Clinical Capacity Building Through Partnerships: Boots on the Ground in Global Neurosurgery.


Journal

Neurosurgery
ISSN: 1524-4040
Titre abrégé: Neurosurgery
Pays: United States
ID NLM: 7802914

Informations de publication

Date de publication:
26 Aug 2024
Historique:
received: 04 11 2023
accepted: 29 06 2024
medline: 26 8 2024
pubmed: 26 8 2024
entrez: 26 8 2024
Statut: aheadofprint

Résumé

Global neurosurgery seeks to provide quality neurosurgical health care worldwide and faces challenges because of historical, socioeconomic, and political factors. To address the shortfall of essential neurosurgical procedures worldwide, dyads between established neurosurgical and developing centers have been established. Concerns have been raised about their effectiveness and ability to sustain capacity development. Successful partnerships involve multiple stakeholders, extended timelines, and twinning programs. This article outlines current initiatives and challenges within the neurosurgical community. This narrative review aims to provide a practical tool for colleagues embarking on clinical partnerships, the Engagements and assets, Capacity, Operative autonomy, Sustainability, and scalability (ECOSystem) of care. To create the ECOSystem of care in global neurosurgery, the authors had multiple online discussions regarding important points in the practical tool. All developed tiers were expanded based on logistics, clinical, and educational aspects. An online search was performed from August to November 2023 to highlight global neurosurgery partnerships and link them to tiers of the ECOSystem. The ECOSystem of care involves 5 tiers: Tiers 0 (foundation), 1 (essential), 2 (complexity), 3 (autonomy), and 4 (final). A nonexhaustive list of 16 neurosurgical partnerships was created and serves as a reference for using the ECOSystem. Personal experiences from the authors through their partnerships were also captured. We propose a tiered approach for capacity building that provides structured guidance for establishing neurosurgical partnerships with the ECOSystem of care. Clinical partnerships in global neurosurgery aim to build autonomy, enabling independent provision of quality healthcare services.

Identifiants

pubmed: 39185894
doi: 10.1227/neu.0000000000003129
pii: 00006123-990000000-01321
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © Congress of Neurological Surgeons 2024. All rights reserved.

