Global neurosurgery

Last updated

Global neurosurgery is a field at the intersection of public health and clinical neurosurgery. It aims to expand provision of improved and equitable neurosurgical care globally. [1]

Contents

Definition and history

Global neurosurgery is "the clinical and public health practice of neurosurgery with the primary purpose of ensuring timely, safe, and affordable neurosurgical care to all who need it." [2] The term global neurosurgery was first used in 1995 by Canadian neurosurgeon Dwight Parkinson to describe comprehensive clinical neurosurgery care in Manitoba; [3] however, the field as defined today was born in the mid-2010s. [4] The modern definition of global neurosurgery was born from a combination of global health and neurosurgery. Hence, global neurosurgery is conceived as a subspecialty of global health within global surgery. [2] [5]

Burden of diseases amenable to neurosurgery

Around 22.6 million people are affected by diseases amenable to neurosurgery each year, and 13.8 million require surgical intervention. [6] The burden of diseases amenable to neurosurgery is disproportionately distributed globally, with low- and middle-income countries bearing more than 78.1% of cases. [6] Low- and middle-income countries lack the workforce, infrastructure, funding, and data needed to address the disease burden. [6] [7] [8] [9] [10] High-income country patients, especially in rural areas and from economically-disadvantaged backgrounds, face unique challenges in accessing safe, timely, and affordable neurosurgical care. [11] For this reason, most global neurosurgery work has focused on access to care in low- and middle-incomce countries despite the global nature of disparities in accessing neurosurgical care. [12]

Practice

Global neurosurgery practice involves advocacy, education, policy, research, and service delivery. [2] The components of global neurosurgery practice are interdependent but global neurosurgeons tend to focus their practice on one or two of them. This trend has allowed for specialization within the field and greater collaboration between individuals and institutions. [12]

Advocacy

Advocacy efforts happen at the international, regional, and local levels and in collaboration with health initiatives that share similar goals with global neurosurgery - universal health coverage and sustainable development. Internationally, global neurosurgery advocacy groups participate in high-level health policy events like the World Health Assembly and the United Nations General Assembly. [13] Global neurosurgery advocates have contributed to numerous high-level decisions including folate fortification, detection and management of congenital malformations, and injury prevention. [13] [14] Locally, global neurosurgery advocacy groups are constituted of health workers and other patient advocates. These groups affect local decision making but they are equally active internationally. Many local advocacy groups are members of international advocacy groups like the G4 Alliance, [15] [14] People and Organisations United for Spina Bifida and Hydrocephalus (PUSH!) Global Alliance, [16] and International Federation Spina Bifida and Hydrocephalus (IFSBH). [17] Local global neurosurgery advocacy groups work within these international organizations to coordinate advocacy efforts regionally and globally.

Education

Global neurosurgery education focuses on two aspects. First, global neurosurgery educators train specialists to serve under-resourced regions. The training focuses primarily on safe and quality service delivery within underserved communities. These global neurosurgery education efforts can be divided into non-specialized and specialized training. Non-specialized training or education for task-sharing/-shifting targets non-specialized healthcare workers such as general surgeons, clinical officers, and general practitioners. [18] [19] Non-specialized training is especially important in increasing access to essential and emergency neurosurgical care rapidly. [20] Non-specialized training, unlike specialized training, can be done in shorter periods, with larger cohorts, and with fewer resources. [19] Specialized neurosurgery training can last anywhere from a few months to 8 years depending on the training level. [21] Postgraduate medical fellowships in one of the neurosurgical subspecialties are open to graduate neurosurgery residents/registrars and can last between three and 24 months. On the other hand, neurosurgery residencies last between 4 and 8 years. [22]

The other focus of global neurosurgery education is fellowships that introduce trainees to global and public health concepts. Global neurosurgery fellowships are relatively new but increasingly popular with institutions like Cambridge, [23] Cornell, [24] Duke, [25] Harvard, [26] and the University of Cape Town [27] offering specialized training. [28]

Policy

Global neurosurgeons contribute significantly to the design and implementation of health policies that improve access to safe, timely, and affordable neurosurgical care globally. Prime examples of global neurosurgery policy efforts include the comprehensive health policy guidelines for traumatic brain and spine injuries [29] [30] and for spina bifida and hydrocephalus. [31] The comprehensive policy guidelines address challenges that affect the patient continuum of care and suggest solutions for every component of the healthcare system. [29] [30] [31] These documents were designed for policymakers in areas with a large burden of diseases amenable to neurosurgery. Traumatic brain and spine injuries were chosen because they constitute more than 47.1% of the global neurosurgical disease burden while hydrocephalus and spina bifida were chosen for their deleterious impact on children. [6]

