Neurosurgical Equipment Donations: A Qualitative Study

Abstract

IntroductionNeurosurgical equipment donation from high-income countries (HICs) to low-and-middle income countries (LMICs) exists. However, there is currently no published literature on whether there is a need for neurosurgical equipment donations or how to design equipment donation programmes that meet the needs of LMIC neurosurgeons. The primary aims of this study were to explore: (1) the need for the donation of neurosurgical equipment from the UK and Ireland to LMICs within the African continent, and (2) the ways through which neurosurgical equipment donations could meet the needs of LMIC neurosurgeons.MethodsThis was a qualitative study using semi-structured, one-on-one, audio-recorded interviews. Purposive sampling was used to recruit and interview consultants or attending neurosurgeons from Ireland, the UK and LMICs in Africa in a continuous process until data saturation. Interviews were conducted by members of the Association of Future African Neurosurgeons during March 2021. Qualitative analysis used a thematic approach using open and axial coding.ResultsFive HIC and 3 LMIC neurosurgeons were interviewed. Five overarching themes were identified: (1) inequality of access to neurosurgical equipment, (2) identifying specific neurosurgical equipment needs, (3) importance of organisations, (4) partnerships between LMIC and HIC centres, and (5) donations are insufficient in isolation.ConclusionThere is a need for greater access to neurosurgical equipment in LMICs. It is unclear if neurosurgical equipment donations are the optimal solution to this issue. Other solutions that are not linked to dependency need to be explored and executed. Collaborative relationships between LMICs and HICs better ensures that neurosurgical equipment donations meet the needs of the recipients. These relationships may be best created within an organisation framework that has the logistical capabilities of coordinating international equipment donation and providing a quality control measure.

The availability, access, challenges and advancements in neurosurgical care in Africa: a mini review

“…However, the initiative faced hurdles such as poor infrastructure for treatments and the absence of basic materials. This paucity of resources extends across several dimensions, profoundly impacting the capacity to deliver effective and quality neurosurgical care 20 . Hospitals and medical centres in these regions frequently face an acute shortage of essential materials, ranging from basic consumables like surgical gloves and radiography film to more complex neurosurgical equipment.…”

Awake craniotomies in South America: Advancements, challenges, and future prospects

“… 11 , 30 Compared to higher income countries (HICs), the availability of functional magnetic resonance imaging (fMRI), diffusion tensor imaging, MRIs, neuronavigation devices, and both motor evoked and somatosensory evoked potentials is very scarce or limited in South America. 11 , 33 The shortage of such essential equipment greatly hinders the ability of the neurophysician to ensure a viable mapping of the brain prior to the procedure. 30 In addition, the significant cost of over 50,000 USD for equipment combined with an inconsistent supply of power further hinders the accessibility of cortical mapping.…”

“… 34 Neurosurgeons in the region hence rely chiefly on a meticulously conducted neurocognitive assessment for brain mapping, relying predominantly on the age-old notion of concept and principle over technology. 11 , 33 Brain mapping technology, including fMRIs, magnetoencephalographic, and intraoperative cortical stimulation devices, has the primary benefit of providing a comprehensive real-time image of the brain during ACs, providing neurosurgeons with enhanced perception and a better understanding of what cortical areas (including those involved in language processing, sensory perception, and motor functioning) to preserve. 35 The widespread utilisation of such brain mapping technology allows surgeons to critically appraise and tailor the craniotomy procedures based on the critical functional brain regions; in contrast, relying on neurocognitive assessment, as is the general consensus in South America, does not provide the same level of precision, which translates into poorer outcomes for South American patients.…”