Bass Connections- Improving Neurosurgery Patient Outcomes in Uganda

Around the world the average neurosurgeon to population ratio is 1 neurosurgeon for every 230,000 people (in the US 1 Neurosurgeon to 88,000 people); however, in 2007 Uganda’s ratio was 1:6 million, with only five neurosurgeons in country. Since that time, the Duke Division of Global Neurosurgery and Neuroscience (DGNN), has created a health system improvement program with three key principles: Technology, Twinning, and Training. Through this effort we have seen significant strides, particularly in building surgical capacity, complexity of cases being performed, and establishing a training program in the country.  However, surgical outcomes for patients in Uganda still require improvements.

Bass Connections

This project is aimed at addressing the specific research question:

How can we improve the management of neurosurgical patients to improve patient outcomes?

We have identified three foundational areas with the greatest need of improvement:

1.     Infection control
Lead: Emily Smith (PhD; DGNN Faculty) (
Description: Implementing hand sanitization pumps to increase hand hygiene compliance with the ultimate goal of reducing preoperative and postoperative infections for neurosurgical patients.
Current Status: Data analysis

2.     Patient Family Education
Lead: Joao Vissoci (PhD; DGNN Faculty) (
Description: Identify and evaluate the needs and barriers to adequate patient -family education at MNRH. Additionally, identify and evaluate the challenges hospital staff encounters in educating family members on patient care.
Current Status: Data analysis

3.     Medication management
Lead: Tony Fuller (MSc-GH, MD (MSIII); DGNN Faculty) (
Description: Identify gaps in current medication management practices. Assess medication and overall confidence levels of patients. Identify barriers that prevent acquisition of and adherence to essential neurological medications. Develop new approaches that will increase medication confidence and adherence.
Current Status: Data analysis