Research

Research is an indispensable aspect of global neurosurgery practice called academic global neurosurgery. [2] Academic global neurosurgery has a broad focus and uses concepts from epidemiology, health economics, health policy, health services, health systems, implementation & dissemination science, and patient safety & quality improvement research. [2] Academic global neurosurgery's exponential growth since 2016 is the result of increased interest and support from the neurosurgical community characterized by the creation of an ad-hoc committee within the World Federation of Neurosurgical Societies, [32] publication of special issues in reputable peer-reviewed journals, [33] [34] creation of a specialized journal, [35] and the creation of global neurosurgery centers. [12] Academic global neurosurgery identifies challenges to accessing neurosurgical care and proposes solutions that increase access to care. [12] The evidence generated by academic global neurosurgery informs the other aspects of global neurosurgery practice.

Service delivery

Service delivery is the oldest component of global neurosurgery practice and can be traced back to the colonial era when surgeons would deliver care in colonies. [21] [36] Global neurosurgery aims to reduce barriers to essential and emergency neurosurgery procedures such as those needed for acute stroke, neural tube defects, traumatic brain injuries, and traumatic spine injuries. [37] [38]

Low- and middle-income country patients have worse outcomes than their high-income country counterparts because they regularly face barriers to accessing timely and safe neurosurgical care. [39] [40] [10]

The workforce deficit in low- and middle-income countries constitutes a significant barrier to receiving care. Although former colonies have trained local neurosurgeons since their independence, the neurosurgical workforce density in many low- and middle-income countries remains below the World Federation of Neurosurgical Societies' recommendation of 1 neurosurgeon per 200,000 people. [41] In addition, the majority of low- and middle income countries have geographical disparities in the neurosurgical workforce with most neurosurgeons working in urban areas whereas the majority of people in these countries are rural-dwellers. [19] In addition, surgical non-governmental organizations from high-income countries help fill the service delivery gap in some low- and middle-income countries. [42] Although most neurosurgical non-governmental organizations offer short-term service delivery in low- and middle-income countries, some like CURE International offer long-term care. [43]

The neurosurgical workforce in low- and middle-income countries has increased gradually in the past decade thanks to targeted efforts from the global neurosurgery community. For example, the World Federation of Neurosurgical Societies supports the training of aspiring neurosurgeons from understaffed countries through scholarships at accredited centers in Africa, Asia, and South America. [44] [45] [46] [21] [47]

Young neurosurgeons from under-resourced regions who have been trained in advanced neurosurgical techniques report their patients do not get safe and timely care because of inadequate infrastructure. [19] Access to neurosurgical infrastructure can be assessed summarily using the World Federation of Neurosurgical Societies facility three-tier classification or using hospital assessment tools. [48] The World Federation of Neurosurgical Societies facility three-tier classification groups facilities into level 1 (equipment for emergency neurosurgery procedures), level 2 (equipment to perform basic microneurosurgical procedures), and level 3 (equipment for complex and advanced neurosurgery).

Related Research Articles

<span class="mw-page-title-main">Neurosurgery</span> Medical specialty of disorders which affect any portion of the nervous system

Neurosurgery or neurological surgery, known in common parlance as brain surgery, is the medical specialty concerned with the surgical treatment of disorders which affect any portion of the nervous system including the brain, spinal cord and peripheral nervous system.

Psychosurgery, also called neurosurgery for mental disorder (NMD), is the neurosurgical treatment of mental disorder. Psychosurgery has always been a controversial medical field. The modern history of psychosurgery begins in the 1880s under the Swiss psychiatrist Gottlieb Burckhardt. The first significant foray into psychosurgery in the 20th century was conducted by the Portuguese neurologist Egas Moniz who during the mid-1930s developed the operation known as leucotomy. The practice was enthusiastically taken up in the United States by the neuropsychiatrist Walter Freeman and the neurosurgeon James W. Watts who devised what became the standard prefrontal procedure and named their operative technique lobotomy, although the operation was called leucotomy in the United Kingdom. In spite of the award of the Nobel prize to Moniz in 1949, the use of psychosurgery declined during the 1950s. By the 1970s the standard Freeman-Watts type of operation was very rare, but other forms of psychosurgery, although used on a much smaller scale, survived. Some countries have abandoned psychosurgery altogether; in others, for example the US and the UK, it is only used in a few centres on small numbers of people with depression or obsessive-compulsive disorder (OCD). In some countries it is also used in the treatment of schizophrenia and other disorders.

