ReviewAnnals of medicine and surgery (2012)2025
Navigating neurosurgical care in low- and middle-income countries from Africa: a narrative review of barriers and facilitators.
Review in Annals of medicine and surgery (2012), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Glioma management and outcome in low-middle-income countries: a systematic review.Frontiers in oncology · 2026Pooled it
- Article
- Ethical aspects of waiting lists in neurosurgery.Acta neurochirurgica · 2026Review
- Burden of Neurological Disorders in Resource-Limited Settings: Lessons from Pakistan for Global Neurology.The Yale journal of biology and medicine · 2026Article
- Distribution of Neurosurgical Workforce and Infrastructure in Nigeria in 2024: A Cross-Sectional National Overview.Nigerian medical journal : journal of the Nigeria Medical AssociationArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Neurosurgical care is vital for conditions such as traumatic brain injury, brain tumors, and hydrocephalus. In African low- and middle-income countries (LMICs), access remains limited due to systemic and structural challenges. Despite bearing 15% of the global neurosurgical burden, the region faces a massive workforce deficit and underdeveloped infrastructure. Objective: To synthesize existing evidence on barriers impeding and facilitators improving access to neurosurgical care in African LMICs. Methods: A narrative review was conducted through a targeted search of PubMed, African Journals Online (AJOL), and Google Scholar for English-language studies published between 2014 and 2024. Studies were included if they focused on African LMICs and addressed access-related barriers or facilitators. In total, 48 studies were selected and analyzed thematically. Results: Barriers to access include an acute workforce shortage (0.15 neurosurgeons per million people), with only 32 of 54 countries offering neurosurgical training. Infrastructure deficits, such as a lack of Intensive Care Units beds, operating microscopes, and anesthesia services, compound these challenges. Financial constraints are significant, with some families in Eastern Africa paying over 130% of their annual income for surgery. Long travel distances (averaging 144 km), cultural stigma, reliance on traditional healers, and political instability further restrict access. Conversely, facilitators include successful international collaborations (e.g., Duke East Africa Neurosurgery Program, WFNS Rabat Training Centre), adoption of telemedicine and teleradiology, and growth in local research capacity, including disease registries and training exchanges. Conclusion: Transforming neurosurgical access in African LMICs demands bold investment in rural services, specialist training, and full integration into national health financing.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.