EEG coverage in Africa: How can the gap be covered?

Electroencephalography (EEG) is a fundamental diagnostic tool used to evaluate epilepsy and other neurological disorders. Despite its clinical relevance, access to EEG services remains highly constrained across Africa, owing to infrastructure and workforce limitations.

To assess the current state of EEG services in Africa, including availability, distribution, usage patterns, and barriers to access, and to propose strategic recommendations for expanding coverage and utilization.

A cross-sectional online survey was conducted between 1st June and December 31, 2025, using a structured questionnaire distributed to different practitioners across 54 African countries. Responses were analyzed using descriptive statistics to evaluate EEG access, infrastructure, training availability, and international collaborations.

A total of 108 respondents from 42 African countries participated in the study. Most countries reported between 1 and 10 EEG machines nationally, corresponding to fewer than 0.4 devices per million population in most sub-Saharan countries, compared with over six devices per million in parts of North Africa. More than 55% of EEG machines were concentrated in capital cities. Only 8.6% of respondents used tele-EEG, and fewer than 22% reported cross-border collaboration. Routine EEG was widely available, while video-EEG and advanced modalities were rare. Limited training opportunities and workforce shortages are major constraints.

There is an urgent need for a continent-wide EEG strategy to address diagnostic and training inequities. Key priorities include decentralizing services through mobile and tele-EEG systems, establishing standardized training pathways, and promoting international collaborations. Strategic investment is essential for equitable neurodiagnostic services in Africa.