Global neurosurgery

Global neurosurgery is "the clinical and public health practice of neurosurgery with the primary purpose of ensuring timely, safe, and affordable neurosurgical care to all who need it."{{cite journal |last1=Kanmounye |first1=Ulrick Sidney |last2=Esene |first2=Ignatius N |title=Letter: Global Neurosurgery Scope and Practice |journal=Neurosurgery Open |date=27 August 2021 |volume=2 |issue=3 |pages=okab025 |doi=10.1093/neuopn/okab025|doi-access=free }} The term global neurosurgery was first used in 1995 by Canadian neurosurgeon Dwight Parkinson to describe comprehensive clinical neurosurgery care in Manitoba;{{cite journal |last1=Parkinson |first1=Dwight |title=Early history of neurosurgery in Manitoba: threads in the tapestry of world neurosurgery |journal=Journal of Neurosurgery |date=May 1995 |volume=82 |issue=5 |pages=900–906 |doi=10.3171/JNS.1995.82.5.0900|pmid=7714620 }} however, the field as defined today was born in the mid-2010s.{{cite journal |last1=Park |first1=Kee B. |last2=Johnson |first2=Walter D. |last3=Dempsey |first3=Robert J. |title=Global Neurosurgery: The Unmet Need |journal=World Neurosurgery |date=1 April 2016 |volume=88 |pages=32–35 |doi=10.1016/j.wneu.2015.12.048 |pmid=26732963 |language=en |issn=1878-8750|doi-access=free }} The modern definition of global neurosurgery was born from a combination of global health and neurosurgery. Hence, global neurosurgery is conceived as a subspecialty of global health within global surgery.{{cite journal |last1=Andrews |first1=Russell J. |title=What's in a Name? "Global Neurosurgery" in the 21st Century |journal=World Neurosurgery |date=November 2020 |volume=143 |pages=336–338 |doi=10.1016/j.wneu.2020.07.233|pmid=32781142 |pmc=7414764 }}

Around 22.6 million people are affected by diseases amenable to neurosurgery each year, and 13.8 million require surgical intervention.{{cite journal |last1=Dewan |first1=Michael C. |last2=Rattani |first2=Abbas |last3=Fieggen |first3=Graham |last4=Arraez |first4=Miguel A. |last5=Servadei |first5=Franco |last6=Boop |first6=Frederick A. |last7=Johnson |first7=Walter D. |last8=Warf |first8=Benjamin C. |last9=Park |first9=Kee B. |title=Global neurosurgery: the current capacity and deficit in the provision of essential neurosurgical care. Executive Summary of the Global Neurosurgery Initiative at the Program in Global Surgery and Social Change |journal=Journal of Neurosurgery |date=April 2019 |volume=130 |issue=4 |pages=1055–1064 |doi=10.3171/2017.11.JNS171500|pmid=29701548 |s2cid=20159320 |doi-access=free }} The burden of diseases amenable to neurosurgery is disproportionately distributed globally, with low- and middle-income countries bearing more than 78.1% of cases. Low- and middle-income countries lack the workforce, infrastructure, funding, and data needed to address the disease burden.{{cite journal |last1=Gnanakumar |first1=Sujit |last2=Abou El Ela Bourquin |first2=Bilal |last3=Robertson |first3=Faith C. |last4=Solla |first4=Davi J. Fontoura |last5=Karekezi |first5=Claire |last6=Vaughan |first6=Kerry |last7=Garcia |first7=Roxanna M. |last8=Hassani |first8=Fahd Derkaoui |last9=Alamri |first9=Alexander |last10=Höhne |first10=Julius |last11=Mentri |first11=Nesrine |last12=Stienen |first12=Martin |last13=Laeke |first13=Tsegazeab |last14=Moscote-Salazar |first14=Luis Rafael |last15=Al-Ahmari |first15=Ahmed Nasser |last16=Al-Jehani |first16=Hosam |last17=Nicolosi |first17=Federico |last18=Samprón |first18=Nicolás |last19=Adelson |first19=P. David |last20=Servadei |first20=Franco |last21=Esene |first21=Ignatius N. |last22=Al-Habib |first22=Amro |last23=Kolias |first23=Angelos G. |title=The World Federation of Neurosurgical Societies Young Neurosurgeons Survey (Part I): Demographics, Resources, and Education |journal=World Neurosurgery: X |date=October 2020 |volume=8 |pages=100083 |doi=10.1016/j.wnsx.2020.100083|pmid=33103109 |pmc=7573644 }}{{cite journal |last1=Robertson |first1=Faith C. |last2=Gnanakumar |first2=Sujit |last3=Karekezi |first3=Claire |last4=Vaughan |first4=Kerry |last5=Garcia |first5=Roxanna M. |last6=Abou El Ela Bourquin |first6=Bilal |last7=Derkaoui Hassani |first7=Fahd |last8=Alamri |first8=Alexander |last9=Mentri |first9=Nesrine |last10=Höhne |first10=Julius |last11=Laeke |first11=Tsegazeab |last12=Al-Jehani |first12=Hosam |last13=Moscote-Salazar |first13=Luis Rafael |last14=Al-Ahmari |first14=Ahmed Nasser |last15=Samprón |first15=Nicolás |last16=Stienen |first16=Martin N. |last17=Nicolosi |first17=Federico |last18=Fontoura Solla |first18=Davi J. |last19=Adelson |first19=P. David |last20=Servadei |first20=Franco |last21=Al-Habib |first21=Amro |last22=Esene |first22=Ignatius |last23=Kolias |first23=Angelos G. |title=The World Federation of Neurosurgical Societies Young Neurosurgeons Survey (Part II): Barriers to Professional Development and Service Delivery in Neurosurgery |journal=World Neurosurgery: X |date=October 2020 |volume=8 |pages=100084 |doi=10.1016/j.wnsx.2020.100084|pmid=33103110 |pmc=7573643 }}{{cite journal |last1=Kanmounye |first1=Ulrick S. |last2=Robertson |first2=Faith C. |last3=Thango |first3=Nqobile S. |last4=Doe |first4=Alvin Nah |last5=Bankole |first5=Nourou Dine Adeniran |last6=Ginette |first6=Pape Aicha |last7=Ondoma |first7=Solomon |last8=Balogun |first8=James A. |last9=Opoku |first9=Isabella |last10=Jokonya |first10=Luxwell |last11=Mbaye |first11=Thioub |last12=Shabhay |first12=Zarina A. |last13=Ashour |first13=Ahmed M. |last14=Silva |first14=Ana Cristina Veiga |last15=Cheserem |first15=Beverly |last16=Karekezi |first16=Claire |last17=Hassani |first17=Fahd Derkaoui |last18=Mentri |first18=Nesrine |last19=Laeke |first19=Tsegazeab |last20=Aklilu |first20=Abenezer Tirsit |last21=Sanoussi |first21=Samuila |last22=Musara |first22=Aaron |last23=Ntalaja |first23=Jeff |last24=Ssenyonga |first24=Peter |last25=Bakhti |first25=Souad |last26=El Abbadi |first26=Najia |last27=Mahmud |first27=Muhammad Raji |last28=El-Ghandour |first28=Nasser M. F. |last29=Al-Habib |first29=Amro |last30=Kolias |first30=Angelos G. |last31=Servadei |first31=Franco |last32=Fieggen |first32=Graham |last33=Qureshi |first33=Mahmood |last34=Esene |first34=Ignatius |title=Needs of Young African Neurosurgeons and Residents: A Cross-Sectional Study |journal=Frontiers in Surgery |date=28 May 2021 |volume=8 |pages=647279 |doi=10.3389/fsurg.2021.647279|pmid=34124134 |pmc=8193351 |doi-access=free }}{{cite journal |last1=Nguembu |first1=Stéphane |last2=Kanmounye |first2=Ulrick Sidney |last3=Tétinou |first3=Francklin |last4=Djiofack |first4=Dylan |last5=Takoukam |first5=Régis |title=Barriers to Management of Nontraumatic Neurosurgical Diseases at 2 Cameroonian Neurosurgical Centers: Cross-Sectional Study |journal=World Neurosurgery |date=July 2020 |volume=139 |pages=e774–e783 |doi=10.1016/j.wneu.2020.04.162|pmid=32376382 |s2cid=218533601 }} High-income country patients, especially in rural areas and from economically-disadvantaged backgrounds, face unique challenges in accessing safe, timely, and affordable neurosurgical care.{{cite journal |last1=Rahman |first1=Sarah |last2=McCarty |first2=Justin C. |last3=Gadkaree |first3=Shekhar |last4=Semco |first4=Robert S. |last5=Bi |first5=Wenya Linda |last6=Dhand |first6=Amar |last7=Jarman |first7=Molly P. |last8=Ortega |first8=Gezzer |last9=Uribe-Leitz |first9=Tarsicio |last10=Bergmark |first10=Regan W. |title=Disparities in the Geographic Distribution of Neurosurgeons in the United States: A Geospatial Analysis |journal=World Neurosurgery |date=July 2021 |volume=151 |pages=e146–e155 |doi=10.1016/j.wneu.2021.03.152|pmid=33831612 |s2cid=233192632 }} For this reason, most global neurosurgery work has focused on access to care in low- and middle-incomce countries despite the global nature of disparities in accessing neurosurgical care.{{cite journal |last1=Kanmounye |first1=Ulrick Sidney |last2=Sebopelo |first2=Lorraine Arabang |last3=Keke |first3=Chiuyu |last4=Zolo |first4=Yvan |last5=Senyuy |first5=Wah Praise |last6=Endalle |first6=Genevieve |last7=Takoukam |first7=Régis |last8=Sichimba |first8=Dawin |last9=Nguembu |first9=Stéphane |last10=Ghomsi |first10=Nathalie |title=Mapping Global Neurosurgery Research Collaboratives: A Social Network Analysis of the 50 Most Cited Global Neurosurgery Articles |journal=Neurosurgery Open |date=11 March 2021 |volume=2 |issue=2 |pages=okab006 |doi=10.1093/neuopn/okab006|doi-access=free }}

