Geospatial Mapping of International Neurosurgical Partnerships and Evaluation of Extent of Training and Engagement

Objective To evaluate the presence, extent, and temporality of transnational neurosurgical partnerships, to understand and inform measures to address neurosurgical deficiencies in low- and middle-income countries (LMICs). Methods A Web search was conducted to identify actors from high-income countries (HICs) participating in neurosurgical delivery and/or capacity-building with LMICs from 2010 to 2018. Descriptive data on current neurosurgical partnerships were collected from published case reports, literature reviews, reports from academic institutions, and information on stakeholder Web pages. The level of training and engagement of each partnership was separately graded based on prespecified criteria, in which grade 3 represented partnerships that have most extensive training and engagement, and grade 1, the least extent. Data were analyzed using descriptive statistics and geospatially depicted on ArcMap GIS software. Results A total of 123 unique HIC–LMIC partnerships were described. Of these partnerships, 85 (69%) are derived from HICs in North America, followed by Europe, with 23 (19%). The most common LMIC partners were from Africa (n = 56, 45%) and Latin America (n = 32, 26%). In addition, most partnerships provided services in pediatric neurosurgery (88%). The most frequent engagement classifications were grade 2 (35%) or 1 (36%). Similarly, for training, the most common classifications were grade 1 (40%) or 2 (30%). Conclusions A robust network of HIC–LMIC partnerships exists with varying degrees of engagement and training activities. Several regions are particularly suitable for growth and development. Systematic consolidation and indexing of transnational neurosurgical partnerships aim to enhance resource allocation and present opportunities for future partnership.