{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T13:53:12Z","timestamp":1781790792847,"version":"3.54.5"},"reference-count":59,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Public Health Research"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:p>Spina bifida (SB) is a neurodevelopmental disorder characterised by the incomplete closure of the embryonic neural tube, resulting in a neural tube defect (NTD) that affects the development of the spine and spinal cord. Both genetic and non-genetic factors contribute to the occurrence of SB, including deficiencies in folic acid and vitamin B12, maternal obesity, smoking, epilepsy, alcohol consumption, drug use, and a history of previous pregnancies affected by SB. Complications associated with SB include meningitis, hydrocephalus, neonatal paralysis, and urinary or faecal incontinence. Considerable advancements have been made in raising awareness, improving diagnostic capabilities, and establishing specialised clinics and multidisciplinary teams (MDTs) dedicated to SB management. However, several gaps persist in its management. These include inadequate awareness and education among healthcare professionals, limited access to healthcare services, a scarcity of surgical workforce and MDTs, social stigma and discrimination, and research and data accessibility gaps. The implications of these management gaps in SB care encompass diminished quality of life, increased morbidity and mortality rates, and economic consequences related to surgical management. To improve SB management outcomes in Africa, strategic interventions should focus on enhancing healthcare infrastructure and resources, strengthening education and awareness programs for SB prevention and support, addressing cultural concerns, improving neonatal surgical care, and enhancing research and guidelines. By addressing these gaps through targeted, equity-focused interventions in healthcare infrastructure, education, cultural adaptation, neonatal surgical care, research, and policy, substantial improvements can be made in SB care and outcomes in Africa, reducing the disproportionate burden of disability in low-resource settings.<\/jats:p>","DOI":"10.1177\/22799036261462197","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T15:35:40Z","timestamp":1781624140000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Appraising spina bifida care in Africa: Challenges, implications, and progress - A perspective review"],"prefix":"10.1177","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5362-3920","authenticated-orcid":false,"given":"Favour Tope","family":"Adebusoye","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Sumy State University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomas","family":"Ferreira","sequence":"additional","affiliation":[{"name":"University of Cambridge"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wireko Andrew","family":"Awuah","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Sumy State University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pearl Ohenewaa","family":"Tenkorang","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Ghana Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-3429-4880","authenticated-orcid":false,"given":"Mohammed","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Ain Shams University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohan Sampat","family":"Mane","sequence":"additional","affiliation":[{"name":"University of Ni\u0161"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon","family":"Lucke-Wold","sequence":"additional","affiliation":[{"name":"University of Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul R.","family":"Krafft","sequence":"additional","affiliation":[{"name":"University of Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie L.","family":"Chan","sequence":"additional","affiliation":[{"name":"University of Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,16]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2015.7"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12887-021-02584-5"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.7189\/jogh.04.010402"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1105209108"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwab061"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-019-4822-6"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1080\/09638288.2019.1647293"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1155\/2020\/4273510"},{"issue":"1","key":"e_1_3_5_10_2","article-title":"Managing Children with Spina Bifida in sub-Saharan Africa: the Zambian experience?","volume":"38","author":"Mweshi MM","year":"2011","unstructured":"Mweshi MM, Amosun SL, Nogma MS, et al. Managing Children with Spina Bifida in sub-Saharan Africa: the Zambian experience? Medical Journal of Zambia 2011; 38(1).","journal-title":"Medical Journal of Zambia"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0261177"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjpo-2023-002235"},{"key":"e_1_3_5_13_2","volume-title":"International Classification of Functioning","author":"WHO","year":"2001","unstructured":"WHO. International Classification of Functioning. Disability and Health, 2001. https:\/\/iris.who.int\/bitstream\/handle\/10665\/42407\/9241545429.pdf?sequence=1, Accessed August 4, 2025."