Global neurosurgery practice involves advocacy, education, policy, research, and service delivery. The components of global neurosurgery practice are interdependent but global neurosurgeons tend to focus their practice on one or two of them. This trend has allowed for specialization within the field and greater collaboration between individuals and institutions.

Advocacy efforts happen at the international, regional, and local levels and in collaboration with health initiatives that share similar goals with global neurosurgery - universal health coverage and sustainable development. Internationally, global neurosurgery advocacy groups participate in high-level health policy events like the World Health Assembly and the United Nations General Assembly.{{cite journal |last1=Rosseau |first1=Gail |last2=Johnson |first2=Walter D. |last3=Park |first3=Kee B. |last4=Hutchinson |first4=Peter J. |last5=Lippa |first5=Laura |last6=Andrews |first6=Russell |last7=Servadei |first7=Franco |last8=Garcia |first8=Roxanna M. |title=Global neurosurgery: continued momentum at the 72nd World Health Assembly |journal=Journal of Neurosurgery |date=April 2020 |volume=132 |issue=4 |pages=1256–1260 |doi=10.3171/2019.11.JNS191823|pmid=31952031 |pmc=7895422 }} Global neurosurgery advocates have contributed to numerous high-level decisions including folate fortification, detection and management of congenital malformations, and injury prevention.{{cite journal |last1=Kanmounye |first1=Ulrick Sidney |last2=Shenaman |first2=Natalie |last3=Ratel |first3=Marj |last4=Park |first4=Kee B. |last5=Woodrow |first5=Sarah |last6=Olubunmi |first6=Comrade Lawal Aiyedun |last7=Tharin |first7=Suzanne |last8=Khan |first8=Tariq |last9=Haq |first9=Makinah |last10=Taylor |first10=Elliott |last11=Harkness |first11=William |last12=Shlobin |first12=Nathan A. |last13=Moser |first13=Richard |last14=Korn |first14=Josh |last15=Dempsey |first15=Robert J. |last16=Rosseau |first16=Gail |title=A Seat at the Table: Representation of Global Neurosurgery in the G4 Alliance |journal=Journal of Global Neurosurgery |date=23 April 2021 |volume=1 |issue=1 |pages=73–77 |doi=10.51437/jgns.v1i1.29 |s2cid=255894229 |url=http://198.12.226.205/index.php/jgn/article/view/237 |language=en |issn=2745-2379|doi-access=free }} Locally, global neurosurgery advocacy groups are constituted of health workers and other patient advocates. These groups affect local decision making but they are equally active internationally. Many local advocacy groups are members of international advocacy groups like the G4 Alliance,{{Cite web |title=Member Organizations |url=https://www.theg4alliance.org/about-g4-alliance-member-organizations |access-date=2022-07-22 |website=The G4 Alliance |language=en-US}} People and Organisations United for Spina Bifida and Hydrocephalus (PUSH!) Global Alliance,{{Cite web |title=Our Member Organisations |url=http://www.pu-sh.org/about-us/our-member-organisations |access-date=2022-07-22 |website=PUSH! Global Alliance |language=en}} and International Federation Spina Bifida and Hydrocephalus (IFSBH).{{Cite web |title=Our Members Archive |url=https://www.ifglobal.org/members/ |access-date=2022-07-22 |website=IF Global |language=en-BE}} Local global neurosurgery advocacy groups work within these international organizations to coordinate advocacy efforts regionally and globally.

