Olivieri Daniel J, Baticulon Ronnie E, Labuschagne Jason J, Harkness William, Warf Benjamin, Dewan Michael C
Department of Neurosurgery, Alpert Medical School, Brown University, Providence, Rhode Island, USA; Watson Institute for International and Public Affairs, Brown University, Providence, Rhode Island, USA.
Division of Neurosurgery, University of the Philippines-Philippine General Hospital, Manila, Philippines.
World Neurosurg. 2020 Dec;144:e898-e907. doi: 10.1016/j.wneu.2020.09.107. Epub 2020 Sep 28.
To evaluate the presence, extent, and temporality of transnational neurosurgical partnerships, to understand and inform measures to address neurosurgical deficiencies in low- and middle-income countries (LMICs).
A Web search was conducted to identify actors from high-income countries (HICs) participating in neurosurgical delivery and/or capacity-building with LMICs from 2010 to 2018. Descriptive data on current neurosurgical partnerships were collected from published case reports, literature reviews, reports from academic institutions, and information on stakeholder Web pages. The level of training and engagement of each partnership was separately graded based on prespecified criteria, in which grade 3 represented partnerships that have most extensive training and engagement, and grade 1, the least extent. Data were analyzed using descriptive statistics and geospatially depicted on ArcMap GIS software.
A total of 123 unique HIC-LMIC partnerships were described. Of these partnerships, 85 (69%) are derived from HICs in North America, followed by Europe, with 23 (19%). The most common LMIC partners were from Africa (n = 56, 45%) and Latin America (n = 32, 26%). In addition, most partnerships provided services in pediatric neurosurgery (88%). The most frequent engagement classifications were grade 2 (35%) or 1 (36%). Similarly, for training, the most common classifications were grade 1 (40%) or 2 (30%).
A robust network of HIC-LMIC partnerships exists with varying degrees of engagement and training activities. Several regions are particularly suitable for growth and development. Systematic consolidation and indexing of transnational neurosurgical partnerships aim to enhance resource allocation and present opportunities for future partnership.
评估跨国神经外科合作关系的存在情况、范围及时间性，以了解并为解决低收入和中等收入国家（LMICs）神经外科不足的措施提供信息。
进行网络搜索，以识别2010年至2018年期间参与向LMICs提供神经外科服务和/或能力建设的高收入国家（HICs）的行为主体。从已发表的病例报告、文献综述、学术机构报告以及利益相关者网页信息中收集当前神经外科合作关系的描述性数据。根据预先设定的标准对每个合作关系的培训水平和参与程度分别进行分级，其中3级代表培训和参与最广泛的合作关系，1级代表程度最低。使用描述性统计分析数据，并在ArcMap GIS软件上进行地理空间描绘。
共描述了123个独特的HIC-LMIC合作关系。在这些合作关系中，85个（69%）来自北美的HICs，其次是欧洲，有23个（19%）。最常见的LMIC合作伙伴来自非洲（n = 56，45%）和拉丁美洲（n = 32，26%）。此外，大多数合作关系提供小儿神经外科服务（88%）。最常见的参与分类是2级（35%）或1级（36%）。同样，在培训方面，最常见的分类是1级（40%）或2级（30%）。
存在一个强大的HIC-LMIC合作关系网络，其参与和培训活动程度各异。几个地区特别适合发展壮大。对跨国神经外科合作关系进行系统整合和编目，旨在加强资源分配，并为未来的合作提供机会。