<span class="mw-page-title-main">Global health</span> Health of populations in a global context

Global health is the health of the populations in the worldwide context; it has been defined as "the area of study, research, and practice that places a priority on improving health and achieving equity in health for all people worldwide". Problems that transcend national borders or have a global political and economic impact are often emphasized. Thus, global health is about worldwide health improvement, reduction of disparities, and protection against global threats that disregard national borders, including the most common causes of human death and years of life lost from a global perspective.

<span class="mw-page-title-main">Majid Samii</span> Iranian neurosurgeon (born 1937)

Majid Samii is an Iranian neurosurgeon and medical scientist.

Endoscopic third ventriculostomy (ETV) is a surgical procedure for treatment of hydrocephalus in which an opening is created in the floor of the third ventricle using an endoscope placed within the ventricular system through a burr hole. This allows the cerebrospinal fluid to flow directly to the basal cisterns, bypassing the obstruction. Specifically, the opening is created in the translucent tuber cinereum on the third ventricular floor.

Neurosurgical anesthesiology, neuroanesthesiology, or neurological anesthesiology is a subspecialty of anesthesiology devoted to the total perioperative care of patients before, during, and after neurological surgeries, including surgeries of the central (CNS) and peripheral nervous systems (PNS). The field has undergone extensive development since the 1960s correlating with the ability to measure intracranial pressure (ICP), cerebral blood flow (CBF), and cerebral metabolic rate (CMR).

<span class="mw-page-title-main">Nicholas Theodore</span> American neurosurgeon

Nicholas Theodore is an American neurosurgeon and researcher at Johns Hopkins University School of Medicine. He is known for his work in spinal trauma, minimally invasive surgery, robotics, and personalized medicine. He is Director of the Neurosurgical Spine Program at Johns Hopkins and Co-Director of the Carnegie Center for Surgical Innovation at Johns Hopkins.

<span class="mw-page-title-main">Ivar Mendez</span> Canadian neurosurgeon and neuroscientist

Ivar Mendez is a neurosurgeon, neuroscientist and Professor of Surgery at the University of Saskatchewan. He is internationally known for his work in cell transplantation for Parkinson's disease and the use of remote presence robotics in neurosurgery and primary health care. In December 2022, Mendez was appointed an officer of the Order of Canada for his pioneering work in the use of remote telemedicine and robotics to revolutionize the delivery of health and patient care.

Albert Loren Rhoton Jr., was an American neurosurgeon and a professor specializing in microsurgical neuroanatomy. He developed and introduced a number of microsurgical techniques that improved the safety and effectiveness of neurosurgery, including the use of the surgical microscope in neurosurgery. He also designed many of the commonly used of microneurosurgical instruments, which bear his name. Such tools in use worldwide include the Rhoton Micro Dissectors designed for delicate work in the treatment of brain aneurysms and tumor resection.

<span class="mw-page-title-main">Aaron Cohen-Gadol</span> American neurosurgeon

Aaron A. Cohen-Gadol is a professor of neurological surgery in the department of neurosurgery at Indiana University School of Medicine and a neurosurgeon at Indiana University Health specializing in the surgical treatment of complex brain tumors, vascular malformations, cavernous malformations, etc. He performs removal of brain tumors via minimally invasive endoscopic techniques, which use the nasal pathways instead of opening the skull.

The Dextroscope is a medical equipment system that creates a virtual reality (VR) environment in which surgeons can plan neurosurgical and other surgical procedures.

Kathryn Ann Kelly "Kelly" McQueen is an American anesthesiologist and global health expert. She currently practices anesthesiology at the UW Health University Hospital in Madison, Wisconsin and serves as the chair for the Department of Anesthesiology at the University of Wisconsin School of Medicine and Public health.

Yoko Kato is a Japanese neurosurgeon. She is professor and chair of the Department of Neurosurgery at Fujita Health University. She was the first woman in Japan to be promoted to full professor of neurosurgery.

<span class="mw-page-title-main">Antonio Bernardo</span>

Antonio Bernardo is an Italian-American neurosurgeon and academic physician. He is a professor of Neurological Surgery and the Director of the Neurosurgical Innovations and Training Center for Skull Base and Microneurosurgery in the Department of Neurological Surgery at Weill Cornell Medical College. He has gained significant notoriety for his expertise in skull base and cerebrovascular surgery, and has published extensively on minimally invasive neurosurgery. He is a pioneer in the use of 3D technology in neurosurgery and a strong advocate for competency-based training in surgery.

