University of Namibia

Taro (Colocasia esculenta L.) is one of the underutilized roots and tuber crops that have the potential to be used as a future smart food to combat malnutrition and hunger in several parts of the world. Taro is one of the world’s oldest domesticated crops and belongs to the Araceae family, which contains 106 and 2500 genera and species, respectively. Nigeria, China, Cameroon, Ghana, and Papua New Guinea are the World’s top taro-producing countries. Taro leaves and stems are the main by-products with promising potential applications. The leaves are rich in proteins, dietary fiber, and micronutrients and low in calories. Several antinutrients (tannins, phytates, and oxalates) are present in these by-products, limiting their wide use in the same way for the taro corms. Alkaloids, flavonoids (catechin, kaempferol, orientin, rutin, quercetin, and vicenin), saponins, sterols, phenolic acids (caffeic, gallic, benzoic, chlorogenic, and ellagic acids), and lectins (tarin) are the main bioactive phytochemicals from taro’s by-products with antiatherogenic, antimicrobial, antioxidant, antidiabetic, anticarcinogenic, antihypertensive, and insecticidal, hepatoprotective, immunoprotective, and neuroprotective properties. Taro by-products have several food applications in the production of gluten-free noodles, bread, and extruded snacks, as well as non-food applications in bioethanol and pharmaceuticals. Gastronomic applications for taro leaves include making traditional dishes and various value-added food products such as purees, sauces, stews, and soups with enhanced nutritional and sensory characteristics. This chapter presents the latest highlights on Taro’s by-products, bioactives, potential applications, health benefits, and biological activities.

Kohlrabi (Brassica oleracea var. gongylodes) is a vegetable of the cruciferous family (Brassicaceae). Based on the color of kohlrabi, it is classified as purple or pale green kohlrabi. Kohlrabi by-products include mainly peels, sprouts, leaves, and seeds, with several phytochemicals being reported from these by-products, such as anthocyanin, flavonoids, glucosinolates, indoles, phenolic acids, and phytosterols. Phytochemicals from kohlrabi by-products possess several biological activities, including anti-hyperalgesic, anti-inflammatory, anti-hyperglycemic, antibacterial, and antioxidant activities. Other health benefits from kohlrabi by-products include blood pressure lowering, cholesterol reduction, cancer-fighting, chemopreventive properties, and weight loss adjuvant. Furthermore, kohlrabi by-products have demonstrated promising applications in silver and gold nanoparticle synthesis, fermented vegetables, functional food formulation and packaging with potent antioxidant, antibacterial, and UV-blocking properties and extended shelf life and preservation properties. This chapter presents the latest research and development on the kohlrabi by-products regarding bioactive phytochemicals, biological activities, and their potential industrial applications.

Although direct seawater irrigation remains utopian, the use of brackish water has the potential to stimulate crop production under arid conditions, such as those in Namibia. Our study evaluated the potential of a seawater—freshwater mixture for tomato drip irrigation under manure and plastic mulch inclusion in aeolian desert soils. The inclusion of seawater up to 20% (v/v) did not significantly (P > 0.05) influence tomato plant biomass, although it significantly influenced tomato fresh yield. Across all treatments, the 20% seawater inclusion level resulted in a total yield of 2496 g, whereas 0% had a total fruit yield of 6910 g per plant. Manure addition resulted in a 29.58% difference in tomato yield between the manure-added and no-manure-added treatments. The addition of manure resulted in a 29.24% difference in marketable tomato yield compared with the case where manure was not added. Across all treatments, the inclusion of 20% seawater resulted in a 33.8% yield loss, whereas the inclusion of 0% seawater resulted in a 20.2% yield loss, when calculated as a fraction of the total yield obtained. Generally, the 0% (without seawater) had the lowest chlorophyll content (21.5), whereas the 20% seawater inclusion had the highest chlorophyll content (24.9). Similarly, the 20% seawater inclusion level resulted in a sugar content of 7.64, which was a 39.9% difference from the 0% seawater inclusion level with a sugar content of 5.1. Our study demonstrated the feasibility of using abundant saline water in arid countries for irrigation of tomatoes, which has the potential to generate tomatoes with higher sugar content, which is desirable for tomato processing markets. Further studies are needed to evaluate the use of saline water with other crops, such as Swiss chard, as part of climate smart cropping systems.