Global neurosurgery education focuses on two aspects. First, global neurosurgery educators train specialists to serve under-resourced regions. The training focuses primarily on safe and quality service delivery within underserved communities. These global neurosurgery education efforts can be divided into non-specialized and specialized training. Non-specialized training or education for task-sharing/-shifting targets non-specialized healthcare workers such as general surgeons, clinical officers, and general practitioners.{{cite journal |last1=Robertson |first1=Faith C. |last2=Esene |first2=Ignatius N. |last3=Kolias |first3=Angelos G. |last4=Kamalo |first4=Patrick |last5=Fieggen |first5=Graham |last6=Gormley |first6=William B. |last7=Broekman |first7=Marike L.D. |last8=Park |first8=Kee B. |last9=Rosenfeld |first9=Jeffrey |last10=Balak |first10=Naci |last11=Ammar |first11=Ahmed |last12=Tisel |first12=Magnus |last13=Haglund |first13=Michael |last14=Smith |first14=Timothy |last15=Mendez |first15=Ivar |last16=Brennum |first16=Jannick |last17=Honeybul |first17=Stephen |last18=Matsumara |first18=Akira |last19=Muneza |first19=Severien |last20=Rubiano |first20=Andres |last21=Rosseau |first21=Gail |last22=Khan |first22=Tariq |last23=Misra |first23=Basant |last24=Bolles |first24=Gene |last25=Adelson |first25=David |last26=Dempsey |first26=Robert |last27=Hutchinson |first27=Peter |last28=Aklilu |first28=Abenezer |last29=Javier-Lizan |first29=Abigail |last30=Belhachmi |first30=Adil |last31=Khizar |first31=Ahtesham |last32=Tascu |first32=Alexandru |last33=Yalcinkaya |first33=Ali |last34=Ndajiwo |first34=Aliyu Baba |last35=Ukacjukwu |first35=Alvan-Emeka |last36=Agrawal |first36=Amit |last37=Thapa |first37=Amit |last38=Silva |first38=Ana C.V. |last39=Gretschel |first39=Armin |last40=Sukumaran |first40=Arvind |last41=Vats |first41=Atul |last42=Jarad |first42=Bakr Abo |last43=Karmacharya |first43=Balgopal |last44=Chaurasia |first44=Bipin |last45=Liew |first45=Boon Seng |last46=Rodriguez Arias |first46=Carlos A. |last47=Karekezi |first47=Claire |last48=Or |first48=Cohen-Inbar |last49=Sale |first49=Danjuma |last50=Kanesen |first50=Davendran |last51=Djilvesi |first51=Djula |last52=Nwaribe |first52=Evarsitus |last53=Mahmoud |first53=M. Elhaj |last54=Awais |first54=Mian |last55=Kumar |first55=Sanjay |last56=Adeleye |first56=Amos O. |last57=Agarwal |first57=Manish |last58=Nkeshimana |first58=Menelas |last59=Ndubuisi Achebe |first59=Sunday David |last60=El Gaddafi |first60=Walid |last61=Uysal |first61=Ece |last62=Morgan |first62=Eghosa |last63=Buno |first63=Elubabor |last64=Sunday |first64=Emmanuel |last65=Adefris |first65=Esayas |last66=Alelyani |first66=Fayez |last67=Constanzo |first67=Felipe |last68=Longo |first68=Gabriel |last69=Farooq |first69=Ghulam |last70=Dunia |first70=Goertz Mirenge |last71=Bot |first71=Gyang Markus |last72=Shabani |first72=Hamisi K. |last73=Deora |first73=Harch |last74=Almenshawy |first74=Hassan |last75=Kuheil |first75=Hazem |last76=Maldonado |first76=Igor Lima |last77=Negoi |first77=Ionut |last78=Yousaf |first78=Irfan |last79=Abdullah |first79=Jafri Malin |last80=Golubovic |first80=Jagos |last81=Ayadi |first81=Khalil |last82=Limpastan |first82=Kriengsak |last83=Jokonya |first83=Luxwell |last84=Hodzic |first84=Mirsad |last85=Kassem |first85=Mohamed |last86=Al-Rawi |first86=Mohammed |last87=Tariq |first87=Muhammad |last88=Vyval |first88=Mykola |last89=Balak |first89=Naci |last90=Abuhadrous |first90=Nidal |last91=Syrmos |first91=Nikolaos |last92=Alser |first92=Osaid |last93=Young |first93=Paul H. |last94=Wahjoepramono |first94=Petra |last95=Sriram |first95=Prabu Rau |last96=Ouchetati |first96=Rafik |last97=Basaran |first97=Recep |last98=Bhoot |first98=Ritesh |last99=Amorim |first99=Robson |display-authors=1 |last100=Iliƒá |first100=Rosanda |last101=Wadanamby |first101=Saman |last102=Fetene |first102=Samuel M. |last103=Behari |first103=Sanjay |last104=Babu |first104=Satish |last105=Khan |first105=Tariq |last106=Duong |first106=Trung Kien |last107=Laeke |first107=Tsegazeab |last108=Kanmounye |first108=Ulrick S. |last109=Komar |first109=Vladimir |last110=George |first110=Ipe Vazheeparambil |last111=Hussain |first111=Zahid |last112=Lucena |first112=Lynne Lourdes N. |last113=Ekouele Mbaki |first113=Hugues Brieux |last114=Kumwenda |first114=Ken-Keller |last115=Bah |first115=Djvnaba |last116=Efe |first116=Ibrahim E. |last117=Bandoh |first117=Dickson |last118=Aji |first118=Yunus Kuntawi |last119=Dakurah |first119=Thomas |title=Task-Shifting and Task-Sharing in Neurosurgery: An International Survey of Current Practices in Low- and Middle-Income Countries |journal=World Neurosurgery: X |date=April 2020 |volume=6 |pages=100059 |doi=10.1016/j.wnsx.2019.100059|pmid=32309800 |pmc=7154228 |s2cid=203529633 }}{{cite journal |last1=Robertson |first1=Faith C. |last2=Esene |first2=Ignatius N. |last3=Kolias |first3=Angelos G. |last4=Khan |first4=Tariq |last5=Rosseau |first5=Gail |last6=Gormley |first6=William B. |last7=Park |first7=Kee B. |last8=Broekman |first8=Marike L.D. |last9=Rosenfeld |first9=Jeffrey |last10=Balak |first10=Naci |last11=Ammar |first11=Ahmed |last12=Tisel |first12=Magnus |last13=Haglund |first13=Michael |last14=Smith |first14=Timothy |last15=Mendez |first15=Ivar |last16=Brennum |first16=Jannick |last17=Honeybul |first17=Stephen |last18=Matsumara |first18=Akira |last19=Muneza |first19=Severien |last20=Rubiano |first20=Andres |last21=Kamalo |first21=Patrick |last22=Fieggen |first22=Graham |last23=Misra |first23=Basant |last24=Bolles |first24=Gene |last25=Adelson |first25=David |last26=Dempsey |first26=Robert |last27=Hutchinson |first27=Peter |last28=Nikova |first28=Alexandrina |last29=Ghazala |first29=Osama |last30=Buno |first30=Elubabor |last31=Bhattacharjee |first31=Shibashish |last32=Iizuka |first32=Takahiro |last33=Abdullah |first33=Jafri Malin |last34=Chaurasia |first34=Bipin |last35=Morgan |first35=Eghosa |last36=Alcedo-Guardia |first36=Rodolfo E. |last37=Lucena |first37=Lynne Lourdes N. |last38=Oktay |first38=Kadir |last39=AbdAllah |first39=Omar Ibrahim |last40=Saihi |first40=Ahlem |last41=Abdeldjalil |first41=Gacem |last42=Asmaa |first42=Mahi |last43=Yampolsky |first43=Claudio |last44=Saladino |first44=Laura P. |last45=Mannara |first45=Francisco |last46=Sachdev |first46=Sonal |last47=Price |first47=Benjamin |last48=Joris |first48=Vincent |last49=Adeniran Bankole |first49=Nourou Dine |last50=Carrasco |first50=Edgar M. |last51=Hodzic |first51=Mirsad |last52=de Sousa Porto |first52=Marcos Wagner |last53=Amorim |first53=Robson |last54=Maldonado |first54=Igor Lima |last55=Yves |first55=Bizoza |last56=Suarez |first56=Gonzalo |last57=Constanzo |first57=Felipe |last58=Valdeblanquez Atencio |first58=Johanna Cecilia |last59=Ruiz Mora |first59=Karen Alexa |last60=Rodriguez Gil |first60=Juan Manuel |last61=Paraskeva |first61=Kiriakos |last62=Egemen |first62=Emrah |last63=Ngamasata |first63=Trevcsor |last64=Ntalaja |first64=Jeff |last65=Beltchika |first65=Antoine |last66=Ntsambi |first66=Glennie |last67=Dunia |first67=Goertz Mirenge |last68=Taha |first68=Mahmoud M. |last69=Arnaout |first69=Mohamed |last70=Kirollos |first70=Ramez |last71=Kassem |first71=Mohamed |last72=Elwardany |first72=Omar |last73=Negida |first73=Ahmed |last74=Dolango |first74=Birhanu |last75=Aseged |first75=Mikael |last76=Mldie |first76=Alemu Adise |last77=Laeke |first77=Tsegazeab |last78=Aklilu |first78=Abenezer |last79=Adefris |first79=Esayas |last80=Luoto |first80=Teemu |last81=Behnam |first81=Rezai Jahromi |last82=De Schlichting |first82=Emmanuel |last83=Nassim |first83=Bougaci |last84=Bourdillon |first84=Pierre |last85=Stienen |first85=Martin N. |last86=Lackermair |first86=Stephan |last87=Schmidt |first87=Franziska Anna |last88=Konczalla |first88=Juergen |last89=Holzgreve |first89=Adrien |last90=Sagerer |first90=Andre |last91=Weinert |first91=Dieter M. |last92=Kumi |first92=Paulette |last93=McLean |first93=Aaron Lawson |last94=Loan |first94=James |last95=Cahill |first95=Julian |last96=Dockrell |first96=Simon |last97=Afshari |first97=Fardad T. |last98=May |first98=Paul |last99=Honeybul |first99=Stephen |display-authors=1 |last100=Athanasiou |first100=Alkinoos |last101=Papadopoulos |first101=Steven |last102=Espinoza |first102=Edroulfo-Georgios |last103=Chatzisotiriou |first103=Athanasios |last104=Vlachogiannis |first104=Pavlos |last105=Karabatsou |first105=Konstantina |last106=Paschalis |first106=Thanasis |last107=Tsitsipanis |first107=Christos |last108=Longo Calderan |first108=Gabriel Mauricio |last109=Leiva |first109=Ronny |last110=Deora |first110=Harsh |last111=Mukkamala |first111=Sreenivas |last112=Batra |first112=Dipesh |last113=Sukumaran |first113=Arvind |last114=Parmar |first114=Kanishk |last115=Bahl |first115=Anuj |last116=Agrawal |first116=Amit |last117=Dev |first117=Nirankar |last118=Thakur |first118=Nikhil |last119=Behari |first119=Sanjay |last120=Yandrapati |first120=Chandrasekhar B.V.K. |last121=Bhoot |first121=Ritesh |last122=Bhatt |first122=Pragnesh |last123=Bhaumik |first123=Uday |last124=Agrawal |first124=Manish |last125=Thomas |first125=Antony |last126=Chandrappa |first126=Harish |last127=Mathur |first127=Ankit |last128=Wahjoepramono |first128=Petra |last129=Oswari |first129=Selfy |last130=Al-Mahfoudh |first130=Rafid |last131=Alnaji |first131=Abbas |last132=Abuhadrous |first132=Nidal |last133=Jarad |first133=Bakr Abo |last134=Nour |first134=Ibrahim |last135=Cohen-Inbar |first135=Or |last136=Colasanti |first136=Roberto |last137=Conti |first137=Alfredo |last138=Raffa |first138=Giovanni |last139=Castrioto |first139=Corrado |last140=Baccanelli |first140=Matteo M. |last141=Tomasi |first141=Santino Ottavio |last142=Zoli |first142=Matteo |last143=Veroni |first143=Andrea |last144=Di Cristofori |first144=Andrea |last145=Giannachi |first145=Luigi |last146=Lippa |first146=Laura |last147=Sgubin |first147=Donatella |last148=Broggi |first148=Morgan |last149=Barbato |first149=Marcello |last150=Restelli |first150=Francesco |last151=Ganau |first151=Mario |last152=Taddei |first152=Graziano |last153=Albadawi |first153=Hamzeh |last154=Salameh |first154=Mohammed |last155=Gulmira |first155=Madieyva |last156=Lashhab |first156=Muffaq |last157=El Gaddafi |first157=Walid |last158=Altoumi |first158=Mohammad |last159=Manvinder |first159=S.M. |last160=Kanesen |first160=Davendran |last161=Teo |first161=Mario |last162=Sriram |first162=Prabu Rau |last163=Zamri |first163=Sarah Atiqah M. |last164=Vinodh |first164=Vayara Perumall |last165=Denou |first165=Moussa |last166=Melhaoui |first166=Adyl |last167=Outani |first167=Oumaima |last168=Boutarbouch |first168=Mahjouba |last169=Gretschel |first169=Armin |last170=Yadav |first170=Pradhumna |last171=Karmacharya |first171=Balgopal |last172=Incekara |first172=Fatih |last173=Boogert |first173=Hugo den |last174=Lopez |first174=Buccket Argvoello |last175=Amadou |first175=Hassane Ali |last176=Sale |first176=Danjuma |last177=Bello |first177=Sanusi |last178=Edward |first178=Poluyi |last179=Ukachukwu |first179=Alvan-Emeka |last180=Nwaribe |first180=Evaristus |last181=Aniaku |first181=Ikechukwu |last182=Ndajiwo |first182=Aliyu Baba |last183=Ayodele |first183=Olabamidele |last184=Bot |first184=Gyang Markus |last185=Ndubuisu Achebe |first185=Sunday David |last186=Jamal |first186=Bakht |last187=Tariq |first187=Muhammad |last188=Farooq |first188=Ghulam |last189=Khan |first189=Tariq |last190=Khan |first190=Danyal Zaman |last191=Khizar |first191=Ahtesham |last192=Hussain |first192=Zahid |last193=Nazir |first193=Anisa |last194=Gonzales-Portillo |first194=Marco |last195=Bautista |first195=Jhosep Silvestre |last196=Torres |first196=Roland A. |last197=Javier-Lizan |first197=Abigail |last198=de los Santos |first198=Isagani Jodl G. |last199=Morais |first199=Nuno |last200=Dias |first200=Lydia |last201=Noronha |first201=Carolina |last202=Silva |first202=Jovelo Monteiro |last203=Seromenho-Santos |first203=Alexandra |last204=Lozanche |first204=Kiril |last205=Negoi |first205=Ionut |last206=Tascu |first206=Alexandru |last207=Kozyrev |first207=Danil A. |last208=Nkeshimana |first208=Menelas |last209=Karekezi |first209=Claire |last210=Ndayishyigikiye |first210=Marcel Didier |last211=Alabbass |first211=Faisal |last212=Farrash |first212=Faisal |last213=Alhazmi |first213=Rawan |last214=Golubovic |first214=Jagos |last215=Lepifá |first215=Milan |last216=Ilifá |first216=Rosanda |last217=Stanimirovifá |first217=Aleksandar |last218=Garcia-Garcia |first218=Sergio |last219=Rodriguez Arias |first219=Carlos A. |last220=Lau |first220=Ruth |last221=Delgado-Fernandez |first221=Juan |last222=Arraez |first222=Miguel A. |last223=Mateos |first223=C. Fernandez |last224=Castano Leon |first224=Ana M. |last225=Wadanamby |first225=Saman |last226=Bervini |first226=David |last227=Shabani |first227=Hamisi K. |last228=Limpastan |first228=Kriengsak |last229=Ayadi |first229=Khalil |last230=Sencer |first230=Altay |last231=Yalcinkaya |first231=Ali |last232=Eren |first232=Elif |last233=Balak |first233=Naci |last234=Basaran |first234=Recep |last235=Gokoglu |first235=Abdulkerim |last236=Mykola |first236=Vyval |last237=Tayong |first237=Felicita |last238=Rosseau |first238=Gail |last239=Zuccarello |first239=Mario |last240=Quinsey |first240=Carolyn |last241=Dewan |first241=Michael C. |last242=Young |first242=Paul H. |last243=Laws |first243=Edward |last244=Rock |first244=Jack |last245=Kurland |first245=David B. |last246=Muh |first246=Carrie R. |last247=Delgado Aguilar |first247=Eri Dario |last248=Burns |first248=Kenneth |last249=Low |first249=Jacob |last250=Keogh |first250=Conor |last251=Uff |first251=Chris |last252=Spina |first252=Alfio |last253=Alelyani |first253=Fayez |title=Global Perspectives on Task Shifting and Task Sharing in Neurosurgery |journal=World Neurosurgery: X |date=April 2020 |volume=6 |pages=100060 |doi=10.1016/j.wnsx.2019.100060|pmid=32309801 |pmc=7154229 }} Non-specialized training is especially important in increasing access to essential and emergency neurosurgical care rapidly.{{cite journal |last1=Robertson |first1=Faith C. |last2=Briones |first2=Richard |last3=Mekary |first3=Rania A. |last4=Baticulon |first4=Ronnie E. |last5=Jimenez |first5=Miguel A. |last6=Leather |first6=Andrew J.M. |last7=Broekman |first7=Marike L.D. |last8=Park |first8=Kee B. |last9=Gormley |first9=William B. |last10=Lucena |first10=Lynne L. |title=Task-Sharing for Emergency Neurosurgery: A Retrospective Cohort Study in the Philippines |journal=World Neurosurgery: X |date=April 2020 |volume=6 |pages=100058 |doi=10.1016/j.wnsx.2019.100058|pmid=32309799 |pmc=7154225 }} Non-specialized training, unlike specialized training, can be done in shorter periods, with larger cohorts, and with fewer resources. Specialized neurosurgery training can last anywhere from a few months to 8 years depending on the training level.{{cite journal |last1=Kato |first1=Y. |last2=Liew |first2=B. S. |last3=Sufianov |first3=A. A. |last4=Rasulic |first4=L. |last5=Arnautovic |first5=K. I. |last6=Dong |first6=V. H. |last7=Florian |first7=I. S. |last8=Olldashi |first8=F. |last9=Makhambetov |first9=Y. |last10=Isam |first10=B. |last11=Thu |first11=M. |last12=Enkhbayar |first12=Ts. |last13=Kumarasinghe |first13=N. |last14=Bajamal |first14=A. H. |last15=Nair |first15=S. |last16=Sharif |first16=S. |last17=Sharma |first17=M. R. |last18=Landeiro |first18=J. A. |last19=Yampolsky |first19=C. G. |last20=El-Ghandour |first20=N. M. F. |last21=Hossain |first21=A. M. |last22=Sim |first22=S. |last23=Chemate |first23=S. |last24=Burhan |first24=Hira |last25=Feng |first25=L. |last26=Andrade |first26=H. |last27=Germano |first27=Isabelle M. |title=Review of global neurosurgery education: Horizon of Neurosurgery in the Developing Countries |journal=Chinese Neurosurgical Journal |date=December 2020 |volume=6 |issue=1 |pages=19 |doi=10.1186/s41016-020-00194-1|pmid=32922948 |pmc=7398343 |doi-access=free }} Postgraduate medical fellowships in one of the neurosurgical subspecialties are open to graduate neurosurgery residents/registrars and can last between three and 24 months. On the other hand, neurosurgery residencies last between 4 and 8 years.{{Cite web |title=Volunteer Toolkit |url=http://www.fiens.org/new-page-2 |access-date=2022-07-22 |website=Foundation for International Education in Neurological Surgery (FIENS)}}

