• Saad Javed, Daniela Perez-Chadid, Eesha Yaqoob, Nathan A Shlobin, Edward I Ham, Vigneshwar Raj Veerappan, Sachin Chemate, Faith C Robertson, Sarah Cain, Federico Nicolosi, Megan E H Still, Zhihua Chen Jehan, Laura Lippa, Marisa Gandia, Veiga SilvaAna CristinaACNeurosurgery Department of Post Graduation Program in Neuropsychiatry and Behavioral Sciences (PosNeuro), Federal University of Pernambuco, Recife, Brazil., Ronnie E Baticulon, Nqobile Thango, Zerubabbel K Asfaw, Luxwell Jokonya, Angelos Kolias, Ernest J Barthélemy, Ignatius Esene, and WFNS Young Neurosurgeons Forum.
• Department of Neurosurgery, Holy Family Hospital, Rawalpindi Medical University, Rawalpindi, Pakistan. Electronic address: saadjaved10095@gmail.com.
• World Neurosurg. 2023 Jun 10.

BackgroundAsia has a marked shortage of neurosurgical care, with approximately 2.5 million critical cases left untreated. The Young Neurosurgeons Forum of the World Federation of Neurosurgical Societies surveyed Asian neurosurgeons to identify research, education, and practice.MethodsA cross-sectional study using a pilot-tested e-survey was circulated to the Asian neurosurgical community from April to November 2018. Descriptive statistics were used to summarize variables pertaining to demographics and neurosurgical practices. The chi-square test was used to explore the relationship between World Bank income level and variables on neurosurgical practices.ResultsA total of 242 responses were analyzed. Respondents were mostly from the low- and middle-income countries (70%). Most represented institutions were teaching hospitals (53%). More than 50% of the hospitals had between 25and 50 neurosurgical beds. Access to an operating microscope (P = 0.038) or image guidance system (P = 0.001) appeared to increase in correlation to a higher World Bank income level. Limited opportunities for conducting research (56%) and hands-on operating opportunities (45%) were leading challenges in daily academic practice. The leading challenges were limited numbers of intensive care unit beds (51%), inadequate or absent insurance coverage (45%), and lack of organized perihospital care (43%). Inadequate insurance coverage decreased with increasing World Bank income levels (P < 0.001). Organized perihospital care (P = 0.001), regular magnetic resonance imaging access (P = 0.032), and equipment necessary for microsurgery (P = 0.007) increased with higher World Bank income levels.ConclusionsImproving neurosurgical care hinges on regional and international collaboration and national policies to ensure universal access to essential neurosurgical care.Copyright © 2023 Elsevier Inc. All rights reserved.

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