Neurosurgery in the Democratic Republic of Congo: a historical review.

Background: The Democratic Republic of Congo (DRC) is a Central African country with the second largest surface area and the fourth largest population on the continent. DRC has witnessed numerous innovations and faced several challenges including health, economic, and social crises. Research question: This historical review aims to outline major developments in DRC neurosurgical practice with an emphasis on challenges and potential solutions. Material and methods: This historical review was compiled using data from stakeholder interviews, grey literature (health policy and event documentation at the hospital, provincial, and national levels) and peer-reviewed document analysis. The authors used triangulation to verify the data collected by each method and the final data were abstracted and presented narratively. Results: The first neurosurgery unit was established in the capital, Kinshasa, in 1979. This centre aimed to provide much needed neurosurgical services and training with the limited resources available at the time. As of July 2023, DRC has 19 neurosurgeons including 2 of female gender. Four neurosurgeons from the diaspora deliver care part-time supplementing the local specialist workforce and 7 residents are enrolled at the University of Kinshasa residency programme. In addition, there are at least 22 DRC residents training in other centres worldwide. Conclusions: DRC neurosurgery has faced numerous challenges, some of which have been overcome in the past decade. The recent improvements are encouraging for this country of more than 95 million inhabitants but more effort and time will be needed to fully overcome existing challenges. [ABSTRACT FROM AUTHOR]