학술논문
Global Perspectives on Task Shifting and Task Sharing in Neurosurgery
Document Type
article
Author
Faith C. Robertson; Ignatius N. Esene; Angelos G. Kolias; Tariq Khan; Gail Rosseau; William B. Gormley; Kee B. Park; Marike L.D. Broekman; Jeffrey Rosenfeld; Naci Balak; Ahmed Ammar; Magnus Tisel; Michael Haglund; Timothy Smith; Ivar Mendez; Jannick Brennum; Stephen Honeybul; Akira Matsumara; Severien Muneza; Andres Rubiano; Patrick Kamalo; Graham Fieggen; Basant Misra; Gene Bolles; David Adelson; Robert Dempsey; Peter Hutchinson; Alexandrina Nikova; Osama Ghazala; Elubabor Buno; Shibashish Bhattacharjee; Takahiro Iizuka; Jafri Malin Abdullah; Bipin Chaurasia; Eghosa Morgan; Rodolfo E. Alcedo-Guardia; Lynne Lourdes N. Lucena; Kadir Oktay; Omar Ibrahim AbdAllah; Ahlem Saihi; Gacem Abdeldjalil; Mahi Asmaa; Claudio Yampolsky; Laura P. Saladino; Francisco Mannara; Sonal Sachdev; Benjamin Price; Vincent Joris; Nourou Dine Adeniran Bankole; Edgar M. Carrasco; Mirsad Hodzic; Marcos Wagner de Sousa Porto; Robson Amorim; Igor Lima Maldonado; Bizoza Yves; Gonzalo Suarez; Felipe Constanzo; Johanna Cecilia Valdeblanquez Atencio; Karen Alexa Ruiz Mora; Juan Manuel Rodriguez Gil; Kiriakos Paraskeva; Emrah Egemen; Trevcsor Ngamasata; Jeff Ntalaja; Antoine Beltchika; Glennie Ntsambi; Goertz Mirenge Dunia; Mahmoud M. Taha; Mohamed Arnaout; Ramez Kirollos; Mohamed Kassem; Omar Elwardany; Ahmed Negida; Birhanu Dolango; Mikael Aseged; Alemu Adise Mldie; Tsegazeab Laeke; Abenezer Aklilu; Esayas Adefris; Teemu Luoto; Rezai Jahromi Behnam; Emmanuel De Schlichting; Bougaci Nassim; Pierre Bourdillon; Martin N. Stienen; Stephan Lackermair; Franziska Anna Schmidt; Juergen Konczalla; Adrien Holzgreve; Andre Sagerer; Dieter M. Weinert; Paulette Kumi; Aaron Lawson McLean; James Loan; Julian Cahill; Simon Dockrell; Fardad T. Afshari; Paul May; Alkinoos Athanasiou; Steven Papadopoulos; Edroulfo-Georgios Espinoza; Athanasios Chatzisotiriou; Pavlos Vlachogiannis; Konstantina Karabatsou; Thanasis Paschalis; Christos Tsitsipanis; Gabriel Mauricio Longo Calderan; Ronny Leiva; Harsh Deora; Sreenivas Mukkamala; Dipesh Batra; Arvind Sukumaran; Kanishk Parmar; Anuj Bahl; Amit Agrawal; Nirankar Dev; Nikhil Thakur; Sanjay Behari; Chandrasekhar B.V.K. Yandrapati; Ritesh Bhoot; Pragnesh Bhatt; Uday Bhaumik; Manish Agrawal; Antony Thomas; Harish Chandrappa; Ankit Mathur; Petra Wahjoepramono; Selfy Oswari; Rafid Al-Mahfoudh; Abbas Alnaji; Nidal Abuhadrous; Bakr Abo Jarad; Ibrahim Nour; Or Cohen-Inbar; Roberto Colasanti; Alfredo Conti; Giovanni Raffa; Corrado Castrioto; Matteo M. Baccanelli; Santino Ottavio Tomasi; Matteo Zoli; Andrea Veroni; Andrea Di Cristofori; Luigi Giannachi; Laura Lippa; Donatella Sgubin; Morgan Broggi; Marcello Barbato; Francesco Restelli; Mario Ganau; Graziano Taddei; Hamzeh Albadawi; Mohammed Salameh; Madieyva Gulmira; Muffaq Lashhab; Walid El Gaddafi; Mohammad Altoumi; S.M. Manvinder; Davendran Kanesen; Mario Teo; Prabu Rau Sriram; Sarah Atiqah M. Zamri; Vayara Perumall Vinodh; Moussa Denou; Adyl Melhaoui; Oumaima Outani; Mahjouba Boutarbouch; Armin Gretschel; Pradhumna Yadav; Balgopal Karmacharya; Fatih Incekara; Hugo den Boogert; Buccket Argvoello Lopez; Hassane Ali Amadou; Danjuma Sale; Sanusi Bello; Poluyi Edward; Alvan-Emeka Ukachukwu; Evaristus Nwaribe; Ikechukwu Aniaku; Aliyu Baba Ndajiwo; Olabamidele Ayodele; Gyang