Public Awareness, Knowledge of Availability, And Willingness to Use Neurosurgical Care Services in Africa: A Cross-Sectional E-Survey Protocol.

Background: Barriers to care cause delays in seeking, reaching, and getting care. These delays affect low-and middle-income countries (LMICs), where 9 out of 10 LMIC inhabitants have no access to basic surgical care. Knowledge of healthcare utilization behavior within underserved communities is useful when developing and implementing health policies. Little is known about the neurosurgical health-seeking behavior of African adults. This study evaluates public awareness, knowledge of availability, and readiness for neurosurgical care services amongst African adults. Methodology: The cross-sectional study will be run using a self-administered e-survey hosted on Google Forms (Google, CA, USA) disseminated from 10th May 2021 to 10th June 2021. The Questionnaire would be in two languages, English and French. The survey will contain closed-ended, open-ended, and Likert Scale questions. The structured questionnaire will have four sections with 42 questions; Sociodemographic characteristics, Definition of neurosurgery care, Knowledge of neurosurgical diseases, practice and availability, and Common beliefs about neurosurgical care. All consenting adult Africans will be eligible. A minimum sample size of 424 will be used. Data will be analyzed using SPSS version 26 (IBM, WA, USA). Odds ratios and their 95% confidence intervals, Chi-Square test, and ANOVA will be used to test for associations between independent and dependent variables. A P-value <0.05 will be considered statistically significant. Also, a multinomial regression model will be used. Dissemination: The study findings will be published in an academic peer-reviewed journal, and the abstract will be presented at an international conference. Highlights The burden of neurosurgical diseases is enormous in low- and middle-income countries, especially in Africa. Unfortunately, most neurosurgical needs in Africa are unmet because of delays in seeking, reaching, and getting care. Most efforts aimed at reducing barriers to care have focused on improving the neurosurgical workforce density and infrastructure. Little or no efforts have been directed towards understanding or reducing the barriers to seeking care. We aimed to understand public awareness, willingness to use, and knowledge of the availability of neurosurgical care in Africa. The study findings can inform effective strategies that promote the utilization of neurosurgical services and patient education in Africa.