The other focus of global neurosurgery education is fellowships that introduce trainees to global and public health concepts. Global neurosurgery fellowships are relatively new but increasingly popular with institutions like Cambridge,{{Cite web |title=NIHR Global Health Research Group on Neurotrauma |url=https://neurotrauma.world/about |access-date=2022-07-22 |language=en-US}} Cornell,{{Cite web |title=Global Health Neurosurgery Fellowship |url=https://neurosurgery.weill.cornell.edu/education/neurosurgical-fellowships/global-health-neurosurgery-fellowship |access-date=2022-07-22 |website=Weill Cornell Medicine}} Duke,{{Cite web |title=Duke Global Neurosurgery & Neurology |url=https://www.dukeglobalneurosurgery.com/ |access-date=2022-07-22 |website= |language=en-US}} Harvard,{{Cite web |title=Paul Farmer Global Surgery Research Fellowship |url=https://www.pgssc.org/paul-farmer-global-surgery-fellowship |access-date=2022-07-22 |website=Harvard Program in Global Surgery and Social Change |language=en}} and the University of Cape Town{{Cite web |title=Education |url=http://www.globalsurgery.uct.ac.za/education-6 |access-date=2022-07-22 |website=University of Cape Town, Global Surgery |language=en}} offering specialized training.{{cite journal |last1=Rolle |first1=Myron L. |last2=Zaki |first2=Mark |last3=Parker |first3=Tariq |last4=Berger |first4=Connor |last5=Knowlton |first5=Harrison |last6=Kerry |first6=Vanessa |last7=Nahed |first7=Brian |title=Global Neurosurgery Education in United States Residency Programs |journal=World Neurosurgery |date=1 September 2020 |volume=141 |pages=e815–e819 |doi=10.1016/j.wneu.2020.06.039 |pmid=32540290 |s2cid=219700753 |url=https://www.sciencedirect.com/science/article/abs/pii/S1878875020312973 |language=en |issn=1878-8750|url-access=subscription }}

