A scoping review of non-governmental organizations in global neurosurgery: contributions, gaps, and future directions

Background Global Neurosurgery, galvanized by the 2016 Bogotá Declaration, seeks to address profound disparities in neurosurgical care access. Non-governmental organizations (NGOs) are pivotal yet underexplored actors in this field. This scoping review aims to systematically identify and characterize the landscape of NGOs contributing to global neurosurgery, analyzing their roles, strategies, and gaps. Methods We conducted a structured search of PubMed, Embase, Global Index Medicus, and grey literature sources following scoping review guidelines. NGOs with a multinational scope, neurosurgical focus, and at least five years of activity were included. Data from websites, reports, and publications were extracted and analyzed thematically. Results We identified 33 NGOs, categorized as neurosurgery-dedicated, global surgery-inclusive, or neurology-inclusive. Their contributions span direct surgical service, innovative training such as virtual hackathons and dyad-based partnerships, research capacity building, and policy advocacy including folate fortification campaigns. Analysis reveals strengths in partnership models and surgical education, but also critical gaps: uneven geographic coverage, particularly in Francophone Africa and Southeast Asia; a lack of published outcome metrics; and minimal evidence of formal collaboration networks between NGOs. Conclusion This review provides the first consolidated mapping of the NGO ecosystem in global neurosurgery. To maximize impact, we recommend the establishment of a centralized collaborative platform, the adoption of standardized outcome reporting, and strategic efforts to address identified geographic and programmatic gaps. Future success depends on moving from isolated efforts to an integrated, accountable, and data-driven coalition. Clinical Trial Number Not applicable.