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ArticleNeurosurgical review2025

Assessment of neurosurgical workforce, infrastructure, and service delivery capacity in East Africa: A collaborative survey.

Alvan-Emeka K Ukachukwu, Andreas Seas, Veronica Brtek, Beverly Cheserem, Claire Karekezi, Sylvia V Shitsama, James Lubuulwa, Philip M Mwachaka, Arsene Daniel Nyalundja, JosephMary Ssembatya and 11 more

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Article in Neurosurgical review, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors.

Alvan-Emeka K UkachukwuDepartment of Neurosurgery, Duke University Health System, Durham, NC, USA. alvan.ukachukwu@duke.edu.
Andreas SeasDuke University School of Medicine, Durham, NC, USA.
Veronica BrtekDuke Global Neurosurgery and Neurology, Department of Neurosurgery Durham, Duke University, Durham, NC, 27710, USA.
Beverly CheseremDepartment of Neurosurgery, Aga Khan University Hospital, Nairobi, Kenya.
Claire KarekeziDepartment of Surgery, Neurosurgery Unit, Rwanda Military Referral and Teaching Hospital, University of Rwanda, Kigali, Rwanda.
Sylvia V ShitsamaDepartment of Surgery, Neurosurgery Unit, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya.
James LubuulwaDepartment of Surgery, Bugando Medical Center, Mwanza, Tanzania.
Philip M MwachakaDepartment of Surgery, University of Nairobi, Nairobi, Kenya.
Arsene Daniel NyalundjaDuke Global Neurosurgery and Neurology, Department of Neurosurgery Durham, Duke University, Durham, NC, 27710, USA.
JosephMary SsembatyaDepartment of Surgery, Mbarara Regional Referral Hospital, Mbarara, Uganda.
Paris S BrownDepartment of Biomedical Engineering, Duke University, Durham, NC, USA.
Abigael N MbalukaWashington State University Elson S Floyd College of Medicine, Spokane, WA, USA.
Amogh R RaoUniversity of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Paula N NjeruDepartment of Neurosurgery, Duke University Health System, Durham, NC, USA.
Jein E SeoDuke University School of Medicine, Durham, NC, USA.
Zoey PetittDuke University School of Medicine, Durham, NC, USA.
Neal DalalDuke Global Neurosurgery and Neurology, Department of Neurosurgery Durham, Duke University, Durham, NC, 27710, USA.
Nancy A Abu-BonsrahDepartment of Neurosurgery, Johns Hopkins University, Baltimore, MD, USA.
Anthony T FullerDuke Global Neurosurgery and Neurology, Department of Neurosurgery Durham, Duke University, Durham, NC, 27710, USA.
Michael M HaglundDepartment of Neurosurgery, Duke University Health System, Durham, NC, USA.
DGNN-Africa Neurosurgery Workforce Working Group Collaborators

Funding

Medical Scientist Training Program Training GrantT32GM145449 · NIGMS · DUKE UNIVERSITY · PI Christopher D Kontos · 2022 to 2026
$6.6M
NIGMS NIH HHS T32 GM145449
6 · The paper itself

Abstract

Workforce development in healthcare is critical, especially in resource-limited regions such as East Africa, where a scarcity of neurosurgeons hinders patient care. This study aims to analyze neurosurgical workforce trends in Kenya, Rwanda, Tanzania, and Uganda over two decades, informing strategies for capacity enhancement. An online survey targeting neurosurgical institutions across the four countries was conducted, focusing on consultants, residents, and general practitioners for the target population. Traumatic brain injury (TBI) served as a proxy for neurosurgical conditions. Data on workforce and training, infrastructure and equipment, and service delivery were collected from April to July 2023, with thirty-two responses analyzed. Descriptive analysis facilitated comparisons across institutions and countries. Among the thirty-two respondents, data trends varied significantly by institution. There was an observed increase in the number of neurosurgeons and consultant positions across hospitals. However, infrastructure disparities persisted, affecting equipment access, with some institutions experiencing consistent equipment availability while others faced severe shortages. Service delivery assessments revealed a rising trend in neurosurgical consultations, cases, and procedures over the past two decades. The prevalence of TBI was high across hospitals, with notable variation in arrival times post-injury. Despite increased medical training and the number of neurosurgeons across countries over the past 20 years, infrastructure deficits persist within each neurosurgical center. Uneven workforce distribution emphasizes the importance of targeted interventions, while collaborations between local and international stakeholders are crucial to address infrastructure disparities and optimize resource allocation. Further research is essential to guide effective interventions and policy development. Clinical trial number. Not applicable.

Indexed as

Delivery of Health CareHealth WorkforceNeurosurgeonsNeurosurgeryNeurosurgical ProceduresAfrica, EasternBrain Injuries, TraumaticHumansKenyaRwandaSurveys and QuestionnairesTanzaniaEast AfricaInfrastructureNeurosurgeryServiceWorkforce

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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.