<span class="mw-page-title-main">William Couldwell</span>

William T. Couldwell M.D., Ph.D., a neurosurgeon, was born in British Columbia, Canada. He is Professor and Chairman of the Department of Neurosurgery at the University of Utah, a position he assumed in 2001.

The Asian Australasian Society of Neurological Surgeons (AASNS) is the inter-continental, non-governmental, learned society representing neurosurgeons of the Asian-Australasian region. It was founded in 1964 and is made up of twenty-eight national societies, totaling 60 percent of neurosurgeons globally. It is the largest of the five continental associations of the World Federation of Neurosurgical Societies. The official journal of the society is the Journal of Clinical Neuroscience.

Faiza Lalam is a medical doctor from Algeria, who is credited as the first woman neurosurgeon in Africa, spearheading the work of women in the specialism on the continent. She was described in 2020 as the "'Dean' of women neurosurgeons in Africa and the Middle East" by the World Federation of Neurosurgical Societies.

<span class="mw-page-title-main">Claire Karekezi</span>

Claire Karekezi is a Neurosurgeon at the Rwanda Military Hospital in Kigali, Rwanda. As the first woman neurosurgeon in Rwanda, and one of six neurosurgeons serving a population of 13 million, Karekezi serves as an advocate for women in neurosurgery. She has become an inspiration for young people pursuing neurosurgery, particularly young women.

<span class="mw-page-title-main">Sandi Lam</span> Canadian pediatric neurosurgeon

Sandi Lam is a Canadian pediatric neurosurgeon and is known for her research in minimally invasive endoscopic hemispherectomy for patients with epilepsy. Lam is the Vice Chair for Pediatric Neurological Surgery at Northwestern University and the Division Chief of Pediatric Neurosurgery at Lurie Children's Hospital. She has spent her career advancing pediatric brain surgery capabilities globally through her work in Kenya performing surgeries as well as training and mentoring local residents and fellows.

Juliet Sekabunga Nalwanga is a physician from Uganda, who is the country's first female neurosurgeon. As of 2021 she was one of only thirteen neurosurgeons in Uganda. As of 2018 she was employed by Mulago National Referral Hospital in Kampala.

