The Growth of Neurosurgery in East Africa: Challenges.

Publication Type	Review
Authors	Santos M, Qureshi M, Budohoski K, Mangat H, Ngerageza J, Schöller K, Shabani H, Zubkov M, Härtl R
Journal	World Neurosurg
Volume	113
Pagination	425-435
Date Published	05/01/2018
ISSN	1878-8769
Keywords	Cost of Illness, Developing Countries, Health Workforce, Neurosurgeons, Neurosurgery
Abstract	As the second of 3 articles in this series, the aim of this article is to provide readers with an understanding of the development of neurosurgery in East Africa (foundations), the challenges that arise in providing neurosurgical care in developing countries (challenges), and an overview of traditional and novel approaches to overcoming these challenges and improving health care in the region (innovations). Recognizing the challenges that need to be addressed is the first step to implementing efficient and qualified surgery delivery systems in low- and middle-income countries. We reviewed the major challenges facing health care in East Africa and grouped them into 5 categories: 1) burden of surgical disease and workforce crisis; 2) global health view of surgery as "the neglected stepchild"; 3) need for recognizing the surgical system as an interdependent network and importance of organizational and equipment deficits; 4) lack of education in the community, failure of primary care systems, and net result of overwhelming tertiary care systems; 5) personal and professional burnout as well as brain drain of promising human resources from low- and middle-income countries in East Africa and similar regions across the world. Each major challenge was detailed and analyzed by authors who have worked or are currently working in the region, providing a personal perspective.
DOI	10.1016/j.wneu.2018.01.084
PubMed ID	29702966