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Fulfilling the specialist neurosurgical workforce needs in Africa: a systematic review and projection toward 2030.

Publication ,  Journal Article
Ukachukwu, A-EK; Still, MEH; Seas, A; von Isenburg, M; Fieggen, G; Malomo, AO; Shokunbi, MT; Egger, JR; Haglund, MM; Fuller, AT
Published in: Journal of neurosurgery
April 2023

Africa contributes significantly to the global neurosurgical disease burden but has only 1% of the neurosurgery workforce. This study appraises the neurosurgical workforce and training capacity in Africa and projects the workforce capacity by 2030.The authors conducted a systematic review of the online literature on neurosurgical workforce and training in Africa obtained from three journal databases (PubMed, Embase, and African Index Medicus), as well as from a gray literature search, between September and December 2020. Included literature passed a two-level screening conducted using a systematic review software by a team of two independent reviewers. Data were extracted from selected articles and documented and analyzed on spreadsheets.One hundred and fifty-nine eligible articles were analyzed: 1974 neurosurgeons serve 1.3 billion people in Africa (density 0.15 per 100,000 persons, ratio 1:678,740), with uneven distribution between the regions. North Africa has 64.39% of the neurosurgical workforce (n = 1271), followed by Southern Africa (12.66%, n = 250), West Africa (11.60%, n = 229), East Africa (8.26%, n = 163), and Central Africa (3.09%, n = 61). At an exponential growth rate of 7.03% (95% CI 5.83%-8.23%) per annum, Africa will have 3418 (95% CI 1811-6080) neurosurgeons by 2030, with a deficit of 5191 neurosurgeons, based on population workforce targets. In terms of training, there are 106 neurosurgery training institutions in 26 African countries. North Africa has 52 training centers (49.05%), West Africa 23 (21.70%), East Africa 15 (14.15%), Southern Africa 14 (13.21%), and Central Africa 2 (1.89%). The major regional training programs are those of the West African College of Surgeons (24 sites in 7 countries) and the College of Surgeons of East, Central, and Southern Africa (17 sites in 8 countries).The study is limited as it is based on the online literature, some of which includes modeled estimates with questionable reliability. However, the results indicate that while countries in North Africa are expected to surpass their population workforce requirements, sub-Saharan African countries are likely to have significant workforce deficits accentuated by the paucity of neurosurgery training programs. To meet the 2030 population workforce requirements, the continent's exponential growth rate should be scaled up to 15.87% per annum. Scaling up neurosurgical training would help to meet this target and requires collaborative efforts from continental, regional, and national agencies and international organizations.

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Published In

Journal of neurosurgery

DOI

EISSN

1933-0693

ISSN

0022-3085

Publication Date

April 2023

Volume

138

Issue

4

Start / End Page

1102 / 1113

Related Subject Headings

  • Workforce
  • Reproducibility of Results
  • Neurosurgery
  • Neurosurgeons
  • Neurology & Neurosurgery
  • Humans
  • Africa
  • 3209 Neurosciences
  • 3202 Clinical sciences
  • 1109 Neurosciences
 

Citation

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Ukachukwu, A.-E., Still, M. E. H., Seas, A., von Isenburg, M., Fieggen, G., Malomo, A. O., … Fuller, A. T. (2023). Fulfilling the specialist neurosurgical workforce needs in Africa: a systematic review and projection toward 2030. Journal of Neurosurgery, 138(4), 1102–1113. https://doi.org/10.3171/2022.2.jns211984
Ukachukwu, Alvan-Emeka K., Megan E. H. Still, Andreas Seas, Megan von Isenburg, Graham Fieggen, Adefolarin O. Malomo, Matthew T. Shokunbi, Joseph R. Egger, Michael M. Haglund, and Anthony T. Fuller. “Fulfilling the specialist neurosurgical workforce needs in Africa: a systematic review and projection toward 2030.Journal of Neurosurgery 138, no. 4 (April 2023): 1102–13. https://doi.org/10.3171/2022.2.jns211984.
Ukachukwu A-EK, Still MEH, Seas A, von Isenburg M, Fieggen G, Malomo AO, et al. Fulfilling the specialist neurosurgical workforce needs in Africa: a systematic review and projection toward 2030. Journal of neurosurgery. 2023 Apr;138(4):1102–13.
Ukachukwu, Alvan-Emeka K., et al. “Fulfilling the specialist neurosurgical workforce needs in Africa: a systematic review and projection toward 2030.Journal of Neurosurgery, vol. 138, no. 4, Apr. 2023, pp. 1102–13. Epmc, doi:10.3171/2022.2.jns211984.
Ukachukwu A-EK, Still MEH, Seas A, von Isenburg M, Fieggen G, Malomo AO, Shokunbi MT, Egger JR, Haglund MM, Fuller AT. Fulfilling the specialist neurosurgical workforce needs in Africa: a systematic review and projection toward 2030. Journal of neurosurgery. 2023 Apr;138(4):1102–1113.

Published In

Journal of neurosurgery

DOI

EISSN

1933-0693

ISSN

0022-3085

Publication Date

April 2023

Volume

138

Issue

4

Start / End Page

1102 / 1113

Related Subject Headings

  • Workforce
  • Reproducibility of Results
  • Neurosurgery
  • Neurosurgeons
  • Neurology & Neurosurgery
  • Humans
  • Africa
  • 3209 Neurosciences
  • 3202 Clinical sciences
  • 1109 Neurosciences