This study assessed stakeholders' perceptions of current methods and technologies for monitoring and controlling fisheries activities in Namibia's Exclusive Economic Zone (EEZ). The research was prompted by reports of illegal fishing and inadequate resources for effective oversight. Understanding stakeholders' views is crucial for policymakers to develop suitable monitoring approaches. A qualitative investigation was conducted using in‐depth interviews (18 participants) and three focus group discussions (22 participants). Findings revealed that men dominate Namibia's fisheries industry. Air surveillance and sea patrols are the primary monitoring measures, supplemented by Vessel Monitoring System (VMS) and Automatic Identification System (AIS) technologies. About 32.5% of participants were fisheries inspectors, observers, and researchers with 11–15 years of experience. Most participants rated current methods and technologies as good: 72.5% for sea patrols, 65% for air surveillance and 80% for technologies. Despite positive ratings, several challenges were identified: lack of resources and funding, inadequate modern infrastructure, high maintenance costs, limited stakeholder cooperation and compliance issues. These findings underscore the need for improvements in vessel documentation and authorization, monitoring methods and the adoption of advanced technologies like drones and onboard cameras. The study highlighted the importance of enhancing regional cooperation and coordination to address the challenges posed by globalization, and to realize the state's sovereignty and territorialization, with the EEZ still being a contested space.

The challenges of climate change are continuously increasing, constituting a major threat to livestock production, which is more than a socio-economic cornerstone in Namibian rural communal farmers, contributing approximately two-thirds of the country’s agricultural GDP. Climate variability, which may be in the form of drought, very high temperatures, floods and frosts has been reported to have detrimental effects on feed and water availability, leading to reduced livestock weight, growth, production and reproductive performance, and ultimately high mortality. Understanding smallholder farmers’ socio-psychological antecedents such as knowledge, attitudes and perceptions and the way they influence their level of adaptation to CC mitigation strategies needs to be assessed, as it guides CC policy formulation and intervention programmes. The study investigated CC perception and adaptation strategies for livestock farmers in Omaheke Region. Data were gathered from (n = 80) purposively sampled farmers in Epukiro and Otjombinde constituencies based on livestock ownership. The study revealed that 93.8% of the respondents were aware that the climate is changing, with attributes such as very high and very low temperatures, high and low rainfall, and drought having been noticed. Climate change has been attributed to both human and natural activity. The study observed that the implementation of CC adaptation strategies in livestock agriculture is low, thus recommends that the improvement of adaptation techniques involving employing extension services, promotion of farmer-to-farmer extension, and utilization of various information sources of climate knowledge, such as farmers' associations and social organizations, should be the future policy priority.

Background Bovine coronavirus (BoCV) causes significant economic losses to cattle farming due to mortality in calves, reduced growth performances and milk production in feedlots and dairy cattle. Worldwide distribution of BoCV has been demonstrated, although knowledge of its epidemiology in Africa, especially in the sub-Saharan region, is limited. Results In the present study, a total of 208 swab samples of wild ruminants and 435 bovines from different regions of Namibia were obtained and tested by a BoCV-specific qRT-PCR. Twenty-six bovine samples tested positive [26/435 (5.98%; 95CI: 3.94-8.64%)] while, among the wild ruminants, only Greater Kudu (Tragelaphus strepsiceros) were shown to be positive [13/52 (25.00%; 95CI: 14.03-38.95%)] of which 8 showed clinical signs. Analysis of partial nucleoprotein and spike protein gene sequences and comparison with international reference sequences demonstrated the existence of a unique Namibian clade, resulting from a single introduction event around 2010 followed by local evolution. Although the introduction source remains unknown, contact between bovine and wild animals appears likely. Conclusions The present study represents the first report of BoCV circulation in southern Africa, which showed a relatively high frequency and the ability of persisting and evolving locally in the absence of further foreign introductions. The implications for disease spread among domestic bovines and the potential impact on wildlife should encourage broader investigations on BoCV involving other African countries. Moreover, the Greater Kudu’s susceptibility to BoCV infection was also proven, further highlighting the host plasticity of this virus.

Porcine circovirus 2 (PCV-2) is a major pathogen of swine, causing significant production losses in the pig industry worldwide. Several studies have detected the virus in different species, both in asymptomatic and diseased subjects, highlighting PCV-2 host plasticity. As PCV-2 has been identified in carnivores, the present study was undertaken to investigate the susceptibility of domestic dogs to PCV-2 infection by testing archived blood samples originating from low-income rural areas in Namibia. The population was selected considering the high exposure probability to PCV-2 due to direct contact and/or feeding with raw pig meat or by-products. Thirty-eight of the samples (6.61%) tested positive for PCV-2, and the complete ORF2 of 7 strains was sequenced, revealing the presence of the three major PCV-2 genotypes (i.e. PCV-2a, -2b, and -2d). Convincing epidemiological links with other Namibian and South African strains were established for PCV-2a and PCV-2b strains, while the PCV-2d strains were part of a broader clade that included sequences of viruses collected worldwide, especially in Asia. Although PCV-2 was reported in diseased dogs, no statistically significant or robust causal association between infection and disease manifestation was demonstrated. In conclusion, PCV-2 infection has been identified in Namibian dogs, most likely due to the ingestion of contaminated meat and by-products. However, the epidemiological and clinical consequences are still unclear and further investigations are necessary. Nevertheless, the high proportion of infected dogs showing clinical signs raises concern about the potential of PCV-2’s role as a relevant viral pathogen in Namibia. The use of raw meat for dog nutrition should be discouraged, considering the known risks to animal and human health through disease transmission.