Références

Dempsey KE, Qureshi MM, Ondoma SM, Dempsey RJ. Effect of geopolitical forces on neurosurgical training in Sub-Saharan Africa. World Neurosurg. 2017;101:196-202.
Barthélemy EJ, Diouf SA, Silva ACV, et al. Historical determinants of neurosurgical inequities in Africa and the African diaspora: a review and analysis of coloniality. PLOS Glob Public Health. 2023;3(2):e0001550.
Homo RL, Grigorian A, Chen J, et al. Regional, racial, and mortality disparities associated with neurosurgeon staffing at level I trauma centers. Am Surg. 2021;87(12):1972-1979.
Meara JG, Greenberg SL. The Lancet Commission on Global Surgery Global surgery 2030: evidence and solutions for achieving health, welfare and economic development. Surgery. 2015;157(5):834-835.
Punchak M, Lazareff JA. Cost-effectiveness of short-term neurosurgical missions relative to other surgical specialties. Surg Neurol Int. 2017;8:37.
Meara JG, Leather AJ, Hagander L, et al. Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development. Lancet (London, England) 2015;386(9993):569-624.
Maleknia P, Shlobin NA, Johnston JrJM, Rosseau G. Establishing collaborations in global neurosurgery: the role of InterSurgeon. J Clin Neurosci. 2022;100:164-168.
Hoffman C, Härtl R, Shlobin NA, et al. Future directions for global clinical neurosurgical training: challenges and opportunities. World Neurosurg. 2022;166:e404-e418.
Ouahabi AE. Strategy to increase neurosurgery care capacity and neurosurgery workforce in LMICs. J Glob Neurosurg. 2023;3(1).
Fuller A, Tran T, Muhumuza M, Haglund MM. Building neurosurgical capacity in low and middle income countries. Eneurologicalsci. 2016;3:1-6.
Timothy J, Ivanov M, Tisell M, et al. Working in low-and middle-income countries: learning from each other. Brain Spine. 2022;2:101689.
Shlobin NA, Kanmounye US, Ozair A, et al. Educating the next generation of global neurosurgeons: competencies, skills, and resources for medical students interested in global neurosurgery. World Neurosurg. 2021;155:150-159.
Shlobin NA, Sharma S, DeCuypere MG, Lam S. Educating the next generation of global neurosurgeons: education for medical students interested in global pediatric neurosurgery. J Glob Neurosurg. Published online September 9, 2022. doi: 10.51437/jgns.v2i1.302.
doi: 10.51437/jgns.v2i1.302
Fuller AT, Barkley A, Du R, et al. Global neurosurgery: a scoping review detailing the current state of international neurosurgical outreach. J Neurosurg. 2020;134(3):1316-1324.
Ukachukwu A-EK, Seas A, Petitt Z, et al. Assessing the success and sustainability of global neurosurgery collaborations: systematic review and adaptation of the framework for assessment of InteRNational surgical success criteria. World Neurosurg. 2022;167:111-121.
Olivieri DJ, Baticulon RE, Labuschagne JJ, Harkness W, Warf B, Dewan MC. Geospatial mapping of international neurosurgical partnerships and evaluation of extent of training and engagement. World Neurosurg. 2020;144:e898-e907.
Lu Z, Tshimbombu TN, Abu-Bonsrah N, et al. Transnational capacity building efforts in global neurosurgery: a review and analysis of their impact and determinants of success. World Neurosurg. 2023;173:188-198.e3.
Hawryluk GW, Aguilera S, Buki A, et al. A management algorithm for patients with intracranial pressure monitoring: the Seattle international severe traumatic brain injury consensus conference (SIBICC). Intensive Care Med. 2019;45(12):1783-1794.
Rodríguez-Mena R, Piquer-Martínez J, Llácer-Ortega JL, et al. The NED foundation experience: a model of global neurosurgery. Brain Spine. 2023;3:101741.
Kuo BJ, Vaca SD, Vissoci JRN, et al. A prospective neurosurgical registry evaluating the clinical care of traumatic brain injury patients presenting to Mulago National Referral Hospital in Uganda. PLoS One. 2017;12(10):e0182285.
Smart LR, Mangat HS, Issarow B, et al. Severe traumatic brain injury at a tertiary referral Center in Tanzania: epidemiology and adherence to brain Trauma Foundation guidelines. World Neurosurg. 2017;105:238-248.
Uche EO, Mezue WC, Ajuzieogu O, et al. Improving capacity and access to neurosurgery in sub-Saharan Africa using a twinning paradigm pioneered by the Swedish African Neurosurgical Collaboration. Acta Neurochir. 2020;162(5):973-981.
Human Development Report 2019. 2019. Accessed April 18, 2024. https://hdr.undp.org/system/files/documents/hdr2019pdf
Support Capacity Development: The UNDP Approach. 2015. Accessed April 18, 2024. https://www.undp.org/publications/support-capacity-development-undp-approach
Ng-Kamstra JS, Greenberg SL, Abdullah F, et al. Global Surgery 2030: a roadmap for high income country actors. BMJ Glob Health. 2016;1(1):e000011.
