Obstacles for accessing customised craniofacial implants in low- and middle-income countries

Introduction Many low resourced low- and middle-income countries (LMICs) do not have access to (high tech) developments in the medical field. The aim of this study is to research how a contemporary high-tech solution, such as customized medical implants, can be transferred to low resource LMICs. Materials and methods We explored the internet to retrieve data regarding internet coverage, services providing free email accounts, and the availability of connecting devices. Additionally, a computerized search was performed for currently available PSI concepts and other important emerging technologies with potential value in craniomaxillofacial surgery. Lastly, we searched the internet for the availability of CT scan devices and smartphones in the LMICs. Results Internet penetration and access to computers/smartphones is low in the LMICs. Moreover, availability of radiology departments and radiologists is very limited (60 radiologists per 190 million Nigerian inhabitants) and a lack of knowledge concerning import regulations and customs clearance, limits the accessibility/availability for patient-specific implants, since this is crucial in developing and delivering these devices. Lastly, appropriate training and instrumentation are vital (yet, currently difficult) to acquire and foresee, in order to achieve the best post-operative results. Conclusion This research confirms great difficulties achieving our aims but with persistence and adoption of well-constructed programs it should be possible.