International partnership
Interpersonal and systemic factors in initiating, developing and maintaining collaborations between European neurosurgical departments and institutions in low-resources settings: A qualitative study
In a prospective qualitative interview-based study Marchesini et al. from the EANS Global and Humanitarian Neurosurgery Committee, Brussels published in *Brain Spine* to identify the key interpersonal and systemic factors that influence the formation, progression, and sustainability of neurosurgical collaborations between European institutions and those in low-resource settings. The study identifies 12 critical themes across three phases (initiation, development, maintenance), underscoring the importance of trust, mutual respect, structured planning, and institutional commitment. Recommendations emphasize continuity, accountability, and capacity-building as central to sustainable partnerships.
Critical Review
This qualitative study is timely and contextually important, offering a rare glimpse into the dynamics of European-led neurosurgical collaborations in LMICs. The authors leveraged matched interviews with equal representation from HIC and LMIC institutions, which enhances the credibility and balance of perspectives. Thematic analysis is appropriately employed to dissect the interpersonal and systemic influences, resulting in a well-organized framework.
However, the paper suffers from significant methodological limitations common to qualitative studies. Despite presenting 12 themes, the work falls short of generating actionable guidelines or evaluative metrics that could be adopted by future initiatives. There's an overreliance on subjective narratives without triangulation through observational or quantitative data. Furthermore, while the selection of participants is described as “matched,” the criteria for matching are not detailed, raising concerns about selection bias.
There’s also a missed opportunity to stratify findings by regional or institutional maturity, which could have offered more granular insights. Moreover, the authors could have explored negative cases or failed partnerships to enrich the discourse on barriers and pitfalls.
The article is conceptually useful but lacks rigor and practical depth needed to inform policy or structured program development.
Final Verdict: A well-intentioned but ultimately superficial exploration of a complex global issue.
Takeaway for Neurosurgeons:
Effective international partnerships require more than goodwill—they demand structure, mutual accountability, and long-term resource commitment.
Bottom Line: Thought-provoking, but stops short of offering operationally valuable guidance.
Rating: 5/10
Publication Date: June 19, 2025
Categories: Global Neurosurgery, Education & Training, Health Policy Tags: global neurosurgery, LMICs, neurosurgical collaboration, qualitative research, international partnerships, health systems, EANS