A Geospatial Analysis of the Availability, Distribution, and Accessibility of Neurosurgical Facilities, Workforce, and Infrastructure in Nigeria; and Projection Towards 2050.

Autor: Ukachukwu AK; Division of Global Neurosurgery and Neurology, Duke University, Durham, NC, USA; Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA. Electronic address: alvan.ukachukwu@duke.edu., Njeru PN; Division of Global Neurosurgery and Neurology, Duke University, Durham, NC, USA; Global Health Institute, Duke University, Durham, NC, USA., Ayodele OA; Department of Surgery, Lagos State University Teaching Hospital, Lagos, Nigeria., Ahmad MH; Department of Surgery, Aminu Kano Teaching Hospital, Kano, Nigeria., Onyia CU; Department of Surgery, Lagoon Hospitals, Lagos, Nigeria., Morgan E; Department of Surgery, Babcock University Teaching Hospital, Ilishan Remo, Nigeria., Ekweogwu OC; Department of Surgery, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria., Usman B; Department of Surgery, University of Maiduguri Teaching Hospital, Maiduguri, Nigeria., Badejo OA; Department of Neurosurgery, University College Hospital, Ibadan, Nigeria., Dawang Y; Department of Surgery, University of Abuja Teaching Hospital, Abuja, Nigeria., Orhorhoro OI; Department of Surgery, Delta State University Teaching Hospital, Oghara, Nigeria., Oyemolade TA; Department of Surgery, Federal Medical Center, Owo, Nigeria., Okere OE; Department of Neurosurgery, University College Hospital, Ibadan, Nigeria., Abu-Bonsrah N; Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA., Petitt Z; Division of Global Neurosurgery and Neurology, Duke University, Durham, NC, USA; Global Health Institute, Duke University, Durham, NC, USA; School of Medicine, Duke University, Durham, NC, USA., Oboh EC; Division of Global Neurosurgery and Neurology, Duke University, Durham, NC, USA., Otun A; School of Medicine, Washington University, St. Louis, MO, USA., Nischal SA; Division of Global Neurosurgery and Neurology, Duke University, Durham, NC, USA; School of Clinical Medicine, University of Cambridge, Cambridge, UK., Deng DD; Division of Global Neurosurgery and Neurology, Duke University, Durham, NC, USA., Mahmud MR; Department of Surgery, National Hospital, Abuja, Nigeria., Mezue WC; Department of Surgery, University of Nigeria Teaching Hospital, Enugu, Nigeria., Malomo AO; Department of Neurosurgery, University College Hospital, Ibadan, Nigeria., Shehu BB; Regional Center for Neurosurgery, Usman DanFodio University Teaching Hospital, Sokoto, Nigeria., Shokunbi MT; Department of Neurosurgery, University College Hospital, Ibadan, Nigeria., Ohaegbulam SC; Memfys Hospital for Neurosurgery, Enugu, Nigeria., Fuller AT; Division of Global Neurosurgery and Neurology, Duke University, Durham, NC, USA; Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA; Global Health Institute, Duke University, Durham, NC, USA., Haglund MM; Division of Global Neurosurgery and Neurology, Duke University, Durham, NC, USA; Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA; Global Health Institute, Duke University, Durham, NC, USA., Chikani MC; Department of Surgery, University of Nigeria Teaching Hospital, Enugu, Nigeria., Adeolu AA; Department of Neurosurgery, University College Hospital, Ibadan, Nigeria., Adeleye AO; Department of Neurosurgery, University College Hospital, Ibadan, Nigeria.
Jazyk: angličtina
Zdroj: World neurosurgery [World Neurosurg] 2024 May; Vol. 185, pp. e16-e29.
DOI: 10.1016/j.wneu.2023.10.146
Abstrakt: Objective: There has been a modest but progressive increase in the neurosurgical workforce, training, and service delivery in Nigeria in the last 2 decades. However, these resources are unevenly distributed. This study aimed to quantitatively assess the availability and distribution of neurosurgical resources in Nigeria while projecting the needed workforce capacity up to 2050.
Methods: An online survey of Nigerian neurosurgeons and residents assessed the country's neurosurgical infrastructure, workforce, and resources. The results were analyzed descriptively, and geospatial analysis was used to map their distribution. A projection model was fitted to predict workforce targets for 2022-2050.
Results: Out of 86 neurosurgery-capable health facilities, 65.1% were public hospitals, with only 17.4% accredited for residency training. Dedicated hospital beds and operating rooms for neurosurgery make up only 4.0% and 15.4% of the total, respectively. The population disease burden is estimated at 50.2 per 100,000, while the operative coverage was 153.2 cases per neurosurgeon. There are currently 132 neurosurgeons and 114 neurosurgery residents for a population of 218 million (ratio 1:1.65 million). There is an annual growth rate of 8.3%, resulting in a projected deficit of 1113 neurosurgeons by 2030 and 1104 by 2050. Timely access to neurosurgical care ranges from 21.6% to 86.7% of the population within different timeframes.
Conclusions: Collaborative interventions are needed to address gaps in Nigeria's neurosurgical capacity. Investments in training, infrastructure, and funding are necessary for sustainable development and optimized outcomes.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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