},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00381-012-1879-5"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1080\/1034912X.2014.998174"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00381-023-05932-1"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12887-016-0709-4"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.17645\/si.v4i1.630"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.7196\/SAJCH.2020.v14i2.1638"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.7196\/SAMJ.8079"},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.4103\/0189-6725.70410"},{"key":"e_1_3_5_22_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12682-012-0126-x"},{"key":"e_1_3_5_23_2","doi-asserted-by":"publisher","DOI":"10.3171\/2019.12.FOCUS19448"},{"key":"e_1_3_5_24_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2214.1991.tb00696.x"},{"key":"e_1_3_5_25_2","doi-asserted-by":"publisher","DOI":"10.3171\/2014.10.PEDS14318"},{"key":"e_1_3_5_26_2","doi-asserted-by":"publisher","DOI":"10.3171\/2019.12.FOCUS19804"},{"key":"e_1_3_5_27_2","doi-asserted-by":"publisher","DOI":"10.3171\/2015.8.PEDS15403"},{"key":"e_1_3_5_28_2","doi-asserted-by":"publisher","DOI":"10.4314\/jmbs.v6i1.3"},{"key":"e_1_3_5_29_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00247-014-2910-7"},{"key":"e_1_3_5_30_2","doi-asserted-by":"publisher","DOI":"10.1259\/bjr.20160852"},{"key":"e_1_3_5_31_2","doi-asserted-by":"publisher","DOI":"10.1097\/JS9.0000000000000011"},{"key":"e_1_3_5_32_2","doi-asserted-by":"publisher","DOI":"10.1136\/wjps-2022-000472"},{"key":"e_1_3_5_33_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1740-8709.2010.00271.x"},{"key":"e_1_3_5_34_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3156.2010.02680.x"},{"key":"e_1_3_5_35_2","doi-asserted-by":"publisher","DOI":"10.3171\/2018.7.FOCUS18280"},{"key":"e_1_3_5_36_2","doi-asserted-by":"publisher","DOI":"10.3171\/2010.11.PEDS10428"},{"key":"e_1_3_5_37_2","doi-asserted-by":"publisher","DOI":"10.1080\/02724936.2000.11748142"},{"key":"e_1_3_5_38_2","doi-asserted-by":"publisher","DOI":"10.1179\/2046905515Y.0000000033"},{"key":"e_1_3_5_39_2","volume-title":"A Better Life for Everyone","author":"International Federation of spina bifida and hydrocephalus","unstructured":"International Federation of spina bifida and hydrocephalus. A Better Life for Everyone. https:\/\/www.ifglobal.org\/about-us\/"},{"key":"e_1_3_5_40_2","volume-title":"Summary Report","author":"Festus Fajemilo","year":"2022","unstructured":"Festus Fajemilo. Summary Report, 2022. https:\/\/www.fesfaj-foundation.org\/wp-content\/uploads\/2023\/04\/Festus-Fajemilo-Foundation-Summary-Annual-Report-2022-_055149.pdf"},{"key":"e_1_3_5_41_2","doi-asserted-by":"publisher","DOI":"10.1177\/21925682211022311"},{"key":"e_1_3_5_42_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2019.03.141"},{"key":"e_1_3_5_43_2","first-page":"60","article-title":"Assessing the prevalence of spina bifida and encephalocele in a Kenyan hospital from 2005-2010: implications for a neural tube defects surveillance system","volume":"18","author":"Githuku JN","year":"2014","unstructured":"Githuku JN, Azofeifa A, Valencia D, et al. Assessing the prevalence of spina bifida and encephalocele in a Kenyan hospital from 2005-2010: implications for a neural tube defects surveillance system. Pan Afr Med J 2014; 18: 60. https:\/\/doi.org\/10.11604\/pamj.2014.18.60.4070","journal-title":"Pan Afr Med J"},{"key":"e_1_3_5_44_2","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(91)90133-A"},{"key":"e_1_3_5_45_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(83)92654-5"},{"key":"e_1_3_5_46_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-011-1080-0"},{"key":"e_1_3_5_47_2","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.23094"},{"issue":"3","key":"e_1_3_5_48_2","first-page":"77","article-title":"WHO's ICF and functional status information in health records","volume":"24","author":"Ust\u00fcn TB","year":"2003","unstructured":"Ust\u00fcn TB, Chatterji S, Kostansjek N, et al. WHO's ICF and functional status information in health records. Health Care Financ Rev. 2003 Spring 2003; 24(3): 77\u201388.","journal-title":"Health Care Financ Rev. 2003 Spring"},{"key":"e_1_3_5_49_2","doi-asserted-by":"publisher","DOI":"10.1177\/0883073814533595"},{"key":"e_1_3_5_50_2","doi-asserted-by":"publisher","DOI":"10.1177\/1559827618806183"},{"key":"e_1_3_5_51_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2021.745814"},{"key":"e_1_3_5_52_2","doi-asserted-by":"publisher","DOI":"10.3233\/PRM-200738"},{"key":"e_1_3_5_53_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.dhjo.2019.06.005"},{"key":"e_1_3_5_54_2","unstructured":"WHO. Accelerating efforts for preventing micronutrient deficiencies and their consequences including spina bifida and other neural tube defects through safe and effective food fortification 2023. https:\/\/apps.who.int\/gb\/ebwha\/pdf_files\/WHA76\/A76_R19-en.pdfhttps:\/\/apps.who.int\/gb\/ebwha\/pdf_files\/WHA76\/A76_R19-en.pdf"},{"key":"e_1_3_5_55_2","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2015.302902"},{"key":"e_1_3_5_56_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(22)00213-3"},{"key":"e_1_3_5_57_2","doi-asserted-by":"publisher","DOI":"10.3171\/2022.9.PEDS22188"},{"key":"e_1_3_5_58_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199212243272602"},{"key":"e_1_3_5_59_2","volume-title":"The Global Alliance for Improved Nutrition (GAIN)","year":"2023","unstructured":"The Global Alliance for Improved Nutrition (GAIN), 2023. https:\/\/www.gainhealth.org\/sites\/default\/files\/news\/documents\/Accelerating-efforts-for-preventing-micronutrient-deficiencies-spina-bifida-and-other-neural-tube-defects-through-safe-and-effective-food-fortification.pdf. Accessed April 4, 2024."},{"key":"e_1_3_5_60_2","doi-asserted-by":"publisher","DOI":"10.1002\/bdr2.2115"}],"container-title":["Journal of Public Health Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/22799036261462197","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/22799036261462197","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/22799036261462197","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T13:16:30Z","timestamp":1781788590000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/22799036261462197"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":59,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1177\/22799036261462197"],"URL":"https:\/\/doi.org\/10.1177\/22799036261462197","relation":{},"ISSN":["2279-9036","2279-9036"],"issn-type":[{"value":"2279-9036","type":"print"},{"value":"2279-9036","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4]]},"article-number":"22799036261462197"}}