Paradie E, Warman PI, Waguia-Kouam R, et al. The scope, growth, and inequities of the global neurosurgery literature: a bibliometric analysis. World Neurosurg. 2022;167:e670-e684.
Uche E, Sundblom J, Uko UK, et al. Global neurosurgery over a 60-year period: conceptual foundations, time reference, emerging co-ordinates and prospects for collaborative interventions in low and middle income countries. Brain Spine. 2022;2:101187.
United Nations Development Programme STRATEGIC PLAN 2022-2025. 2021. Accessed April 18, 2024. https://strategicplan.undp.org/
Lartigue JW, Dada OE, Haq M, et al. Emphasizing the role of neurosurgery within global health and national health systems: a call to action. Front Surg. 2021;8:690735.
Rallo MS, Strong MJ, Teton ZE, et al. Targeted public health training for neurosurgeons: an essential task for the prioritization of neurosurgery in the evolving global health landscape. Neurosurgery. 2023;92(1):10-17.
Lin H, Halvorsen K, Win MT, et al. Clinical spine care partnerships between high-income countries and low-and-middle-income countries: a scoping review. Plos One. 2023;18(10):e0287355.
Garcia RM, Ghotme KA, Arynchyna-Smith A, et al. Global neurosurgery: progress and resolutions at the 75th World Health Assembly. Neurosurgery. 2023;93(3):496-501.
Stone SS, Warf BC. Combined endoscopic third ventriculostomy and choroid plexus cauterization as primary treatment for infant hydrocephalus: a prospective North American series. J Neurosurg Pediatr. 2014;14(5):439-446.
Uche E, Okorie E, Emejulu J, Ajuzieogu O, Uche N. Challenges and outcome of cranial neuroendoscopic surgery in a resource constrained developing African country. Niger J Clin Pract. 2016;19(6):811-815.
Wang Z, Garcia RM, Huff HV, Niquen-Jimenez M, Marcos LA, Lam SK. Neurocysticercosis control for primary epilepsy prevention: a systematic review. Pathog Glob Health. 2022;116(5):282-296.
Venturini S, Park KB. Evaluating the effectiveness and the impact of donated neurosurgical equipment on neurosurgical units in low-and middle-income countries: the World Federation of Neurosurgical Societies experience. World Neurosurg. 2018;109:98-109.
Safe Surgery Initiative. 2024. Accessed April 18, 2024. https://theg4alliance.org/organization-member/.
Chua MH, Hong R, Rydeth T, et al. Spine trauma as a component of essential neurosurgery: an outcomes analysis from Cambodia. World Neurosurg. 2018;114:375-380.
Chan BC, Craven BC, Furlan JC. A scoping review on health economics in neurosurgery for acute spine trauma. Neurosurg Focus. 2018;44(5):E15.
Fraser HS, St John DM. Information Technology and Telemedicine in Sub-Saharan Africa: Economical Solutions Are Available to Support Health Care in Remote Areas. Vol 321. British Medical Journal Publishing Group; 2000:465-466.
Rubiano AM, Carney N, Chesnut R, Puyana JC. Global neurotrauma research challenges and opportunities. Nature. 2015;527(7578):S193-S197.
Rubiano AM, Griswold DP, Jibaja M, Rabinstein AA, Godoy DA. Management of severe traumatic brain injury in regions with limited resources. Brain Inj. 2021;35(11):1317-1325.
Barthélemy EJ, Hackenberg AE, Lepard J, et al. Neurotrauma surveillance in national registries of low-and middle-income countries: a scoping review and comparative analysis of data dictionaries. Int J Health Pol Manag. 2022;11(11):2373-2380.
Thango N, Baticulon RE, Lippa L. The role of registries in neurotrauma research: translating data into health policy that enhances patient care: comment on “neurotrauma surveillance in national registries of low-and middle-income countries: a scoping review and comparative analysis of data dictionaries”. Int J Health Pol Manag. 2023;12:7521.
Corley J, Barthélemy EJ, Lepard J, et al. Comprehensive policy recommendations for head and spine injury care in low-and middle-income countries. World Neurosurg. 2019;132:434-436.
Chesnut RM, Temkin N, Carney N, et al. A trial of intracranial-pressure monitoring in traumatic brain injury. New Engl J Med. 2012;367(26):2471-2481.
Karekezi C. Low-cost patient-specific cranial implants for cranioplasty. Acta Neurochir. 2023;165(8):2225-2226.
Tan ET, Ling JM, Dinesh SK. The feasibility of producing patient-specific acrylic cranioplasty implants with a low-cost 3D printer. J Neurosurg. 2016;124(5):1531-1537.
Chesnut RM, Temkin N, Dikmen S, et al. A method of managing severe traumatic brain injury in the absence of intracranial pressure monitoring: the imaging and clinical examination protocol. J Neurotrauma. 2018;35(1):54-63.
Mullapudi B, Grabski D, Ameh E, et al. Estimates of number of children and adolescents without access to surgical care. Bull World Health Organ. 2019;97(4):254-258.
Shlobin NA, LoPresti MA, Du RY, Lam S. Folate fortification and supplementation in prevention of folate-sensitive neural tube defects: a systematic review of policy. J Neurosurg Pediatr. 2020;27(3):294-310.