References

  1. ↑ Bath, Michael; Bashford, Tom; Fitzgerald, J E (October 2019). "What is 'global surgery'? Defining the multidisciplinary interface between surgery, anaesthesia and public health". BMJ Global Health. 4 (5): e001808. doi:10.1136/bmjgh-2019-001808. PMC   6830053 . PMID   31749997.
  2. 1 2 3 4 5 Kanmounye, Ulrick Sidney; Esene, Ignatius N (27 August 2021). "Letter: Global Neurosurgery Scope and Practice". Neurosurgery Open. 2 (3): okab025. doi:10.1093/neuopn/okab025.
  3. ↑ Parkinson, Dwight (May 1995). "Early history of neurosurgery in Manitoba: threads in the tapestry of world neurosurgery". Journal of Neurosurgery. 82 (5): 900–906. doi:10.3171/JNS.1995.82.5.0900. PMID   7714620.
  4. ↑ Park, Kee B.; Johnson, Walter D.; Dempsey, Robert J. (1 April 2016). "Global Neurosurgery: The Unmet Need". World Neurosurgery. 88: 32–35. doi: 10.1016/j.wneu.2015.12.048 . ISSN   1878-8750. PMID   26732963.
  5. ↑ Andrews, Russell J. (November 2020). "What's in a Name? "Global Neurosurgery" in the 21st Century". World Neurosurgery. 143: 336–338. doi:10.1016/j.wneu.2020.07.233. PMC   7414764 . PMID   32781142.
  6. 1 2 3 4 Dewan, Michael C.; Rattani, Abbas; Fieggen, Graham; Arraez, Miguel A.; Servadei, Franco; Boop, Frederick A.; Johnson, Walter D.; Warf, Benjamin C.; Park, Kee B. (April 2019). "Global neurosurgery: the current capacity and deficit in the provision of essential neurosurgical care. Executive Summary of the Global Neurosurgery Initiative at the Program in Global Surgery and Social Change". Journal of Neurosurgery. 130 (4): 1055–1064. doi: 10.3171/2017.11.JNS171500 . PMID   29701548. S2CID   20159320.
  7. ↑ Gnanakumar, Sujit; Abou El Ela Bourquin, Bilal; Robertson, Faith C.; Solla, Davi J. Fontoura; Karekezi, Claire; Vaughan, Kerry; Garcia, Roxanna M.; Hassani, Fahd Derkaoui; Alamri, Alexander; Höhne, Julius; Mentri, Nesrine; Stienen, Martin; Laeke, Tsegazeab; Moscote-Salazar, Luis Rafael; Al-Ahmari, Ahmed Nasser; Al-Jehani, Hosam; Nicolosi, Federico; Samprón, Nicolás; Adelson, P. David; Servadei, Franco; Esene, Ignatius N.; Al-Habib, Amro; Kolias, Angelos G. (October 2020). "The World Federation of Neurosurgical Societies Young Neurosurgeons Survey (Part I): Demographics, Resources, and Education". World Neurosurgery: X. 8: 100083. doi:10.1016/j.wnsx.2020.100083. PMC   7573644 . PMID   33103109.
  8. ↑ Robertson, Faith C.; Gnanakumar, Sujit; Karekezi, Claire; Vaughan, Kerry; Garcia, Roxanna M.; Abou El Ela Bourquin, Bilal; Derkaoui Hassani, Fahd; Alamri, Alexander; Mentri, Nesrine; Höhne, Julius; Laeke, Tsegazeab; Al-Jehani, Hosam; Moscote-Salazar, Luis Rafael; Al-Ahmari, Ahmed Nasser; Samprón, Nicolás; Stienen, Martin N.; Nicolosi, Federico; Fontoura Solla, Davi J.; Adelson, P. David; Servadei, Franco; Al-Habib, Amro; Esene, Ignatius; Kolias, Angelos G. (October 2020). "The World Federation of Neurosurgical Societies Young Neurosurgeons Survey (Part II): Barriers to Professional Development and Service Delivery in Neurosurgery". World Neurosurgery: X. 8: 100084. doi:10.1016/j.wnsx.2020.100084. PMC   7573643 . PMID   33103110.
  9. ↑ Kanmounye, Ulrick S.; Robertson, Faith C.; Thango, Nqobile S.; Doe, Alvin Nah; Bankole, Nourou Dine Adeniran; Ginette, Pape Aicha; Ondoma, Solomon; Balogun, James A.; Opoku, Isabella; Jokonya, Luxwell; Mbaye, Thioub; Shabhay, Zarina A.; Ashour, Ahmed M.; Silva, Ana Cristina Veiga; Cheserem, Beverly; Karekezi, Claire; Hassani, Fahd Derkaoui; Mentri, Nesrine; Laeke, Tsegazeab; Aklilu, Abenezer Tirsit; Sanoussi, Samuila; Musara, Aaron; Ntalaja, Jeff; Ssenyonga, Peter; Bakhti, Souad; El Abbadi, Najia; Mahmud, Muhammad Raji; El-Ghandour, Nasser M. F.; Al-Habib, Amro; Kolias, Angelos G.; Servadei, Franco; Fieggen, Graham; Qureshi, Mahmood; Esene, Ignatius (28 May 2021). "Needs of Young African Neurosurgeons and Residents: A Cross-Sectional Study". Frontiers in Surgery. 8: 647279. doi: 10.3389/fsurg.2021.647279 . PMC   8193351 . PMID   34124134.
