Clinical spine care partnerships between low- and high-resource countries: A scoping review

BackgroundClinical collaboration between spine professionals in high-resource (HR) and low-resource (LR) countries may provide improvements in the accessibility, efficacy, and safety of global spine care. Currently, the scope and effectiveness of these collaborations remain unclear. In this review, we describe the literature on the current state of these partnerships to provide a framework for exploring future best practices. MethodsPubMed, Embase, and Cochrane Library were queried for articles on spine-based clinical partnerships between HR and LR countries published between 2000 and March 10, 2023. This search yielded 1528 total publications. After systematic screening, nineteen articles were included in the final review. ResultsAll published partnerships involved direct clinical care and 13/19 included clinical training of local providers. Most of the published collaborations reviewed involved one of four major global outreach organizations with the majority of sites in Africa. Participants were primarily physicians and physicians-in-training. Only 5/19 studies reported needs assessments prior to starting their partnerships. Articles were split on evaluative focus, with some only evaluating clinical outcomes and some evaluating the nature of the partnership itself. ConclusionsPublished studies on spine-focused clinical partnerships between HR and LR countries remain scarce. Those that are published often do not report needs assessments and formal metrics to evaluate the efficacy of such partnerships. Toward improving the quality of spine care globally, we recommend an increase in the quality and quantity of published studies involving clinical collaborations between HR and LR countries, with careful attention to reporting early needs assessments and evaluation strategies.