Global neurosurgeons contribute significantly to the design and implementation of health policies that improve access to safe, timely, and affordable neurosurgical care globally. Prime examples of global neurosurgery policy efforts include the comprehensive health policy guidelines for traumatic brain and spine injuries{{cite journal |last1=Corley |first1=Jacquelyn |last2=Barthélemy |first2=Ernest J. |last3=Lepard |first3=Jacob |last4=Alves |first4=Jose Luis |last5=Ashby |first5=Joanna |last6=Khan |first6=Tariq |last7=Park |first7=Kee B. |title=Comprehensive Policy Recommendations for Head and Spine Injury Care in Low- and Middle-Income Countries |journal=World Neurosurgery |date=December 2019 |volume=132 |pages=434–436 |doi=10.1016/j.wneu.2019.08.240|pmid=31810143 |s2cid=208812952 }}{{cite web |title=Comprehensive Policy Recommendations for Head and Spine Injury Care in LMICs |url=https://docs.wixstatic.com/ugd/d9a674_1ba60c38a07341a7bbbe8b1e3f0ff507.pdf|website=Harvard Global Neurosurgery Initiative |access-date=4 December 2021}} and for spina bifida and hydrocephalus.{{cite web |title=Comprehensive Policy Recommendations for the Management of Spina Bifida & Hydrocephalus in Low- & Middle-Income Countries |url=https://www.chyspr.org/ |access-date=22 July 2022 |website=CHYSPR group}} The comprehensive policy guidelines address challenges that affect the patient continuum of care and suggest solutions for every component of the healthcare system. These documents were designed for policymakers in areas with a large burden of diseases amenable to neurosurgery. Traumatic brain and spine injuries were chosen because they constitute more than 47.1% of the global neurosurgical disease burden while hydrocephalus and spina bifida were chosen for their deleterious impact on children.

