The Barriers to Neurosurgical Care in The Gambia.

Neurosurgery has experienced significant growth over the past century, but much of that development has been centralized in Europe and North America. Despite their high burden of neurosurgical conditions, African countries like The Gambia continue to face barriers in accessing neurosurgical care. We intend to accentuate the barriers to neurosurgical care in The Gambia, elucidate pragmatic ways of improving this issue, and highlight models of sustainable neurosurgical development that have been used in similar lower- and middle-income countries. Our study analyzed the limited literature available on The Gambia's neurosurgical capabilities, disease burden, and outcomes. The keywords "Gambia" and "Neurosurgery" were searched on PubMed, from inception to July 1, 2024. Then, a complementary search was performed on Google using the keywords "The Gambia," "Healthcare," "Neurosurgery," and "Africa." The pertinent data from our search were collected and composed into a review. Neurosurgery in The Gambia is still in its infancy. Although several domestic general surgeons and a few visiting neurosurgeons have performed neurosurgical procedures in the past, the country did not have a designated neurosurgical department until 2018. Although neurosurgical activity has ramped up in The Gambia recently, the country continues to trail behind both regionally and internationally in neurosurgical care capacity. While the shortage of a neurosurgical workforce is the core of this issue, paucity of neurosurgical research and training and the limited availability of neuroimaging also amplify this problem. Neurosurgery in The Gambia is plodding because of workforce shortage, paucity of research, and inadequate neuroimaging. Eradicating these barriers would be salient in attaining sustainable neurosurgical development. With the devotion of the local team and the philanthropic efforts of international partners, The Gambia can experience similar advances seen in other lower- and middle-income countries.