Large ungulates across the world are threatened with extinction due to habitat loss, land use change, and other anthropogenic pressures. While conservation measures are critical, for many populations the implementation of conservation measures is often not practical, either due to a lack of information on the species' biology or their conservation status. Here we consider 2 large ungulates, the roan (Hippotragus equinus) and sable (H. niger) antelopes, occurring in Mudumu National Park (MNP) Namibia, for which data on populations trends and habitat use are largely unknown. Here, we used camera trapping data collected in the dry and wet seasons between March and September 2021 in visit frequency models to understand the relationship between habitat variables and the distribution dynamics of roan and sable over time at MNP. Our results showed that roans in the wet season were detected more at sites with increased grass cover and detected less at sites near the Kwando River. In the dry season, roans were detected more at sites with increased grass cover and more termite mounds but detected less at sites near the Kwando River. In the wet season, sables were detected more at sites with fewer termite mounds. In the dry season, sables were detected more at sites with increased grass cover. We hypothesized that roan and sable use fewer areas near permanent water to avoid high predator densities and high grazing intensity by dense herds of short‐grass grazers. The study findings are useful knowledge on 2 threatened ungulates and will be used to inform and develop comprehensive conservation programs and strategies that aim to lower the risk of extinction for roan and sable at a Namibian protected area.

Most rural households rely on farming for their livelihoods, but the nonfarm economy has gained prominence in complementing farm incomes. Using nationally representative data, this paper examines the implications of participation in nonfarm work (self‐employment and wage employment) for household welfare in rural Cameroon. The paper employs the inverse probability weighting with regression adjustment (IPWRA) technique to estimate average treatment effects and blends the IPWRA and unconditional quantile regression to compute unconditional quantile treatment effects. The results show that households at the lower tail of the unconditional distribution benefit significantly less from participation in nonfarm work compared to households at the upper tail of the distribution. Findings further indicate that nonfarm self‐employment yields significantly higher welfare gains for households at the lower tail of the distribution, compared to nonfarm wage employment. Meanwhile, at the upper tail of the distribution, nonfarm wage employment generates more substantial welfare benefits than self‐employment. It is therefore imperative to create a conducive environment that promotes the development of the rural nonfarm economy.

Background: Clear communication during informed consent is crucial in paediatric computed tomography (CT) procedures, particularly in resource-constrained settings. CT offers valuable diagnostic information but carries potential radiation risks, especially for paediatric patients. Parents play a critical role in decision-making, necessitating thorough risk-benefit discussions. This study aimed to explore parental experiences regarding risk-benefit communication during their children's CT scans in under-resourced healthcare facilities. Methods: A qualitative approach with a descriptive design was employed. Semi-structured interviews were conducted with 13 purposefully selected and consenting parents accompanying paediatric patients for CT scans at two public hospitals. Data were analysed using Tesch's eight-step method and ATLAS.ti software. Results: Participants were parents of children aged 0-10 years (8 males, 5 females), with 11 making their first visit to the CT department. Three main themes emerged: (1) Compromised consenting process, characterised by inadequate explanation of consent and limited risk-benefit communication; (2) Procedural information deficiency, including minimal communication about the procedure and lack of information on examination results; and (3) Preference for improved communication, with parents expressing a desire for comprehensive information and varied opinions on who should disseminate this information. Parents reported feeling uninformed, anxious, and unable to make well-informed decisions due to communication gaps. Conclusions: Significant improvements are needed in risk-benefit communication during paediatric CT scans. Healthcare providers should use simplified language, visual aids, and patient-centred discussions to enhance understanding and reduce parental anxiety. Radiographers should allocate sufficient time for discussions, involve referring physicians when necessary, and document the informed consent process thoroughly. Addressing these issues can improve patient experiences and contribute to positive health outcomes in resource-constrained settings. Keywords: Informed consent; Paediatric CT; Parental experience; Resource-constrained healthcare; Risk-benefit communication.

