Global neurosurgery

Abstract

Global neurosurgery is the clinical and public health practice of neurosurgery intended to ensure timely, safe, and affordable neurosurgical care. Each year, approximately 5 million essential neurosurgical cases go untreated, and over 23,000 more neurosurgeons are needed in low- and middle-income countries (LMICs) to address this treatment gap. This thesis explores the multifaceted challenges impeding neurosurgical care LMICs and seeks to identify opportunities for improvement. The data illustrate a need for initiatives focused on workforce development, training programs, policy formulation, and research aimed at building local capacity, improving education, establishing comprehensive health policies, and fostering research collaborations to ensure sustainable neurosurgical development.

When studying the workforce gap, this thesis specifically examines the evolving landscape of task-shifting and task-sharing. We delve into global perspectives, practices in LMICs, and specific case studies, such as emergency neurosurgery in the Philippines. We also explore the implications of task-shifting and task-sharing during the COVID-19 pandemic, where neurosurgeons were redeployed to provide care beyond their typical training scope, emphasizing the need for resilient healthcare systems that can adapt to crises. Finally, we emphasize the significance of technology, innovative training approaches, policy development and implementation, and gender equity in advancing neurosurgery care globally.