Neurocritical care in low- and middle-income countries

The growing incidence of acute neurological disorders, has underscored the increasing global need for dedicated neurocritical care (NCC) services. The organization and delivery of NCC services in low- and middle-income countries (LMICs) continue to evolve from a fragmented care system toward a comprehensive care model. This article reviews the available literature on the delivery of NCC services in LMICs and examines key domains, including infrastructure requirements, education and training frameworks, and research capacity, to support organizational models of care.

Earlier publications from LMICs highlight the state of NCC services and the persistent rural versus urban disparities in access to specialized care. Authors have also discussed the organization of existing NCC units and have proposed minimum standards for establishing NCC units. In an effort toward standardized care for NCC patients, researchers have focused on strategies to increase education, training, and research capacity. They discuss pragmatic strategies and future directions aimed at strengthening and expanding NCC services across LMICs.

There is an urgent need to strengthen NCC facilities across LMICs to mitigate the ongoing variability in clinical practice and service delivery. Addressing NCC infrastructure together with disparities experienced by critically ill patients requires targeted, context-sensitive interventions.