GLOBAL INEQUITY IN ACCESS TO NEUROSURGICAL TRAUMA CARE: BARRIERS AND OPPORTUNITIES talhahbinislam@gmail.com

PW03-20

GLOBAL INEQUITY IN ACCESS TO NEUROSURGICAL TRAUMA CARE: BARRIERS AND OPPORTUNITIES

1

United Kingdom

Oral only

Traumatic brain injury (TBI) drives time-critical neurosurgical demand, with 27.16 million new cases in 2019. Access in many LMICs is constrained by an uneven workforce (~73,000 neurosurgeons globally; density often <1/100,000) and diagnostic scarcity (typically <1 CT per million in LMICs vs ~40 in HICs). This study will quantify the neurotrauma access gap and identify system levers, aligned to the Lancet Commission’s 2-hour essential surgery target.

Mixed-methods health-systems analysis: (1) structured scoping review; (2) secondary synthesis of GBD burden, WFNS/JNS workforce, and radiology capacity datasets; and (3) geospatial modelling of 2-hour access to neurosurgical-capable facilities using population rasters and road networks. Eligibility: studies since 2010 reporting LMIC neurotrauma capacity, referrals, transfer times, or outcomes. Outcomes: access coverage, workforce and CT densities, and qualitative bottleneck themes.

Planned outputs: regional estimates of population within 2 hours of neurosurgical-capable care by income group; associations between workforce/CT density and access or case-fatality; and a barriers framework spanning workforce, diagnostics, referral/prehospital, ICU, and financing. Scenario analyses will estimate the marginal impact of adding CT at first-referral hospitals, strengthening transfer networks, and expanding trainee pipelines.

Large, remediable inequities in neurotrauma care are anticipated. Policy-ready levers include targeted workforce growth, diffusion of basic imaging, and strengthened prehospital and referral systems. The analysis aims to provide actionable targets for national surgical plans to reduce preventable TBI mortality and disability.