Research is an indispensable aspect of global neurosurgery practice called academic global neurosurgery. Academic global neurosurgery has a broad focus and uses concepts from epidemiology, health economics, health policy, health services, health systems, implementation & dissemination science, and patient safety & quality improvement research. Academic global neurosurgery's exponential growth since 2016 is the result of increased interest and support from the neurosurgical community characterized by the creation of an ad-hoc committee within the World Federation of Neurosurgical Societies,{{Cite web |title=Global Neurosurgery Committee of the WFNS |url=https://globalneurosurgery.org/ |archive-url=https://web.archive.org/web/20161017122706/https://globalneurosurgery.org/ |url-status=usurped |archive-date=October 17, 2016 |access-date=2022-07-22 |website=Global Neurosurgery Committee of the WFNS |language=en}} publication of special issues in reputable peer-reviewed journals,{{Cite web |title=Prioritizing Global Neurosurgery in the Focus of Global Public Health: The ethical, financial and clinical necessities {{!}} Frontiers Research Topic |url=https://www.frontiersin.org/research-topics/16838/prioritizing-global-neurosurgery-in-the-focus-of-global-public-health-the-ethical-financial-and-clin |access-date=2022-07-22 |website=Frontiers in Surgery}}{{Cite journal |date=Oct 2018 |title=Reducing Inequities in Global Neurosurgery Delivery |url=https://thejns.org/focus/view/journals/neurosurg-focus/45/4/neurosurg-focus.45.issue-4.xml |journal=Neurosurgical Focus |volume=45 |issue=4 |pages= |doi= |issn=1092-0684}} creation of a specialized journal,{{Cite journal |title=Journal of Global Neurosurgery |url=https://doi.org/10.51437/jgns.v1i1 |journal=Journal of Global Neurosurgery |volume=1 |issue=1 |doi=10.51437/jgns.v1i1 |issn=2745-2379|year=2022 |url-access=subscription }} and the creation of global neurosurgery centers. Academic global neurosurgery identifies challenges to accessing neurosurgical care and proposes solutions that increase access to care. The evidence generated by academic global neurosurgery informs the other aspects of global neurosurgery practice.

