Neurocritical Care Organization in the Low-Income and Middle-Income Countries

Area of Science:

• Global Health
• Neuroscience
• Critical Care Medicine

Background:

• Neurocritical care services in low- and middle-income countries (LMICs) are crucial but face significant challenges.
• Assessing the current state of neurocritical care in LMICs is essential for identifying areas for improvement.

Purpose of the Study:

• To evaluate the organization, infrastructure, workforce, and protocol adherence in neurocritical care across LMICs.
• To identify key gaps and opportunities for enhancing neurocritical care in resource-limited settings.

Main Methods:

• A cross-sectional survey was administered to 408 healthcare providers in 42 LMICs.
• Data collected included neurointensive care unit availability, workforce composition, technology access, and protocol adherence.
• Analysis involved descriptive statistics and comparisons across geographical regions and economic strata (LICs, LoMICs, UMICs).

Main Results:

• Only 36.8% of facilities had dedicated neurointensive care units, with significant regional and economic disparities.
• Access to critical care technologies like portable CT scanners (9.3%) and tele-ICU services (14.9%) was limited.
• Protocol adherence for stroke and TBI was low, particularly in low-income countries, with workforce shortages being a major concern.

Conclusions:

• Critical gaps in neurocritical care infrastructure, workforce, and technology exist in LMICs.
• Strategic investments in neurointensive care unit capacity, workforce development, and affordable technologies are urgently needed.
• These findings provide a roadmap for policymakers to prioritize neurocritical care and reduce global outcome disparities.