Paediatric neurological care in Sub-Saharan Africa: Current status and future directions

Paediatric neurology has evolved significantly since its early recognition as a subspecialty in the mid-20th century, though interest in childhood neurological conditions dates back centuries. In Sub-Saharan Africa (SSA), however, the field remains underdeveloped, despite a rising burden of neurological disorders such as epilepsy, cerebral palsy, cerebral malaria, autism spectrum disorder, and paediatric brain tumours. These conditions represent a significant proportion of paediatric morbidity and mortality in the region, yet limited epidemiological data, underdiagnosis, and health system constraints continue to obscure their true impact. Aetiological factors in SSA are diverse and include infectious diseases, perinatal complications, genetic disorders and environmental exposures. While countries such as South Africa, have made strides in diagnosis and care, progress remains uneven across the region. Structured training programmes like the African Paediatric Fellowship Programme and public engagement initiatives have contributed to capacity building, but most countries in the region still lack adequate specialist care, essential diagnostic tools such as electroencephalography and magnetic resonance imaging, and sustained investment in paediatric neurology infrastructure and epidemiological research. To address these gaps, this narrative review recommends expanding local training programmes, integrating task-shifting approaches to empower general practitioners and community health workers, and investing in clinical and epidemiological research. Equally critical is the need to strengthen health systems, improve access to diagnostic services, and promote inclusive, stigma reducing advocacy. Only through coordinated efforts can paediatric neurological care in SSA be advanced to meaningfully improve child health outcomes across the region. Thus, this narrative review explores the evident burdens of paediatric neurology care in SSA and proposes potential strategies to address these challenges.