Neurologic services in the nations of Africa

Objective: To define the current state of neurologic health care services in the nations of Africa. Methods: A survey on neurologic services was prepared in English, French, and Portuguese and sent to representatives of 53 of 53 African nations. Representatives for each country were identified first through the Pan African Association of Neurologic Sciences, followed by the World Federation of Neurology and the World Health Organization ( WHO). If these representatives did not return survey results, contacts were attempted through officials in the embassies in Washington, DC, or Addis Ababa, Ethiopia, or local ministries of health. Results: Surveys were received from representatives of 38 (71.7%) of the 53 African nations. Data from the WHO were added for 12 nations, resulting in information on 50 (94.3%) of the 53 nations. The nations were divided into four categories according to the number of neurologists per nation. Group A (>10 neurologists/country) included 11 nations, averaging 711,856 population per neurologist. Group B (5 to 10 neurologists/country) included five nations, averaging 1,612,039 population per neurologist. Group C (1 to 4 neurologists/country) included 23 nations, averaging 5,099,908 population per neurologist. Group D included 12 nations with a total population of 25,939,273 that reported having no neurologists. The level of training, presence of local training programs, ancillary equipment, and practice setting options decreased progressively from Group A to Group D. Conclusions: The population/neurologist ratio in all African nations far exceeds that of the United States and other developed nations. Neurologic services in the African nations range from no formal care at all to established neurologic care with residency training and ancillary equipment.