Neurosurgical Practice, Training, and Research Capacity Assessment in Nigeria: A Methodological Approach

• Published in: World neurosurgery Vol. 185; pp. e4 - e15
• Main Authors: Ukachukwu, Alvan-Emeka K., Adeolu, Augustine A., Adeleye, Amos O., Chikani, Mark C., Haglund, Michael M., Fuller, Anthony T.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.2024
• Subjects: Adult; Aged; Biomedical Research; Capacity assessment; Female; Humans; Internship and Residency; Male; Methodology; Middle Aged; Neurosurgeons; Neurosurgery; Neurosurgery - education; Neurosurgical Procedures - education; Nigeria; Surveys and Questionnaires; Young Adult; Nigeria; NCAP; Methodology; NPMCN; NW; Neurosurgery; Capacity assessment; LAUTECH; SE; WACS; UK; FIENS; Nigeria; DGNN; NANS; EC; LUTH; NAUTH; CHERRIES; SS; NIHR; USA; HIC; OR; SW; SANC; CAANS; PRISMA; UNTH; KBNF; PIPES; NSNS; PAANS; AMSTAR; AFNS; NC; IRB; LMIC; ICU; PROSPERO; UCH; WFNS
• ISSN: 1878-8750; 1878-8769; 1878-8769
• DOI: 10.1016/j.wneu.2024.03.016

There has been a progressive growth of neurosurgery in Nigeria over the past 6 nulldecades. This study aims to comprehensively evaluate the state of neurosurgical practice, training, and research in the country. We used a mixed-methods approach that combined a survey of neurosurgery providers and a systematic review of the neurosurgical literature in Nigeria. The 83-question online survey had 3 core sections for assessing capacity, training, and gender issues. The systematic review involved a search of 4 global databases and gray literature over a 60-year period. One hundred and forty-nine respondents (95% male) completed the survey (65.4%). Their age ranged from 20 to 68 years, with a mean of 41.8 (±6.9) years. Majority were from institutions in the nation’s South-West region; 82 (55.0%) had completed neurosurgery residency training, with 76 (51%) employed as consultants; 64 (43%) identified as residents in training, 56 (37.6%) being senior residents, and 15 (10.1%) each held academic appointments as lecturers or senior lecturers. The literature review involved 1,023 peer-reviewed journal publications: 254 articles yielding data on 45,763 neurotrauma patients, 196 on 12,295 pediatric neurosurgery patients, and 127 on 8,425 spinal neurosurgery patients. Additionally, 147 papers provided data on 5,760 neuro-oncology patients, and 56 on 3,203 patients with neuro-vascular lesions. Our mixed-methods approach provided significant insights into the historical, contemporary, and future trends of neurosurgery in Nigeria. The results could form the foundation for policy improvement; health-system strengthening; better resource-planning, prioritization, and allocation; and more purposive collaborative engagement in Nigeria and other low- and middle-income countries.