Validation of the Twinning Model in Enhancing Neurosurgical Care in The Gambia

Overview

The study validates the INTIMA twinning model through a mission at Edward Francis Small Teaching Hospital in The Gambia, demonstrating increased surgical volume and multidisciplinary collaboration. The mission facilitated microneurosurgery capabilities by delivering equipment and education, resulting in improved neurosurgical care before, during, and after the intervention.

Background

Access to neurosurgical care is limited in many low- and middle-income countries, including West Africa, due to inconsistent infrastructure and specialist availability. Neurosurgery requires multidisciplinary collaboration beyond surgery, including postoperative care and rehabilitation services. Global neurosurgery partnerships have been developed to address these challenges, with the INTIMA model focusing on sustainable development of resource-challenged neurosurgical departments. This study aimed to validate the INTIMA model through a mission at EFSTH in The Gambia, the country’s sole neurosurgical center.

Data Highlights

Key Findings

• The INTIMA twinning model was successfully implemented at EFSTH, The Gambia, enhancing neurosurgical capacity.
• Surgical volume increased from 24 cases pre-mission to 43 cases post-mission over comparable three-month periods.
• Introduction of microneurosurgical equipment, including an operating microscope and high-speed drill, enabled more complex procedures.
• Multidisciplinary education was provided to surgical nurses, perioperative and postoperative care staff, and patients with spinal cord injury.
• The mission fostered professional linkages and research collaborations, including participation in a symposium on epilepsy and neurosurgery.

Clinical Implications

The INTIMA twinning model offers a validated framework for sustainable neurosurgical development in resource-limited settings by combining equipment donation, multidisciplinary education, and professional collaboration. Implementing such partnerships can increase surgical capacity and improve perioperative care quality, ultimately enhancing patient outcomes in LMIC neurosurgical units.

Conclusion

This study confirms that the INTIMA twinning model effectively strengthens neurosurgical services in resource-challenged environments through capacity building and multidisciplinary collaboration. The observed increase in surgical volume and complexity post-mission highlights the model’s potential for sustainable neurosurgical development.

References

1. Sundblom et al. 2023 -- Effective Implementation of the Twinning Model for International Neurosurgery Partnerships: A Validation Analysis