Improvement has been achieved in outcomes of neonatal surgery in Africa in the past two decades, although several of the studies reviewed are retrospective and poorly designed. Cost effective adaptations for neonatal intensive care, improved health-care funding, coordinated neonatal surgical care via regional centres, and collaboration with international partners are potential interventions that could help to address the challenges and further improve outcome.

Highlighted are the myriad obstacles which interface the successful set up of neuroendoscopy service especially in resource-constrained settings. Endoscopic procedures become safer with experience and complications reduce significantly after a steep learning curve.

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Preoperative carbohydrate or water intake up to 2 h before surgery is safe with better satisfaction when compared to overnight fasting.