  10. 1 2 Nguembu, Stéphane; Kanmounye, Ulrick Sidney; Tétinou, Francklin; Djiofack, Dylan; Takoukam, Régis (July 2020). "Barriers to Management of Nontraumatic Neurosurgical Diseases at 2 Cameroonian Neurosurgical Centers: Cross-Sectional Study". World Neurosurgery. 139: e774–e783. doi:10.1016/j.wneu.2020.04.162. PMID   32376382. S2CID   218533601.
  11. ↑ Rahman, Sarah; McCarty, Justin C.; Gadkaree, Shekhar; Semco, Robert S.; Bi, Wenya Linda; Dhand, Amar; Jarman, Molly P.; Ortega, Gezzer; Uribe-Leitz, Tarsicio; Bergmark, Regan W. (July 2021). "Disparities in the Geographic Distribution of Neurosurgeons in the United States: A Geospatial Analysis". World Neurosurgery. 151: e146–e155. doi:10.1016/j.wneu.2021.03.152. PMID   33831612. S2CID   233192632.
  12. 1 2 3 4 Kanmounye, Ulrick Sidney; Sebopelo, Lorraine Arabang; Keke, Chiuyu; Zolo, Yvan; Senyuy, Wah Praise; Endalle, Genevieve; Takoukam, Régis; Sichimba, Dawin; Nguembu, Stéphane; Ghomsi, Nathalie (11 March 2021). "Mapping Global Neurosurgery Research Collaboratives: A Social Network Analysis of the 50 Most Cited Global Neurosurgery Articles". Neurosurgery Open. 2 (2): okab006. doi: 10.1093/neuopn/okab006 .
  13. 1 2 Rosseau, Gail; Johnson, Walter D.; Park, Kee B.; Hutchinson, Peter J.; Lippa, Laura; Andrews, Russell; Servadei, Franco; Garcia, Roxanna M. (April 2020). "Global neurosurgery: continued momentum at the 72nd World Health Assembly". Journal of Neurosurgery. 132 (4): 1256–1260. doi:10.3171/2019.11.JNS191823. PMC   7895422 . PMID   31952031.
  14. 1 2 Kanmounye, Ulrick Sidney; Shenaman, Natalie; Ratel, Marj; Park, Kee B.; Woodrow, Sarah; Olubunmi, Comrade Lawal Aiyedun; Tharin, Suzanne; Khan, Tariq; Haq, Makinah; Taylor, Elliott; Harkness, William; Shlobin, Nathan A.; Moser, Richard; Korn, Josh; Dempsey, Robert J.; Rosseau, Gail (23 April 2021). "A Seat at the Table: Representation of Global Neurosurgery in the G4 Alliance". Journal of Global Neurosurgery. 1 (1): 73–77. doi: 10.51437/jgns.v1i1.29 . ISSN   2745-2379. S2CID   255894229.
  15. ↑ "Member Organizations". The G4 Alliance. Retrieved 2022-07-22.
  16. ↑ "Our Member Organisations". PUSH! Global Alliance. Retrieved 2022-07-22.
  17. ↑ "Our Members Archive". IF Global. Retrieved 2022-07-22.
  18. ↑ Robertson, Faith C.; et al. (April 2020). "Task-Shifting and Task-Sharing in Neurosurgery: An International Survey of Current Practices in Low- and Middle-Income Countries". World Neurosurgery: X. 6: 100059. doi:10.1016/j.wnsx.2019.100059. PMC   7154228 . PMID   32309800. S2CID   203529633.
  19. 1 2 3 4 Robertson, Faith C.; et al. (April 2020). "Global Perspectives on Task Shifting and Task Sharing in Neurosurgery". World Neurosurgery: X. 6: 100060. doi:10.1016/j.wnsx.2019.100060. PMC   7154229 . PMID   32309801.
  20. ↑ Robertson, Faith C.; Briones, Richard; Mekary, Rania A.; Baticulon, Ronnie E.; Jimenez, Miguel A.; Leather, Andrew J.M.; Broekman, Marike L.D.; Park, Kee B.; Gormley, William B.; Lucena, Lynne L. (April 2020). "Task-Sharing for Emergency Neurosurgery: A Retrospective Cohort Study in the Philippines". World Neurosurgery: X. 6: 100058. doi:10.1016/j.wnsx.2019.100058. PMC   7154225 . PMID   32309799.
  21. 1 2 3 Kato, Y.; Liew, B. S.; Sufianov, A. A.; Rasulic, L.; Arnautovic, K. I.; Dong, V. H.; Florian, I. S.; Olldashi, F.; Makhambetov, Y.; Isam, B.; Thu, M.; Enkhbayar, Ts.; Kumarasinghe, N.; Bajamal, A. H.; Nair, S.; Sharif, S.; Sharma, M. R.; Landeiro, J. A.; Yampolsky, C. G.; El-Ghandour, N. M. F.; Hossain, A. M.; Sim, S.; Chemate, S.; Burhan, Hira; Feng, L.; Andrade, H.; Germano, Isabelle M. (December 2020). "Review of global neurosurgery education: Horizon of Neurosurgery in the Developing Countries". Chinese Neurosurgical Journal. 6 (1): 19. doi: 10.1186/s41016-020-00194-1 . PMC   7398343 . PMID   32922948.