Markus Bot; Sunday David Ndubuisu Achebe; Bakht Jamal; Muhammad Tariq; Ghulam Farooq; Danyal Zaman Khan; Ahtesham Khizar; Zahid Hussain; Anisa Nazir; Marco Gonzales-Portillo; Jhosep Silvestre Bautista; Roland A. Torres; Abigail Javier-Lizan; Isagani Jodl G. de los Santos, Jr.; Nuno Morais; Lydia Dias; Carolina Noronha; Jovelo Monteiro Silva; Alexandra Seromenho-Santos; Kiril Lozanche; Ionut Negoi; Alexandru Tascu; Danil A. Kozyrev; Dr. Menelas Nkeshimana; Claire Karekezi; Marcel Didier Ndayishyigikiye; Faisal Alabbass; Faisal Farrash; Rawan Alhazmi; Jagos Golubovic; Milan Lepifá; Rosanda Ilifá; Aleksandar Stanimirovifá; Sergio Garcia-Garcia; Carlos A. Rodriguez Arias; Ruth Lau; Juan Delgado-Fernandez; Miguel A. Arraez; C. Fernandez Mateos; Ana M. Castano Leon; Saman Wadanamby; David Bervini; Hamisi K. Shabani; Kriengsak Limpastan; Khalil Ayadi; Altay Sencer; Ali Yalcinkaya; Elif Eren; Recep Basaran; Abdulkerim Gokoglu; Vyval Mykola; Felicita Tayong; Mario Zuccarello; Carolyn Quinsey; Michael C. Dewan; Paul H. Young; Edward Laws; Jack Rock; David B. Kurland; Carrie R. Muh; Eri Dario Delgado Aguilar; Kenneth Burns; Jacob Low; Conor Keogh; Chris Uff; Alfio Spina; Fayez Alelyani
Source
World Neurosurgery: X, Vol 6, Iss , Pp - (2020)
Subject
Language
English
ISSN
2590-1397
Abstract
Background: Neurosurgical task shifting and task sharing (TS/S), delegating clinical care to non-neurosurgeons, is ongoing in many hospital systems in which neurosurgeons are scarce. Although TS/S can increase access to treatment, it remains highly controversial. This survey investigated perceptions of neurosurgical TS/S to elucidate whether it is a permissible temporary solution to the global workforce deficit. Methods: The survey was distributed to a convenience sample of individuals providing neurosurgical care. A digital survey link was distributed through electronic mailing lists of continental neurosurgical societies and various collectives, conference announcements, and social media platforms (July 2018–January 2019). Data were analyzed by descriptive statistics and univariate regression of Likert Scale scores. Results: Survey respondents represented 105 of 194 World Health Organization member countries (54.1%; 391 respondents, 162 from high-income countries and 229 from low- and middle-income countries [LMICs]). The most agreed on statement was that task sharing is preferred to task shifting. There was broad consensus that both task shifting and task sharing should require competency-based evaluation, standardized training endorsed by governing organizations, and maintenance of certification. When perspectives were stratified by income class, LMICs were significantly more likely to agree that task shifting is professionally disruptive to traditional training, task sharing should be a priority where human resources are scarce, and to call for additional TS/S regulation, such as certification and formal consultation with a neurosurgeon (in person or electronic/telemedicine). Conclusions: Both LMIC and high-income countries agreed that task sharing should be prioritized over task shifting and that additional recommendations and regulations could enhance care. These data invite future discussions on policy and training programs. Key words: Global health, Global neurosurgery, LMIC, Neurotrauma, Task sharing, Task shifting, Workforce