Kancherla V, Botto LD, Rowe LA, et al. Preventing birth defects, saving lives, and promoting health equity: an urgent call to action for universal mandatory food fortification with folic acid. Lancet Glob Health. 2022;10(7):e1053-e1057.
Shlobin NA, Roach JT, Kancherla V, et al. The role of neurosurgeons in global public health: the case of folic acid fortification of staple foods to prevent spina bifida. J Neurosurg Pediatr. 2022;1(aop):1-8.
Shlobin NA, Ghotme K, Caceres A, et al. Neurosurgeon-led advocacy for folic acid fortification to prevent spina bifida. World Neurosurg. 2023;172:96-97.
Debas HT, Donkor P, Gawande A, Jamison DT, Kruk ME, Mock CN. Disease Control Priorities, (Volume 1): Essential Surgery. World Bank Publications; 2015.
Leidinger A, Piquer J, Kim EE, Nahonda H, Qureshi MM, Young PH. Treating pediatric hydrocephalus at the neurosurgery education and development Institute: the reality in the Zanzibar archipelago, Tanzania. World Neurosurg. 2018;117:e450-e456.
Piquer J, Qureshi MM, Young PH, Dempsey RJ. Neurosurgery Education and Development program to treat hydrocephalus and to develop neurosurgery in Africa using mobile neuroendoscopic training. J Neurosurg Pediatr. 2015;15(6):552-559.
Baticulon RE, Dewan MC, Wittayanakorn N, Aldana PR, Maixner WJ. Pediatric neurosurgery in Asia and Australasia: training and clinical practice. J Neurosurg Pediatr. 2020;27(1):93-101.
Dewan MC, Baticulon RE, Rattani A, Johnston JM, Warf BC, Harkness W. Pediatric neurosurgical workforce, access to care, equipment and training needs worldwide. Neurosurg Focus. 2018;45(4):E13.
Can DDT, Lepard JR, Anh NM, et al. Nonsyndromic craniosynostosis in Vietnam: initial surgical outcomes of subspecialty mentorship. J Neurosurg Pediatr. 2021;28(5):508-515.
Dewan MC, Onen J, Bow H, Ssenyonga P, Howard C, Warf BC. Subspecialty pediatric neurosurgery training: a skill-based training model for neurosurgeons in low-resourced health systems. Neurosurg Focus. 2018;45(4):e2.
Bell JS, Koffie RM, Rattani A, et al. Global incidence of brain and spinal tumors by geographic region and income level based on cancer registry data. J Clin Neurosci. 2019;66:121-127.
Kedia S, Banson M, Cheserem B, et al. Brain Tumor Programs in Asia and Africa: current status, challenges, and future perspectives. World Neurosurg. 2023;175:e1041-e1048.
Mofatteh M, Mashayekhi MS, Arfaie S, et al. Awake craniotomy in africa: a scoping review of literature and proposed solutions to tackle challenges. Neurosurgery. 2023;93(2):274-291.
Howe KL, Zhou G, July J, et al. Teaching and sustainably implementing awake craniotomy in resource-poor settings. World Neurosurg. 2013;80(6):e171-e174.
Chu K. Inspirational women in surgery: Dr Claire Karekezi, neurosurgeon, Rwanda. World J Surg. 2022;46(9):2061-2062.
Mangat HS, Schoeller K, Budohoski KP, et al. Neurosurgery in East Africa: foundations. World Neurosurg. 2018;113:411-424.
Santos MM, Qureshi MM, Budohoski KP, et al. The growth of neurosurgery in East Africa: challenges. World Neurosurg. 2018;113:425-435.
LoPresti MA, Zhang L, Lam S. Disparities in pediatric drug-resistant epilepsy care. Childs Nervous Syst. 2023;39(6):1611-1617.
Improving Treatment for Ugandan Children with Epilepsy. 2021. Accessed April 18, 2024. https://www.luriechildrens.org/en/news-stories/improving-treatment-for-ugandan-children-with-epilepsy/
Marchesini N, Demetriades AK, Alves OL, Sala F, Rubiano AM. Exploring perspectives and adherence to guidelines for adult spinal trauma in low and middle-income healthcare economies: a survey on barriers and possible solutions (part I). Brain Spine. 2022;2:100932.
Demetriades AK, Marchesini N, Alves OL, Rubiano AM, Sala F. A survey on the early management of spinal trauma in low and middle-income countries: from the scene of injury to the diagnostic phase (part II). Brain Spine. 2022;2:101694.
Marchesini N, Rubiano AM, Sala F, Demetriades AK, Alves OL. Secondary damage management of acute traumatic spinal cord injury in low and middle-income countries: a survey on a global scale (Part III). Brain Spine. 2022;2:101694.
Yadav N, Kumar A, Hedaoo K, Jain A, Singh K, Vikram A. Establishing a new neurointerventional facility in a remote area of a low–middle income country (LMIC): initial experience. Asian J Neurosurg. 2022;17(01):050-057.
Enriquez CAG, Diestro JDB, Omar IIAT, Geocadin RG, Legaspi GD. Safety and clinical outcome of good-grade aneurysmal subarachnoid hemorrhage in non-intensive care units. J Stroke Cerebrovasc Dis. 2020;29(10):105123.
Hoz SS, Al-Sharshahi ZF, Esene IN, et al. More laboratory simulations—fewer brain complications: prospects from the first neurosurgery laboratory in Iraq. World Neurosurg. 2022;157:30-34.

