The Rating of Nigerian Neurosurgical Facilities Based on the Availability of Sub-Specialty Services in 2024
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Keywords
Aneurysm, C-arm, neuroendoscopy, neuronavigation, operative-microscopy, spine-instrumentation
Abstract
Background: Nigerian neurosurgery is striving to catch up with emerging sub-specialties, in accordance with international best practices. The study aims to profile the available sub-specialty services in Nigerian neurosurgery and rate the facilities based on their capacities.
Methodology: A cross-sectional study involving all centres with full-time neurosurgical services in Nigeria. Data collection was done electronically with questionnaires, WhatsApp, and short message services (SMS), from practising and resident neurosurgeons per centre. Clarifications on equivocal responses were sought by direct phone interviews. The rating of facilities was based on the availability of 7 major sub-specialty services – spine instrumentation / C-Arm, operative microscopy, trans-sphenoidal/-nasal cranial procedures, neuroendoscopy, aneurysmal clipping, neuronavigation and aneurysmal coiling. Scores and ratings were done based on the number of available services.
Results: A total of 44 neurosurgery facilities were profiled, 38 (86.4%) being government-owned, and 6 (23.6%) privately-owned. Of the 38 government facilities, 30 are federal. The modal available service is spine instrumentation/C-Arm fluoroscopy (78%), then operative microscopy (58.5%) and trans-sphenoidal/-nasal cranial procedures (51.2%). The mean subspecialty services are as follows: spine instrumentation/C-arm 0.8, operative microscopy 0.6, transsphenoidal/nasal procedure 0.5, neuroendoscopy 0.4, aneurysm clipping 0.4, neuronavigation 0.1, aneurysm coiling 0.04. Amongst the top-10 facilities, 7 are government and 3 privately-owned, but amongst the top-3 facilities, 2 are privately-owned. All 10 lowest-ranked facilities are government-owned.
Conclusions: Spine surgery and operative microscopy are more readily available in Nigeria, while aneurysmal clipping and coiling and neuroendoscopy services are poor in Nigeria. Despite the government-owned institutions being in the lead, the privately-owned institutions have massive future prospects.
References
Emejulu JKC. Neurosurgery in Nigeria - An Evaluation of the Perception of Health Personnel in a new Centre and a Comparison of the Nigerian Situation with that of other African States. Niger J Clin Pract. 2008;11(4):291–295.
Ohaegbulam SC. Half a century of neurosurgery in Nigeria. Afr J Med Med Sci. 2008;37(3):293–302. PMID: 18982825.
Ukachukwu A-EK, Petitit Z, Usman B, Ekweogwu OC, Dawang Y, Ahmad MH, et al. The status of specialist neurosurgical training in Nigeria: a survey of practitioners, trainers and trainees. World Neurosurg. 2024;185:e44–e56.
Kumar R, Pal R. India achieves WHO recommended doctor population ratio: a call for paradigm shift in public health discourse. J Family Med Prim Care. 2018;7:841–844.
Du RY, Thiong’o GM, LoPresti MA, Mohan NK, Dewan MC, Lepard J, Lam S. Pediatric neurosurgery in East Africa: an education and needs-based survey. World Neurosurg. 2020;141:e374–e382.
Worldometer. Nigeria Population 2024. [https://www.worldometers.info/world-population/nigeria-population](https://www.worldometers.info/world-population/nigeria-population).
Neurosurgeons in Nigeria. [https://www.nans.org.com](https://www.nans.org.com).
Pate MA. Nigeria copes with growing shortage of doctors, nurses. VOA Africa. 2024 April 9. [https://www.voaafrica.com](https://www.voaafrica.com).
Medical and Dental Council of Nigeria. How the new health policy will help bring back Nigerian doctors from diaspora. Channels Television. 2024 August 14. [https://www.channelstv.com](https://www.channelstv.com).
Ogaboh AA, Udom HT, Eke IT. Why brain drain in the Nigerian health sector? Asian J Appl Sci. 2020;8(2):95–104.
Mlambo VH, Adetiba TC. Effects of brain drain on the South African health sector: analysis of the dynamics of its push factors. J Econ Behav Stud. 2017;9(4):62–72.
Kamarulzaman A, Ramnarayan K, Mocumbi AO. Plugging the medical brain drain. Lancet. 2022;400(10362):1492–4.
World Bank. Nigeria overview: development news, research, data. [https://www.worldbank.org/en/country/nigeria/overview](https://www.worldbank.org/en/country/nigeria/overview).
Abuja Declaration: 10 Years On. [https://www.who.int/healthsystems/publications/abuja_declaration/en](https://www.who.int/healthsystems/publications/abuja_declaration/en).
Oriyomi A, Oginni O. Budget blues: Nigeria shortchanges its future, health with underfunding. Business Day. 2024 February 14.
