Financing of Neurosurgical Care for Brain Tumors in Low- and Middle-Income Countries: A Scoping Review of Barriers and Strategies.

ABSTRACT

BACKGROUND: Making neurosurgical care accessible to a larger portion of the population in low- and middle-income countries (LMICs) is integral due to the high mortality and morbidity associated with brain tumors. However, the high cost of care often makes it financially out of reach for many individuals. Therefore, this review aims to identify barriers to neurosurgical care of brain tumors in terms of financing in LMICs. METHODS: Without restriction to language, a search of the literature was undertaken in a number of databases, including PubMed, Scopus, Google Scholar, and CINAHL, in order to find the most pertinent research involving financing of brain tumors in LMICs. The last day of the search was October 20, 2022. Following screening and data extraction, significant themes were found and categorized using thematic analysis. RESULTS: A total of 28 studies were analyzed in this review. The review highlighted some of the barriers to providing surgical care of brain tumors in LMICs. In the cited studies, surgical expenses (41%), neuroimaging costs (30%), and care-related expenses (33%) were the primary concerns. Addressing these challenges involves cross-border collaboration (23%), transparent financing systems (46%), awake craniotomy (15%), cost-effective/reusable intra-operative supplies (8%), and optimizing resources in healthcare systems (8%). CONCLUSIONS: This study explored barriers and challenges to financing neurosurgical care of brain tumors in LMICs. Government support and transparency in healthcare financing should be prioritized to ensure that all individuals have access to surgical care of brain tumors.