Assessment of neurosurgical workforce, infrastructure, and service delivery capacity in East Africa: A collaborative survey

Workforce development in healthcare is critical, especially in resource-limited regions such as East Africa, where a scarcity of neurosurgeons hinders patient care. This study aims to analyze neurosurgical workforce trends in Kenya, Rwanda, Tanzania, and Uganda over two decades, informing strategies for capacity enhancement. An online survey targeting neurosurgical institutions across the four countries was conducted, focusing on consultants, residents, and general practitioners for the target population. Traumatic brain injury (TBI) served as a proxy for neurosurgical conditions. Data on workforce and training, infrastructure and equipment, and service delivery were collected from April to July 2023, with thirty-two responses analyzed. Descriptive analysis facilitated comparisons across institutions and countries. Among the thirty-two respondents, data trends varied significantly by institution. There was an observed increase in the number of neurosurgeons and consultant positions across hospitals. However, infrastructure disparities persisted, affecting equipment access, with some institutions experiencing consistent equipment availability while others faced severe shortages. Service delivery assessments revealed a rising trend in neurosurgical consultations, cases, and procedures over the past two decades. The prevalence of TBI was high across hospitals, with notable variation in arrival times post-injury. Despite increased medical training and the number of neurosurgeons across countries over the past 20 years, infrastructure deficits persist within each neurosurgical center. Uneven workforce distribution emphasizes the importance of targeted interventions, while collaborations between local and international stakeholders are crucial to address infrastructure disparities and optimize resource allocation. Further research is essential to guide effective interventions and policy development. Clinical trial number. Not applicable.