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Identifying Gaps in Bolivian Neurosurgery: A Systematic Review and Proposed Framework for Resource Implementation.
Caleigh S Roach1, Jacob J Shawwa2, Connor S Nee2
1Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, USA.
Cureus
|November 7, 2025
Summary
Neurosurgical care in Bolivia shows strengths in pediatric cases but faces significant gaps in advanced technology and infrastructure. Targeted investment and collaboration are crucial for improving neurosurgical services in this low- and middle-income country.
Area of Science:
- Global Health
- Neurosurgery
- Health Systems Research
Background:
- Low- and middle-income countries (LMICs) experience significant neurosurgical care challenges.
- Bolivia, a South American LMIC, has limited representation in global neurosurgical research.
Purpose of the Study:
- To systematically review Bolivian neurosurgical literature.
- Identify strengths, gaps, and opportunities for investment and technology in Bolivian neurosurgery.
Main Methods:
- Systematic literature review using PubMed, Scopus, and Embase.
- Extracted data on study design, patient population, surgical volume, institutional capacity, technology, outcomes, and barriers.
- Descriptive statistics and thematic synthesis were employed.
Main Results:
- Eleven studies were included, with 98% focusing on pediatric neurosurgery.
- Gaps identified: limited advanced technology (neuronavigation, microsurgery), restricted imaging access (64%), and high loss to follow-up (21%).
- Barriers included infrastructure, workforce, infection control, and referral delays.
Conclusions:
- Bolivian neurosurgery is characterized by concentrated pediatric research, variable infrastructure, and fragmented systems.
- Key opportunities exist for capacity-building and targeted collaboration.
- Strengthening neurosurgical care in Bolivia can serve as a model for similar LMICs.