Service delivery is the oldest component of global neurosurgery practice and can be traced back to the colonial era when surgeons would deliver care in colonies.{{cite journal |last1=Dada |first1=Olaoluwa Ezekiel |last2=Karekezi |first2=Claire |last3=Mbangtang |first3=Celestin Bilong |last4=Chellunga |first4=Edwin Samwel |last5=Mbaye |first5=Thioub |last6=Konan |first6=Landry |last7=Adeniran Bankole |first7=Nourou Dine |last8=Merci Kabulo |first8=Katenga Dieu |last9=Hugues Dokponou |first9=Yao Christian |last10=Ghomsi |first10=Nathalie Christelle |last11=Negida |first11=Ahmed |last12=Nguembu |first12=Stéphane |last13=Thango |first13=Nqobile |last14=Cheserem |first14=Beverly |last15=Kamabu |first15=Larrey Kasereka |last16=Alalade |first16=Andrew F. |last17=Esene |first17=Ignatius |last18=Kanmounye |first18=Ulrick Sidney |title=State of Neurosurgical Education in Africa: A Narrative Review |journal=World Neurosurgery |date=July 2021 |volume=151 |pages=172–181 |doi=10.1016/j.wneu.2021.05.086|pmid=34058355 |s2cid=235266965 }} Global neurosurgery aims to reduce barriers to essential and emergency neurosurgery procedures such as those needed for acute stroke, neural tube defects, traumatic brain injuries, and traumatic spine injuries.{{Cite book |last1=Debas |first1=H. T. |url=http://elibrary.worldbank.org/doi/book/10.1596/978-1-4648-0346-8 |title=Disease Control Priorities, Third Edition (Volume 1): Essential Surgery |last2=Donkor |first2=P. |last3=Gawande |first3=A. |last4=Jamison |first4=D. T. |last5=Kruk |first5=M. E. |author-link5=Margaret Elizabeth Kruk |last6=Mock |first6=C. N. |date=2015-03-23 |publisher=The World Bank |isbn=978-1-4648-0346-8 |editor-last=Debas |editor-first=Haile T. |language=en |chapter=Surgery and Trauma Care |doi=10.1596/978-1-4648-0346-8 |hdl=10986/21568 |pmid=26740991 |editor-last2=Donkor |editor-first2=Peter |editor-last3=Gawande |editor-first3=Atul |editor-last4=Jamison |editor-first4=Dean T. |editor-last5=Kruk |editor-first5=Margaret E. |editor-link5=Margaret Elizabeth Kruk |editor-last6=Mock |editor-first6=Charles N. |chapter-url=https://dcp-3.org/sites/default/files/chapters/DCP3_Essential%20Surgery_Ch3.pdf}}{{Cite book |last1=Debas |first1=H. T. |url=http://elibrary.worldbank.org/doi/book/10.1596/978-1-4648-0346-8 |title=Disease Control Priorities, Third Edition (Volume 1): Essential Surgery |last2=Donkor |first2=P. |last3=Gawande |first3=A. |last4=Jamison |first4=D. T. |last5=Kruk |first5=M. E. |author-link5=Margaret Elizabeth Kruk |last6=Mock |first6=C. N. |date=2015-03-23 |publisher=The World Bank |isbn=978-1-4648-0346-8 |editor-last=Debas |editor-first=Haile T. |language=en |chapter=Surgical Interventions for Congenital Anomalies |doi=10.1596/978-1-4648-0346-8 |hdl=10986/21568 |pmid=26740991 |editor-last2=Donkor |editor-first2=Peter |editor-last3=Gawande |editor-first3=Atul |editor-last4=Jamison |editor-first4=Dean T. |editor-last5=Kruk |editor-first5=Margaret E. |editor-link5=Margaret Elizabeth Kruk |editor-last6=Mock |editor-first6=Charles N. |chapter-url=https://dcp-3.org/sites/default/files/chapters/DCP3_Essential%20Surgery_Ch8.pdf}}

Low- and middle-income country patients have worse outcomes than their high-income country counterparts because they regularly face barriers to accessing timely and safe neurosurgical care.{{cite journal |last1=Biccard |first1=Bruce M. |last2=Madiba |first2=Thandinkosi E. |last3=Kluyts |first3=Hyla-Louise |last4=Munlemvo |first4=Dolly M. |last5=Madzimbamuto |first5=Farai D. |last6=Basenero |first6=Apollo |last7=Gordon |first7=Christina S. |last8=Youssouf |first8=Coulibaly |last9=Rakotoarison |first9=Sylvia R. |last10=Gobin |first10=Veekash |last11=Samateh |first11=Ahmadou L. |last12=Sani |first12=Chaibou M. |last13=Omigbodun |first13=Akinyinka O. |last14=Amanor-Boadu |first14=Simbo D. |last15=Tumukunde |first15=Janat T. |last16=Esterhuizen |first16=Tonya M. |last17=Manach |first17=Yannick Le |last18=Forget |first18=Patrice |last19=Elkhogia |first19=Abdulaziz M. |last20=Mehyaoui |first20=Ryad M. |last21=Zoumeno |first21=Eugene |last22=Ndayisaba |first22=Gabriel |last23=Ndasi |first23=Henry |last24=Ndonga |first24=Andrew K. N. |last25=Ngumi |first25=Zipporah W. W. |last26=Patel |first26=Ushmah P. |last27=Ashebir |first27=Daniel Zemenfes |last28=Antwi-Kusi |first28=Akwasi A. K. |last29=Mbwele |first29=Bernard |last30=Sama |first30=Hamza Doles |last31=Elfiky |first31=Mahmoud |last32=Fawzy |first32=Maher A. |last33=Pearse |first33=Rupert M. |title=Perioperative patient outcomes in the African Surgical Outcomes Study: a 7-day prospective observational cohort study |journal=Lancet |date=21 April 2018 |volume=391 |issue=10130 |pages=1589–1598 |doi=10.1016/S0140-6736(18)30001-1 |pmid=29306587 |s2cid=4666606 |url=https://pubmed.ncbi.nlm.nih.gov/29306587/ |issn=1474-547X}}{{cite journal |last1=Vaca |first1=Silvia D |last2=Kuo |first2=Benjamin J |last3=Nickenig Vissoci |first3=Joao Ricardo |last4=Staton |first4=Catherine A |last5=Xu |first5=Linda W |last6=Muhumuza |first6=Michael |last7=Ssenyonjo |first7=Hussein |last8=Mukasa |first8=John |last9=Kiryabwire |first9=Joel |last10=Rice |first10=Henry E |last11=Grant |first11=Gerald A |last12=Haglund |first12=Michael M |title=Temporal Delays Along the Neurosurgical Care Continuum for Traumatic Brain Injury Patients at a Tertiary Care Hospital in Kampala, Uganda |journal=Neurosurgery |date=2019 |volume=84 |issue=1 |pages=95–103 |doi=10.1093/neuros/nyy004 |pmid=29490070 |pmc=6292785 |issn=0148-396X}}