Auteurs

Laura Lippa (L)

Neurosurgery Unit, Department of Neurosciences, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
Sezione di Traumatologia Cranica, Società Italiana di Neurochirurgia (SINCh), Padua, Italy.

Magalie Cadieux (M)

Department of Neurosurgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA.
Division of Neurosurgery, Muhimbili Orthopaedic Hospital, Dar Es Salaam, Tanzania.
Och Spine at NewYork-Presbyterian/Weill Cornell Medical Center, New York, New York, USA.

Ernest J Barthélemy (EJ)

Global Neurosurgery Laboratory, Division of Neurosurgery, SUNY Downstate Health Sciences University, Brooklyn, New York, USA.

Ronnie E Baticulon (RE)

Division of Neurosurgery, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines.

Kemel A Ghotme (KA)

Translational Neuroscience Research Lab, School of Medicine, Universidad de La Sabana, Chia, Colombia.
Neurosurgery Department, Fundacion Santa Fe De Bogota, Bogota, Colombia.

Nathan A Shlobin (NA)

Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.

José Piquer (J)

Chair VIU-NED Foundation, Hospital de la Ribera, Alzira, Valencia, Spain.

Roger Härtl (R)

Division of Neurosurgery, Muhimbili Orthopaedic Hospital, Dar Es Salaam, Tanzania.
Och Spine at NewYork-Presbyterian/Weill Cornell Medical Center, New York, New York, USA.

Jesus Lafuente (J)

Spine Center, Hospital Del Mar, Barcelona, Spain.

Enoch Uche (E)

Division of Neurosurgery, University of Nigeria Teaching Hospital, Enugu, Nigeria.
Division of Neurosurgery, College of Medicine, University of Nigeria Nsukka, Ituku/Ozalla Campus, Enugu, Nigeria.

Paul H Young (PH)

Section of Neurosurgery, Department of Surgery, St. Louis University, St. Louis, Missouri, USA.

William R Copeland (WR)

Division of Neurosurgery, Tenwek Hospital, Bomet, Kenya.

Fraser Henderson (F)

Division of Neurosurgery, Tenwek Hospital, Bomet, Kenya.
Department of Neurosurgery, Loma Linda University, Loma Linda, California, USA.

Hugh P Sims-Williams (HP)

Division of Neurosurgery, Tenwek Hospital, Bomet, Kenya.

Roxanna M Garcia (RM)

Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.

Gail Rosseau (G)

Department of Neurosurgery, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA.
Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA.

Mubashir Mahmood Qureshi (MM)

Aga Khan University Hospital, Nairobi, Kenya.

Classifications MeSH