The establishment and development of neurosurgery services in Papua New Guinea

Kaptigau, W. Matui, Rosenfeld, Jeffrey V., Kevau, Ikau and Watters, David A. 2016, The establishment and development of neurosurgery services in Papua New Guinea, World journal of surgery, vol. 40, no. 2, pp. 251-257, doi: 10.1007/s00268-015-3268-1.

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Title The establishment and development of neurosurgery services in Papua New Guinea
Author(s) Kaptigau, W. Matui
Rosenfeld, Jeffrey V.
Kevau, Ikau
Watters, David A.ORCID iD for Watters, David A.
Journal name World journal of surgery
Volume number 40
Issue number 2
Start page 251
End page 257
Total pages 7
Publisher Springer
Place of publication Berlin, Germany
Publication date 2016-02
ISSN 1432-2323
Summary BACKGROUND: Papua New Guinea (PNG) is a developing Pacific Nation of 7.3 million people. Although neurosurgery training was introduced to PNG in the year 2000, it was in 2003 that a neurosurgery service was established. Prior to this time, neurosurgery in PNG was performed by general surgeons, with some assistance from visiting Australian neurosurgeons. Neurosurgical training was introduced to PNG in 2000. The model involved a further 3 years of training for a surgeon who had already completed 4 years of general surgical training. We aim to review the output, outcomes and impact achieved by training the first national neurosurgeon. METHODS: The data on activity (output) and outcomes were collected prospectively from 2003-2012. Ongoing mentoring and continuing professional development were provided through annual neurosurgical visits from Australia. There were serious limitations in the provision of equipment, with a lack of computerized tomographic or MR imaging, and adjuvant oncological services. RESULTS: There were 1618 neurosurgery admissions, 1020 neurosurgical procedures with a 5.74 % overall mortality. Seventy percent of cases presented as emergencies. There were improved outcomes, particularly for head injuries, whilst hydrocephalus was managed with an acceptable morbidity and revision rate. CONCLUSIONS: The training of a neurosurgeon resulted in PNG patients receiving a better range of surgical services, with a lower mortality. The outcomes able to be delivered were limited by late presentations of patients and lack of resources including imaging. These themes are familiar to all low- and middle-income countries (LMICs) and this may serve as a model for other LMIC neurosurgical services to adopt as they consider whether to establish and develop neurosurgical and other sub-specialist surgical services.
Language eng
DOI 10.1007/s00268-015-3268-1
Field of Research 111799 Public Health and Health Services not elsewhere classified
1103 Clinical Sciences
Socio Economic Objective 920299 Health and Support Services not elsewhere classified
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2016, Springer
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