  22. ↑ "Volunteer Toolkit". Foundation for International Education in Neurological Surgery (FIENS). Retrieved 2022-07-22.
  23. ↑ "NIHR Global Health Research Group on Neurotrauma" . Retrieved 2022-07-22.
  24. ↑ "Global Health Neurosurgery Fellowship". Weill Cornell Medicine. Retrieved 2022-07-22.
  25. ↑ "Duke Global Neurosurgery & Neurology" . Retrieved 2022-07-22.
  26. ↑ "Paul Farmer Global Surgery Research Fellowship". Harvard Program in Global Surgery and Social Change. Retrieved 2022-07-22.
  27. ↑ "Education". University of Cape Town, Global Surgery. Retrieved 2022-07-22.
  28. ↑ Rolle, Myron L.; Zaki, Mark; Parker, Tariq; Berger, Connor; Knowlton, Harrison; Kerry, Vanessa; Nahed, Brian (1 September 2020). "Global Neurosurgery Education in United States Residency Programs". World Neurosurgery. 141: e815–e819. doi:10.1016/j.wneu.2020.06.039. ISSN   1878-8750. PMID   32540290. S2CID   219700753.
  29. 1 2 Corley, Jacquelyn; Barthélemy, Ernest J.; Lepard, Jacob; Alves, Jose Luis; Ashby, Joanna; Khan, Tariq; Park, Kee B. (December 2019). "Comprehensive Policy Recommendations for Head and Spine Injury Care in Low- and Middle-Income Countries". World Neurosurgery. 132: 434–436. doi:10.1016/j.wneu.2019.08.240. PMID   31810143. S2CID   208812952.
  30. 1 2 "Comprehensive Policy Recommendations for Head and Spine Injury Care in LMICs" (PDF). Harvard Global Neurosurgery Initiative. Retrieved 4 December 2021.
  31. 1 2 "Comprehensive Policy Recommendations for the Management of Spina Bifida & Hydrocephalus in Low- & Middle-Income Countries". CHYSPR group. Retrieved 22 July 2022.
  32. ↑ "Global Neurosurgery Committee of the WFNS". Global Neurosurgery Committee of the WFNS. Retrieved 2022-07-22.
  33. ↑ "Prioritizing Global Neurosurgery in the Focus of Global Public Health: The ethical, financial and clinical necessities | Frontiers Research Topic". Frontiers in Surgery. Retrieved 2022-07-22.
  34. ↑ "Reducing Inequities in Global Neurosurgery Delivery". Neurosurgical Focus. 45 (4). Oct 2018. ISSN   1092-0684.
  35. ↑ "Journal of Global Neurosurgery". Journal of Global Neurosurgery. 1 (1). 2022. doi:10.51437/jgns.v1i1. ISSN   2745-2379.
  36. ↑ Dada, Olaoluwa Ezekiel; Karekezi, Claire; Mbangtang, Celestin Bilong; Chellunga, Edwin Samwel; Mbaye, Thioub; Konan, Landry; Adeniran Bankole, Nourou Dine; Merci Kabulo, Katenga Dieu; Hugues Dokponou, Yao Christian; Ghomsi, Nathalie Christelle; Negida, Ahmed; Nguembu, Stéphane; Thango, Nqobile; Cheserem, Beverly; Kamabu, Larrey Kasereka; Alalade, Andrew F.; Esene, Ignatius; Kanmounye, Ulrick Sidney (July 2021). "State of Neurosurgical Education in Africa: A Narrative Review". World Neurosurgery. 151: 172–181. doi:10.1016/j.wneu.2021.05.086. PMID   34058355. S2CID   235266965.
  37. ↑ Debas, H. T.; Donkor, P.; Gawande, A.; Jamison, D. T.; Kruk, M. E.; Mock, C. N. (2015-03-23). "Surgery and Trauma Care" (PDF). In Debas, Haile T.; Donkor, Peter; Gawande, Atul; Jamison, Dean T.; Kruk, Margaret E.; Mock, Charles N. (eds.). Disease Control Priorities, Third Edition (Volume 1): Essential Surgery. The World Bank. doi:10.1596/978-1-4648-0346-8. hdl:10986/21568. ISBN   978-1-4648-0346-8. PMID   26740991.
  38. ↑ Debas, H. T.; Donkor, P.; Gawande, A.; Jamison, D. T.; Kruk, M. E.; Mock, C. N. (2015-03-23). "Surgical Interventions for Congenital Anomalies" (PDF). In Debas, Haile T.; Donkor, Peter; Gawande, Atul; Jamison, Dean T.; Kruk, Margaret E.; Mock, Charles N. (eds.). Disease Control Priorities, Third Edition (Volume 1): Essential Surgery. The World Bank. doi:10.1596/978-1-4648-0346-8. hdl:10986/21568. ISBN   978-1-4648-0346-8. PMID   26740991.
