVEILING BARRIERS AND STRENGHTENING FACILITATORS

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Kenya

Oral or Poster

Neurosurgical care is essential for managing conditions such as traumatic brain injury, brain tumors, and infections of the nervous system. The demand for neurosurgical services in Africa is high, requiring a 1700% increase in the healthcare workforce to meet patient needs.

A targeted literature search was conducted in PubMed and Google Scholar to identify studies on barriers and facilitators affecting neurosurgical care in LMICs across Africa. Studies were included if they focused on Africa, were published in English between 2014 and 2024, and addressed neurosurgical care access. Exclusion criteria included studies conducted in high-income countries, non-English publications, and non-peer-reviewed content. A total of 34 articles met the eligibility criteria and were analyzed thematically.

Access to neurosurgical care in African LMICs is hindered by a severe shortage of neurosurgeons, with a workforce density of 0.15 neurosurgeons per million people. Limited access to education and training, available in only 32 countries. Infrastructure deficiencies, such as the lack of operating microscopes, financial barriers where patients spend up to 132% of their annual income on treatment, and geographic inaccessibility, with patients traveling an average of 144 km for care, further restrict access. Sociocultural factors, including brain tumor-related stigma, also pose challenges. However, facilitators such as telemedicine, international collaborations like the Duke East Africa Neurosurgery Project, and efforts to foster research have shown potential to improve access

Despite significant barriers, strengthening existing resources and implementing multisectoral approaches from the public and private sectors could enhance neurosurgical care accessibility in African LMICs.