The workforce deficit in low- and middle-income countries constitutes a significant barrier to receiving care. Although former colonies have trained local neurosurgeons since their independence, the neurosurgical workforce density in many low- and middle-income countries remains below the World Federation of Neurosurgical Societies' recommendation of 1 neurosurgeon per 200,000 people.{{cite journal |last1=Kanmounye |first1=Ulrick Sidney |last2=Lartigue |first2=Jean Wilguens |last3=Sadler |first3=Samantha |last4=Yuki Ip |first4=Ho Kei |last5=Corley |first5=Jacquelyn |last6=Arraez |first6=Miguel Angel |last7=Park |first7=Kee |title=Emerging Trends in the Neurosurgical Workforce of Low- and Middle-Income Countries: A Cross-Sectional Study |journal=World Neurosurgery |date=October 2020 |volume=142 |pages=e420–e433 |doi=10.1016/j.wneu.2020.07.067|pmid=32688040 |s2cid=220669140 }} In addition, the majority of low- and middle income countries have geographical disparities in the neurosurgical workforce with most neurosurgeons working in urban areas whereas the majority of people in these countries are rural-dwellers. In addition, surgical non-governmental organizations from high-income countries help fill the service delivery gap in some low- and middle-income countries.{{cite journal |last1=Ng-Kamstra |first1=Joshua S. |last2=Riesel |first2=Johanna N. |last3=Arya |first3=Sumedha |last4=Weston |first4=Brad |last5=Kreutzer |first5=Tino |last6=Meara |first6=John G. |last7=Shrime |first7=Mark G. |title=Surgical Non-governmental Organizations: Global Surgery's Unknown Nonprofit Sector |journal=World Journal of Surgery |date=August 2016 |volume=40 |issue=8 |pages=1823–1841 |doi=10.1007/s00268-016-3486-1 |pmid=27008646 |s2cid=22325600 |url=https://pubmed.ncbi.nlm.nih.gov/27008646/ |issn=1432-2323}} Although most neurosurgical non-governmental organizations offer short-term service delivery in low- and middle-income countries, some like CURE International offer long-term care.{{Cite web |title=CURE International |url=https://cure.org/ |access-date=2022-07-22 |website=cure.org}}

The neurosurgical workforce in low- and middle-income countries has increased gradually in the past decade thanks to targeted efforts from the global neurosurgery community. For example, the World Federation of Neurosurgical Societies supports the training of aspiring neurosurgeons from understaffed countries through scholarships at accredited centers in Africa, Asia, and South America.{{Cite web|url=https://wfnsfoundationgazette.com/our-training-centers-2-2|title = Our Training Centers}}{{Cite web|url=https://wfnsfoundationgazette.com/our-training-centers-2|title = Our Training Centers}}{{Cite web |title=How to standardize further training of international students? Tips from our Neurosurgery Department - West China hospital, sichuan university - West China hospital, sichuan university |url=http://www.wchscu.cn/details/50314.html |access-date=2022-07-22 |website=West China School of Medicine/West China Hospital of Sichuan University (WCSM/WCH)}}{{cite journal |last1=Dada |first1=Olaoluwa Ezekiel |last2=Karekezi |first2=Claire |last3=Mbangtang |first3=Celestin Bilong |last4=Chellunga |first4=Edwin Samwel |last5=Mbaye |first5=Thioub |last6=Konan |first6=Landry |last7=Adeniran Bankole |first7=Nourou Dine |last8=Merci Kabulo |first8=Katenga Dieu |last9=Hugues Dokponou |first9=Yao Christian |last10=Ghomsi |first10=Nathalie Christelle |last11=Negida |first11=Ahmed |last12=Nguembu |first12=Stéphane |last13=Thango |first13=Nqobile |last14=Cheserem |first14=Beverly |last15=Kamabu |first15=Larrey Kasereka |last16=Alalade |first16=Andrew F. |last17=Esene |first17=Ignatius |last18=Kanmounye |first18=Ulrick Sidney |title=State of Neurosurgical Education in Africa: A Narrative Review |journal=World Neurosurgery |date=July 2021 |volume=151 |pages=172–181 |doi=10.1016/j.wneu.2021.05.086 |pmid=34058355 |s2cid=235266965 |url=https://www.sciencedirect.com/science/article/abs/pii/S1878875021007816|url-access=subscription }}

Young neurosurgeons from under-resourced regions who have been trained in advanced neurosurgical techniques report their patients do not get safe and timely care because of inadequate infrastructure. Access to neurosurgical infrastructure can be assessed summarily using the World Federation of Neurosurgical Societies facility three-tier classification or using hospital assessment tools.{{cite journal |last1=Kanmounye |first1=Ulrick Sidney |last2=Ghomsi |first2=Nathalie C. |last3=Djiofack |first3=Dylan |last4=Tétinou |first4=Francklin |last5=Nguembu |first5=Stéphane |last6=Zolo |first6=Yvan |last7=Esene |first7=Ignatius |title=The Implications of Global Neurosurgery for Low- and Middle-income Countries: The Case of Cameroon |journal=Iranian Journal of Neurosurgery |date=10 April 2020 |volume=6 |issue=2 |pages=93–100 |doi=10.32598/irjns.6.2.7 |s2cid=226073509 |url=https://irjns.org/article-1-209-en.html |language=en|doi-access=free }} The World Federation of Neurosurgical Societies facility three-tier classification groups facilities into level 1 (equipment for emergency neurosurgery procedures), level 2 (equipment to perform basic microneurosurgical procedures), and level 3 (equipment for complex and advanced neurosurgery).

{{reflist}}

{{Neuroscience}}

Category:Global health

Category:Neurosurgery