Challenges and Progress in Neurosurgery: A Comprehensive Assessment of the Landscape in Nepal.

A large portion of the global population lacks access to essential surgical care, despite surgical conditions contributing significantly to the overall burden of disease worldwide. This burden is heaviest in developing countries like Nepal, where disparities in access to surgery for neurosurgical disorders stem from health system failures including an inadequate neurosurgical workforce, lack of requisite neurosurgical equipment, and challenges in perioperative care. By bibliometric analysis of neurosurgery-related publications in Nepal through PubMed search using the search terms "Neurosurg* AND Nepal", we have found a total of 528 articles with a notable increase in the number of such publications from 14 to 25 between 2015 and 2016, with over 300 published in 2021, 2022, and 2023. Nepal has also seen a drastic increase in neurosurgeon density from 0.166 per 100,000 population in 2016 to 0.377 per 100,000 population in 2023 compared to 0.780 in China, 0.274 in India, 0.130 in Bhutan, and 0.092 per 100,000 population in Bangladesh in 2023. This study underscores the pressing need for enhanced neurosurgical capacity and improved health equity in Nepal.