加纳神经外科学能评估:挑战与机遇。
Assessment of the Neurosurgical Capacity in Ghana: Challenges and Opportunities.
机构信息
Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon.
Department of Neurosurgery, University of Ghana Medical Centre, Accra, Ghana.
出版信息
World Neurosurg. 2022 Nov;167:e953-e961. doi: 10.1016/j.wneu.2022.08.120. Epub 2022 Sep 5.
BACKGROUND
Low- and middle-income countries experience numerous challenges in the provision of neurosurgical care. However, limited information exists on the neurosurgical workforce and the constraints under which care is delivered in Ghana, West Africa.
METHODS
A 19-item survey assessing neurosurgical workforce, infrastructure, and education was administered to Ghanaian consultant neurosurgeons and neurosurgeon trainees between November 8, 2021, and January 20, 2022. The data were analyzed using summary descriptions, and qualitative data were categorized into themes.
RESULTS
There were 25 consultant neurosurgeons and 8 neurosurgical trainees (from 2 training centers) identified at 11 hospitals in Ghana totaling a workforce density of 1 neurosurgeon per 1,240,000. Most neurosurgical centers were located in Accra, the capital city. Almost half of the population did not have access to a hospital with a neurosurgeon in their region. Of hospitals, 82% had in-house computed tomography and/or magnetic resonance imaging scanners. In the operating room, most neurosurgeons had access to a high-speed drill (91%) but lacked microscopes and endoscopic sets (only 64% and 36% had these tools, respectively). There were no neurointensivists or neurological intensive care units in the entire country, and there was a paucity of neurovascular surgeries and functional neurosurgical procedures.
CONCLUSIONS
The provision of neurosurgical care in Ghana has come a long way since the 1960s. However, the neurosurgical community continues to face significant challenges. Alleviating these barriers to care will call for systems-level changes that allow for the prioritization of neurosurgical care within the Ghanaian health care system.
背景
中低收入国家在提供神经外科护理方面面临诸多挑战。然而,关于西非加纳的神经外科劳动力以及在这些约束条件下提供护理的情况,相关信息有限。
方法
我们对加纳的顾问神经外科医生和神经外科受训人员进行了一项评估神经外科劳动力、基础设施和教育的 19 项调查,调查时间为 2021 年 11 月 8 日至 2022 年 1 月 20 日。使用摘要描述对数据进行了分析,并将定性数据分类为主题。
结果
在加纳的 11 家医院中确定了 25 名顾问神经外科医生和 8 名神经外科受训人员(来自 2 个培训中心),总劳动力密度为每 124 万人口 1 名神经外科医生。大多数神经外科中心都位于首都阿克拉。近一半的人口无法在其所在地区的医院获得神经外科医生的治疗。82%的医院拥有内部 CT 和/或 MRI 扫描仪。在手术室中,大多数神经外科医生都可以使用高速钻头(91%),但缺乏显微镜和内窥镜套件(只有 64%和 36%的医院配备了这些工具)。整个国家都没有神经重症监护医生或神经重症监护病房,神经血管手术和功能神经外科手术也很少。
结论
自 20 世纪 60 年代以来,加纳的神经外科护理已经取得了长足的进步。然而,神经外科界仍然面临着重大挑战。缓解这些护理障碍需要进行系统层面的变革,以便在加纳的医疗保健系统中优先考虑神经外科护理。