  39. ↑ Biccard, Bruce M.; Madiba, Thandinkosi E.; Kluyts, Hyla-Louise; Munlemvo, Dolly M.; Madzimbamuto, Farai D.; Basenero, Apollo; Gordon, Christina S.; Youssouf, Coulibaly; Rakotoarison, Sylvia R.; Gobin, Veekash; Samateh, Ahmadou L.; Sani, Chaibou M.; Omigbodun, Akinyinka O.; Amanor-Boadu, Simbo D.; Tumukunde, Janat T.; Esterhuizen, Tonya M.; Manach, Yannick Le; Forget, Patrice; Elkhogia, Abdulaziz M.; Mehyaoui, Ryad M.; Zoumeno, Eugene; Ndayisaba, Gabriel; Ndasi, Henry; Ndonga, Andrew K. N.; Ngumi, Zipporah W. W.; Patel, Ushmah P.; Ashebir, Daniel Zemenfes; Antwi-Kusi, Akwasi A. K.; Mbwele, Bernard; Sama, Hamza Doles; Elfiky, Mahmoud; Fawzy, Maher A.; Pearse, Rupert M. (21 April 2018). "Perioperative patient outcomes in the African Surgical Outcomes Study: a 7-day prospective observational cohort study". Lancet. 391 (10130): 1589–1598. doi:10.1016/S0140-6736(18)30001-1. ISSN   1474-547X. PMID   29306587. S2CID   4666606.
  40. ↑ Vaca, Silvia D; Kuo, Benjamin J; Nickenig Vissoci, Joao Ricardo; Staton, Catherine A; Xu, Linda W; Muhumuza, Michael; Ssenyonjo, Hussein; Mukasa, John; Kiryabwire, Joel; Rice, Henry E; Grant, Gerald A; Haglund, Michael M (2019). "Temporal Delays Along the Neurosurgical Care Continuum for Traumatic Brain Injury Patients at a Tertiary Care Hospital in Kampala, Uganda". Neurosurgery. 84 (1): 95–103. doi:10.1093/neuros/nyy004. ISSN   0148-396X. PMC   6292785 . PMID   29490070.
  41. ↑ Kanmounye, Ulrick Sidney; Lartigue, Jean Wilguens; Sadler, Samantha; Yuki Ip, Ho Kei; Corley, Jacquelyn; Arraez, Miguel Angel; Park, Kee (October 2020). "Emerging Trends in the Neurosurgical Workforce of Low- and Middle-Income Countries: A Cross-Sectional Study". World Neurosurgery. 142: e420–e433. doi:10.1016/j.wneu.2020.07.067. PMID   32688040. S2CID   220669140.
  42. ↑ Ng-Kamstra, Joshua S.; Riesel, Johanna N.; Arya, Sumedha; Weston, Brad; Kreutzer, Tino; Meara, John G.; Shrime, Mark G. (August 2016). "Surgical Non-governmental Organizations: Global Surgery's Unknown Nonprofit Sector". World Journal of Surgery. 40 (8): 1823–1841. doi:10.1007/s00268-016-3486-1. ISSN   1432-2323. PMID   27008646. S2CID   22325600.
  43. ↑ "CURE International". cure.org. Retrieved 2022-07-22.
  44. ↑ "Our Training Centers".
  45. ↑ "Our Training Centers".
  46. ↑ "How to standardize further training of international students? Tips from our Neurosurgery Department - West China hospital, sichuan university - West China hospital, sichuan university". West China School of Medicine/West China Hospital of Sichuan University (WCSM/WCH). Retrieved 2022-07-22.
  47. ↑ Dada, Olaoluwa Ezekiel; Karekezi, Claire; Mbangtang, Celestin Bilong; Chellunga, Edwin Samwel; Mbaye, Thioub; Konan, Landry; Adeniran Bankole, Nourou Dine; Merci Kabulo, Katenga Dieu; Hugues Dokponou, Yao Christian; Ghomsi, Nathalie Christelle; Negida, Ahmed; Nguembu, Stéphane; Thango, Nqobile; Cheserem, Beverly; Kamabu, Larrey Kasereka; Alalade, Andrew F.; Esene, Ignatius; Kanmounye, Ulrick Sidney (July 2021). "State of Neurosurgical Education in Africa: A Narrative Review". World Neurosurgery. 151: 172–181. doi:10.1016/j.wneu.2021.05.086. PMID   34058355. S2CID   235266965.
  48. ↑ Kanmounye, Ulrick Sidney; Ghomsi, Nathalie C.; Djiofack, Dylan; Tétinou, Francklin; Nguembu, Stéphane; Zolo, Yvan; Esene, Ignatius (10 April 2020). "The Implications of Global Neurosurgery for Low- and Middle-income Countries: The Case of Cameroon". Iranian Journal of Neurosurgery. 6 (2): 93–100. doi: 10.32598/irjns.6.2.7 . S2CID   226073509.
This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.