Emerging Trends in the Neurosurgical Workforce of Low- and Middle-Income Countries: A Cross-Sectional Study

Background Every year, there are an estimated 22.6 million new neurosurgical consultative cases worldwide, of which 13.8 million require surgery. In 2016, the global neurosurgical workforce was estimated and mapped as open-access information to guide neurosurgeons, affiliates, and policymakers. Here we present a subsequent investigation for mapping the global neurosurgical workforce for the year 2018 to demonstrate the replicability of prior data collection methods as well as show any changes in workforce density. Methods We extracted data on the absolute number of neurosurgeons per low and middle-income countries (LMICs) in 2016 from the database of the global neurosurgical workforce mapping project. The estimated number of neurosurgeons in each LMIC during the year 2018 was obtained from collaborators. The median workforce densities were calculated for the year 2016 and the year 2018. Neurosurgical workforce density heat maps were generated. Results We received data from 119 countries (response rate 86.2%) and imputed data for 19 (13.8%) countries. 78 (56.5%, n=138) countries had an increase in their number of neurosurgeons, 9 (6.5%) showed a decrease, while 51 (37.0%) had the same number of neurosurgeons in both years. The pooled median increased from 0.17 (IQR=0.54) in 2016 to 0.18 (IQR=0.59) in 2018. Conclusions Overall, the density of the neurosurgical workforce has increased from 2016 to 2018. However, at the current rate, 80 (58.0%) LMICs will not meet the neurosurgical workforce density target by 2030.