The role of surgical research in low- and middle-income countries

It has been estimated that 4.8 billion people lack access to safe and affordable surgery. Many of these people reside in low- and middle-income countries (LMIC). [1] This inevitably results in a significant disparity in surgical outcomes compared with high income countries (HIC) with increased rates of mortality having been reported [2, 3]. Currently, the majority of surgical research is conducted in highly developed countries [4] and these results are not always applicable to resource-limited countries. In order for surgical care to be improved in these countries, it is important that the research conducted is focused on the unique challenges that healthcare professionals in these settings face. The Journal of Surgical Protocols and Research Methodologies (JSPRM) is highly supportive of research in LMIC as seen in our April 2022 issue. Dalle et al. [5] have set out to conduct a scoping review of the epidemiology, presentation, management and outcomes of traumatic spinal cord injuries (TSCI) in children in LMIC. TSCI can have a devastating impact not only on the individual but also on those around them. The hope is that this research will allow for a greater understanding of the extent of this problem in Africa, help guide future research and contribute to the development of strategies to manage these challenging injuries. Ooi et al. [6] are also conducting research focused on Africa. Their efforts are directed at investigating the workforce challenges that are faced throughout the continent. In their protocol, they have set out to assess the undergraduate experience of African medical students in neurosurgery and their subsequent interest in pursuing a career in this specialty. Africa is already facing a significant workforce deficit within neurosurgery and this study will look to highlight a potential cause for this that may be possible to address. Both protocols have highlighted differing types of research methodologies that can be utilized and the wide range of questions that can be answered in LMIC to help address health inequalities. Continuing the theme of medical students and their future careers, Godoi et al. [7] published their protocol on their cross sectional study of UK medical students. Much work has previously been conducted to assess their readiness to practice. However, there is limited understanding of their preparedness for their career and opportunities for career planning. They shall be collecting data via a questionnaire with the aim of facilitating the development of career development programmes and resources. The importance and impact of collaborative research has been highlighted in our previous issues. It allows for larger populations and increased generalizability of the findings of studies. This is a model that has been successfully used in a variety of settings throughout the world including LMICs. Nasser et al. [8] describe the UK experience and provide a highly practical how-to guide for setting up a multicentre collaborative research study. This overview will prove to be very useful for those planning such collaborative studies in the future. As we approach our 1 year anniversary, JSPRM is proud to have created a platform that has allowed for the publication of a wide range of surgical research protocols and research methodology articles from all parts of the globe. Nevertheless, there remain gaps in the delivery of surgical care in LMICs despite it being cost effective [9] and having wider health benefits [10]. One area highlighted as requiring support to address these inequalities is the academic and research output from LMICs [11]. JSPRM provides a platform where the global health community can share its ideas, highlight research priorities and hopefully inspire others to contribute to addressing the many issues faced by both healthcare professionals and patients in the developing world. None declared.