Chukwuka EJ, Amahi FU. Effects of medical tourism on economic growth of Nigeria. Int J Res Innov Soc Sci. 2021.
Kobayashi K, Sato K, Kato F, Kanemura T, Yoshihara H, Sakai Y, et al. Trends in the numbers of spine surgeries and spine surgeons over the past 15 years. Nagoya J Med Sci. 2022;84(1):155.
Uluç K, Kujoth GC, Başkaya MK. Operating microscopes: past, present, and future. Neurosurg Focus. 2009;27(3):E4.
Wirtz WS, Albert FK, Schwaderer M, Heuer C, Staubert A, Tronnier VM, Knauth M, Kunze S. The benefit of neuronavigation for neurosurgery analyzed by its impact on glioblastoma surgery. Neurol Res. 2000;22(4):354–360.
Li KW, Nelson C, Suk I, Jallo GI. Neuroendoscopy: past, present, and future. Neurosurg Focus. 2005;19(6):1–5.
Ojo OA, Bankole OB, Onyia CU, Awofeso O, Dawang Y. Surgical management of aneurysmal subarachnoid haemorrhage in a resource-constrained region: a Nigerian regional experience. Brain Spine. 2023;3:101778.
Ugwuanyi CU, Anigbo AA, Nwaribe EE, Ayogu OM, Okpata CI, Salawu MM. A review of aneurysmal subarachnoid hemorrhage managed in resource-challenged setting. Clin Surg. 2021;6:3155.
Ndubuisi CA, Ogolo D, Ndukuba K, Campbell F, Okwoma O, Nnama S, et al. Intracranial aneurysm surgery in Southeast Nigeria: experience and challenges from neurosurgical management. East Afr J Neurol Sci. 2026;5(1).
Balogun S, Omon H, Anele C, Ajekwu T, Ejembi G, Ojo O, Komolafe E. Pituitary tumors-02 evolution of pituitary surgeries to the trans-sphenoidal approach in a Nigerian teaching hospital: leaning on local transfer of skills. Neuro-Oncol Adv. 2023;5(Suppl_4):iv12.
Kolo ES, Hassan I, Ibrahim M, Misbahu AH, Adamu A, Ismail NJ, Salahu D, Ramalan M. Early outcome of endoscopic trans-nasal trans-sphenoidal pituitary surgery in Kano, Nigeria. Niger J Basic Clin Sci. 2020;17(2):145–150.
World Federation of Neurological Societies. Clinical guidelines – clinical resources. [https://www.wfns.org](https://www.wfns.org).
Shrime MG, Bickler SW, Alkire BC, Mock G. Global burden of surgical disease: an estimation from the provider perspective. Lancet Glob Health. 2015;3(Suppl 2):S8–S9.
Taylor KK, Ibrahim AM, Scott J. A proposed framework for measuring access to surgical care in the United States. JAMA Surg. 2022;157(12):1075–1077.
Dewan MC, Rattani A, Fieggen G, et al. Global neurosurgery: the current capacity and deficit in the provision of essential neurosurgical care. J Neurosurg. 2018;130(4):1055–1064.
Hagland MM, Fuller AT. Global neurosurgery: innovators, strategies and the way forward. J Neurosurg. 2019;131(4):993–999.
Slettebo H, Grover AC, Ronning P, Tisell M, Kamalo P. Establishing neurosurgery in Malawi – the story of a fruitful collaboration. J Glob Neurosurg. 2022;2(1).
Kanmounye US, Robertson FC, Thango NS, Doe AN, Bankole NDA, Ginette PA, et al. Needs of young African neurosurgeons and residents: cross-sectional study. Front Surg. 2021;8:647279.
Oguh FA, Adamu JG. Bureaucracy of government establishments and business efficiency in Nigeria: an evidence of Nigerian National Petroleum Corporation (NNPC) E &P limited. Open Access J Manag Sci Res. 2025;3(1):1–27.
Memfys Hospital. [https://memfys.net/](https://memfys.net/).
Ipinnimo TM, Durowade KA, Afolayan CA, Ajayi PO, Akande TM. The Nigeria National Health Insurance Authority Act and its implications towards achieving universal health coverage. Niger Postgrad Med J. 2022;29(4):281–287.
Madu AC, Osborne K. Healthcare financing in Nigeria: a policy review. Int J Soc Determ Health Health Serv. 2023;53(4):434–443.
Adebisi YA, Umah JO, Olaoye OC, Alaran AJ, Busayo Sina-Odunsi A, Eliseo Lucero-Prisno III D. Assessment of health budgetary allocation and expenditure toward achieving universal health coverage in Nigeria. Int J Health Life Sci. 2020;6(2).
Ochuba C. Impact of government budget deficits on public health sector output in Nigeria. World J Adv Res Rev. 2021;11(02):350–364.
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