Neurosurgery Education Around the World: Africa

Document Type

Book Chapter




Isabelle M. Germano

Publication (Name of Journal)

Neurosurgery and Global Health


General Surgery (East Africa)


Springer, Cham


New York


In Africa, neurosurgery, as an independent specialty, started approximately 60 years ago introduced by European neurosurgeons in their respective colonized countries. After gaining independence from Europe, in many African countries local physicians and especially neurosurgeons were scarce or absent. In 1998, the neurosurgeon/inhabitant ratio was 1/230,000 in the world, whereas in Africa they averaged at 1/1,238,000. Since 86% of African neurosurgeons were concentrated in the North and South, SSA had a ratio of 1/6,368,000. In North and South Africa, neurosurgery had a faster pace in developing than in Sub-Saharan Africa (SSA) for many reasons, including socioeconomics. Since then, efforts to grow the neurosurgery workforce have been very successful. Their success stemmed from the hard work of local neurosurgeons coupled with international efforts, including the World Federation of Neurosurgical Societies (WFNS). This joint venture created cost-effective neurosurgical training centers in Africa with high retention rate of the trained workforce. By 2025, the African population is expected to reach 1.4 billion people with 1.1 billion in SSA. Such growth poses opportunities and challenges to the continued efforts to improve the availability of workforce, facilities, equipment, and supplies to provide neurosurgical care in Africa. In this chapter, the authors provide background, data, and proposed strategies for the above-summarized topics.