Global Neurosurgery in the Context of Global Public Health Practice–A Literature Review of Case Studies

Veerappan, Vigneshwar Raj; Gabriel, Phabinly; Shlobin, Nathan A.; Marks, Katya; Ooi, Setthasorn Zhi Yang; Aukrust, Camilla Grøver; Ham, Edward I.; Abdi, Hodan; Negida, Ahmed; Park, Kee B.; Ouahabi, Abdessamad El

doi:10.1016/j.wneu.2022.06.022

Cited by 18 publications

(7 citation statements)

References 44 publications

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“…Regardless of the uncertainties, global and national initiatives have been launched to improve neurological capacity. Notably, the "4 T’s Paradigm" established through Duke and Uganda’s collaborative efforts has significantly increased training and technological capacity [ 55 , 63 , 64 ]. The neurological providers expressed gratitude to Duke University, DGNN, CURE International, and numerous other supporters for their ongoing efforts to improve neurosurgery practice.…”

Section: Discussionmentioning

confidence: 99%

The feasibility, appropriateness, and usability of mobile neuro clinics in addressing the neurosurgical and neurological demand in Uganda

Mukumbya,

Kitya,

Trillo-Ordonez

et al. 2024

PLoS ONE

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Introduction Uganda has a high demand for neurosurgical and neurological care. 78% of the over 50 million population reside in rural and remote communities where access to neurosurgical and neurological services is lacking. This study aimed to determine the feasibility, appropriateness, and usability of mobile neuro clinics (MNCs) in providing neurological care to rural and remote Ugandan populations. Methods Neurosurgery, neurology, and mobile health clinic providers participated in an education and interview session to assess the feasibility, appropriateness, and usability of the MNC intervention. A qualitative analysis of the interview responses using the constructs in the updated Consolidated Framework for Implementation Research was performed. Providers’ opinions were weighted using average sentiment scores on a novel sentiment-weighted scale adapted from the CFIR. A stakeholder analysis was also performed to assess the power and interest of the actors described by the participants. Results Twenty-one healthcare providers completed the study. Participants discussed the potential benefits and concerns of MNCs as well as potential barriers and critical incidents that could jeopardize the intervention. Of the five CFIR domains evaluated, variables in the implementation process domain showed the highest average sentiment scores, followed by the implementation climate constructs, inner setting, innovation, and outer setting domains. Furthermore, many interested stakeholders were identified with diverse roles and responsibilities for implementing MNCs. These findings demonstrate that MNC innovation is feasible, appropriate, and usable. Conclusion The findings of this study support the feasibility, appropriateness, and usability of MNCs in Uganda. However, integration of this innovation requires careful planning and stakeholder engagement at all levels to ensure the best possible outcomes.

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Section: Discussionmentioning

confidence: 99%

The feasibility, appropriateness, and usability of mobile neuro clinics in addressing the neurosurgical and neurological demand in Uganda

Mukumbya,

Kitya,

Trillo-Ordonez

et al. 2024

PLoS ONE

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“…However, the involvement of neurosurgeons in public health initiatives is scarce. Their participation, advocacy, and lobbying can be impactful in promoting evidence-based policies and integrating the neurosurgical burden into national health planning systems [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

Barriers and facilitators to the implementation of mandatory folate fortification as an evidence-based policy to prevent neural tube defects

Ghotme,

Arynchyna-Smith,

Maleknia

et al. 2023

Childs Nerv Syst

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Background Neural tube defects continue to be one of the main congenital malformations affecting the development of the nervous system and a significant cause of disability and disease burden to individuals living with these conditions. Mandatory food fortification with folic acid is, by far, one of the most efficacious, safe, and cost-effective interventions to prevent neural tube defects. However, most countries fail to effectively fortify staple foods with folic acid, impacting public health and healthcare systems and generating dismal disparities. Aim This article discusses the main barriers and facilitators for implementing mandatory food fortification as an evidence-based policy to prevent neural tube defects worldwide. Methods A comprehensive review of the scientific literature allowed the identification of the determinant factors acting as barriers or facilitators for the reach, adoption, implementation, and scaling up of mandatory food fortification with folic acid as an evidence-based policy. Results We identified eight barriers and seven facilitators as determinant factors for food fortification policies. The identified factors were classified as individual, contextual, and external, inspired by the Consolidated Framework for Implementation of Research (CFIR). We discuss mechanisms to overcome obstacles and seize the opportunities to approach this public health intervention safely and effectively. Conclusions Several determinant factors acting as barriers or facilitators influence the implementation of mandatory food fortification as an evidence-based policy worldwide. Notoriously, policymakers in many countries may lack knowledge of the benefits of scaling up their policies to prevent folic acid-sensitive neural tube defects, improve the health status of their communities, and promote the protection of many children from these disabling but preventable conditions. Not addressing this problem negatively affects four levels: public health, society, family, and individuals. Science-driven advocacy and partnerships with essential stakeholders can help overcome the barriers and leverage the facilitators for safe and effective food fortification.

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“…Furthermore, collaborative partnerships with the Foundation for International Education in Neurological Surgery (FIENS) are examples of education-focused initiatives to help develop neurosurgical capacity/workforce abroad. Also, WFNS centers have contributed to neurosurgical training in places such as Rabat, Nairobi, Alger, and Dakar ( Veerappan et al., 2022 ). The WFNS Rabat Training Center has trained 69 neurosurgeons from 17 sub-Saharan countries ( Karekezi and Khamlichi, 2019 ; Karekezi et al., 2020 ), proving to be cost-effective and sustainable in sub-Saharan African countries.…”

Section: Discussionmentioning

confidence: 99%

The NED foundation experience: A model of global neurosurgery

Rodríguez-Mena¹,

Piquer-Martínez²,

Llácer-Ortega³

et al. 2023

Brain and Spine

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Global Neurosurgery in the Context of Global Public Health Practice–A Literature Review of Case Studies

Cited by 18 publications

References 44 publications

The feasibility, appropriateness, and usability of mobile neuro clinics in addressing the neurosurgical and neurological demand in Uganda

The feasibility, appropriateness, and usability of mobile neuro clinics in addressing the neurosurgical and neurological demand in Uganda

Barriers and facilitators to the implementation of mandatory folate fortification as an evidence-based policy to prevent neural tube defects

The NED foundation experience: A model of global neurosurgery

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