Clinical Capacity Building Through Partnerships: Boots on the Ground in Global Neurosurgery

Laura Lippa, Neurosurgery Unit, Department of Neurosciences, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
Magalie Cadieux, Department of Neurosurgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA.
Ernest J. Barthélemy, Global Neurosurgery Laboratory, Division of Neurosurgery, SUNY Downstate Health Sciences University, Brooklyn, New York, USA.
Ronnie E. Baticulon, Division of Neurosurgery, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines.
Kemel A. Ghotme, Translational Neuroscience Research Lab, School of Medicine, Universidad de La Sabana, Chia, Colombia.
Nathan A. Shlobin, Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
José Piquer, Chair VIU-NED Foundation, Hospital de la Ribera, Alzira, Valencia, Spain.
Roger Härtl, Division of Neurosurgery, Muhimbili Orthopaedic Hospital, Dar Es Salaam, Tanzania.
Jesus Lafuente, Spine Center, Hospital Del Mar, Barcelona, Spain.
Enoch Uche, Division of Neurosurgery, University of Nigeria Teaching Hospital, Enugu, Nigeria.
Paul H. Young, Section of Neurosurgery, Department of Surgery, St. Louis University, St. Louis, Missouri, USA.
William R. Copeland, Division of Neurosurgery, Tenwek Hospital, Bomet, Kenya.
Fraser Henderson, Division of Neurosurgery, Tenwek Hospital, Bomet, Kenya.
Hugh P. Sims-Williams, Division of Neurosurgery, Tenwek Hospital, Bomet, Kenya.
Roxanna M. Garcia, Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Gail Rosseau, Department of Neurosurgery, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA.
Mubashir Mahmood Qureshi, Aga Khan University Hospital, Nairobi, Kenya.

Document Type

Article

Abstract

Global neurosurgery seeks to provide quality neurosurgical health care worldwide and faces challenges because of historical, socioeconomic, and political factors. To address the shortfall of essential neurosurgical procedures worldwide, dyads between established neurosurgical and developing centers have been established. Concerns have been raised about their effectiveness and ability to sustain capacity development. Successful partnerships involve multiple stakeholders, extended timelines, and twinning programs. This article outlines current initiatives and challenges within the neurosurgical community. This narrative review aims to provide a practical tool for colleagues embarking on clinical partnerships, the Engagements and assets, Capacity, Operative autonomy, Sustainability, and scalability (ECOSystem) of care. To create the ECOSystem of care in global neurosurgery, the authors had multiple online discussions regarding important points in the practical tool. All developed tiers were expanded based on logistics, clinical, and educational aspects. An online search was performed from August to November 2023 to highlight global neurosurgery partnerships and link them to tiers of the ECOSystem. The ECOSystem of care involves 5 tiers: Tiers 0 (foundation), 1 (essential), 2 (complexity), 3 (autonomy), and 4 (final). A nonexhaustive list of 16 neurosurgical partnerships was created and serves as a reference for using the ECOSystem. Personal experiences from the authors through their partnerships were also captured. We propose a tiered approach for capacity building that provides structured guidance for establishing neurosurgical partnerships with the ECOSystem of care. Clinical partnerships in global neurosurgery aim to build autonomy, enabling independent provision of quality healthcare services.

Publication Date

8-26-2024

Publication Title

Neurosurgery

E-ISSN

1524-4040

PubMed ID

39185894

Digital Object Identifier (DOI)

10.1227/neu.0000000000003129

Link to Full Text

Share

COinS