Geographical Ddistribution of neurosurgeons and emergency neurosurgical services in Pakistan

Authors

Dr Saqib Kamran Bakhshi, Aga Khan UniversityFollow
Zara Shah, Aga Khan UniversityFollow
Mujtaba Khalil, Aga Khan UniversityFollow
Ayub Khan, Aga Khan UniversityFollow
Abdul Momin Kazi, Aga Khan UniversityFollow
Qurat -Ul-Ain Virani, Aga Khan University
Rashid Jooma, Aga Khan UniversityFollow
Michael Christopher Dewan, Vanberbilt University Medical Centre, Nashville, USA
Muhammad Shahzad Shamim, Aga Khan UniversityFollow

Document Type

Article

Department

Paediatrics and Child Health; Neurosurgery

Abstract

Background and objective: According to the World Federation of Neurosurgical Societies (WFNS), a minimum neurosurgery workforce density should be 1 per 200,000 population for optimum access to neurosurgical care. Pakistan lags behind in the number of neurosurgeons, and disproportionate geographical distribution further increases disparity. Our objective was to geographically map the density of neurosurgeons and emergency neurosurgical services (ENS) in Pakistan.
Methods: This survey was circulated among 307 neurosurgeons. Data were analyzed using SPSS v21. The number of neurosurgeons and ENS were plotted on the population density map using ArcGIS Pro 3.0.0 software.
Results: Three hundred and seven neurosurgeons working at 74 centers responded to our survey (93.3% coverage). The current density of neurosurgeons in Pakistan is 0.14/100,000. The 2 more populous provinces, Punjab and Sindh, have 42.3% (130) and 35.8% (110) neurosurgeons, respectively. They also housed nearly 3 quarters of all the neurosurgery centers in urban districts. Karachi and Lahore accommodate 135 (44%) of all the country's neurosurgeons, having 0.29 and 0.51 neurosurgeons/100,000 respectively. Management of traumatic brain injury is offered at 65 centers (87.8%). Nearly all centers are equipped with computed tomography (CT) scan machine (74; 97%), but magnetic resonance imaging (MRI) facility is available at 55 (72%) centers and 37 (49%) centers have angiography suites. Sixty nine centers (93.2%) have C-arm fluoroscopes available.
Conclusions: The geographical mapping of neurosurgeons and neurosurgical facilities is highly skewed towards urban centers, increasing disparity in access to timely neurosurgical emergency services. Four times more neurosurgeons are required in Pakistan to bridge the gap in neurosurgical workforce

Comments

Volume, issue, and pagination are not provided by the author/publisher.

Publication (Name of Journal)

World Neurosurgery

DOI

https://doi.org/10.1016/j.wneu.2023.08.133

Recommended Citation

Kamran Bakhshi, D., Shah, Z., Khalil, M., Khan, A., Kazi, A., Virani, Q. -., Jooma, R., Dewan, M. C., Shamim, M. (2023). Geographical Ddistribution of neurosurgeons and emergency neurosurgical services in Pakistan. World Neurosurgery.
Available at: https://ecommons.aku.edu/pakistan_fhs_mc_surg_neurosurg/358