Temperature extremes (commonly referred to as cold spell and heat waves) are regarded as the most significant climate events and have been extensively studied over the last several decades. The heat waves and drought during the summer of 2017 in Namibia sent shock waves to the energy industry, farming and water resources infrastructures and health system in terms of system vulnerability and management. This paper focuses on modeling of extreme temperatures using Extreme Value Theory (EVT). The aim is to explore the frequency of occurrences of extremely low and extremely high temperatures. The dataset consists of 27900 daily maximum temperatures from 1990 to 2019 collected from the Namibia Meteorological services. Block maxima (BM) approach is used to fit the Generalized Extreme Value Distribution (GEVD) while the Peak Over Threshold approach is employed to fit the Generalized Pareto Distribution (GPD) model which analyzes the upper and lower tails of the distribution of the data. The Maximum Likelihood Estimation (MLE) technique is used to estimate the parameters in two distributions. The model’s goodness of fit is assessed graphically means, such as probability plots, quantile-quantile plots and mean excess plots as well using some empirical goodness-of-fit tests. Results indicate that, the models under consideration provide overall good fits for the data Subject Classifications: 68Txx, 68Pxx, 68Nxx.

The auto insurance industry constantly seeks innovative approahes to accurately predict and manage both the frequency and severity of insurance claims. This study delves into leveraging machine learning techniques to model insurance claims, focusing on estimating the frequency and severity of claims. A comprehensive dataset encompassing a wide array of variables related to policyholders, vehicles, accidents, and historical claims was used to train and validate the machine learning models. For a frequency prediction, models such as poisson regression, decision tress, random forests, and gradient boosting were employed to estimate the likelihood of a claim occurence. The severity prediction entailed the application of regression-based models, such as linear regression and decision trees, for the purpose of forecasting the financial magnitude of claims in the event of their occurrence. The results demonstrate the efficacy of machine learning in accurately predicting the frequency and severity of auto insurance claims. The predictive models achieved notable accuracy and performance metrics, aiding insurers in assesing risk, setting premiums, and optimizing their claim handling processes. Moreover, this study illuminates the prospect of augmenting decision-making and risk management capabilities in the automobile insurance sector by incorporating advanced machine learning methodologies. Mathematics Subject Classification: 34A08, 65M06, 65N12, 35R11.

Assessing the species diversity, richness, and abundance of dung beetles in wildlife and wildlife-livestock systems is crucial in understanding the effects of anthropogenic processes on the community structures of dung beetles to improve conservation strategies in Namibia. We tested the hypothesis that the species diversity, richness, and abundance of dung beetles in wildlife systems will be better than in wildlife-livestock systems. Sampling of dung beetles was carried out using baited pitfall traps for a period of 12 months. Linear transects of 1.1 km in length were installed with 12 pitfall traps separated by a distance of 100 m from each other. An independent samples test was used to compare the abundance, richness, and diversity of dung beetles in two ecosystems. A total of 47,818 individuals were collected from both wildlife and wildlife-livestock systems belonging to 44 species, 25 genera, and 8 tribes. Dung beetle abundance, richness, and diversity were significantly higher in the wildlife system than in the wildlife-livestock system (T = 4.676, df = 59.04, p < 0.05; T = 1.825, df = 35, p < 0.05; T = 4.676, df = 59.04, p < 0.05). The wildlife system was more species-rich (n = 43) when compared to the wildlife-livestock system (n = 34). A higher Shannon-Wiener Index was reported in wildlife systems (H’ = 2.561) than in wildlife-livestock systems (H’ = 2.289). The results from the non-metric multidimensional scaling ordination demonstrated a dissimilarity (stress = 0.155) in species composition and abundance of dung beetles between the two systems. Different land-use systems have proven to have an impact on species assemblage of dung beetles. We concluded that wildlife systems in Namibia have a richer ecological and functional dung beetle community as compared to a wildlife-livestock system, most likely influenced by anthropogenic activities.

Poaching is the most significant contemporary threat to the world’s wild rhinos. The ability to address it will play a critical role in twenty-first century rhino conservation success and will depend on understanding and tackling poaching drivers and methods. Reflecting on the history of humans exploiting rhinos reveals that the concept of poaching is socially constructed, highlighting contested views over the rights to benefit from rhinos. In recent history there were two distinct global poaching waves: the first, starting in the 1970s, swept across most of Africa and parts of Asia until it was contained in the mid-1990s; the second surged in the early twenty-first century and peaked during 2015 but persists at threatening levels. The factors driving these waves, and the responses to them, have evolved over time, influenced by shifting socio-political conditions and technological developments. Increasing sophistication of poaching methods and levels of enabling corruption were key features of the second wave. Whereas some countries have managed to contain poaching through a combination of strict enforcement accompanied by harnessing local community support, others continue to struggle and have had to resort to measures such as dehorning to reduce the economic incentive to poach. Rhino poaching has had seriously negative consequences for conservation, having driven two Asian species to the brink of extinction and with several subspecies already extinct in both Africa and Asia. The loss of large contiguous populations has created added risks of inbreeding, and poaching pressure renders the cost of protecting residual fragmented populations prohibitively high for all but the most well-funded conservation agencies and landowners. The future of rhino conservation will depend in no small part on the ability to maintain sustainable sources of funding for comprehensive anti-poaching measures, which will continue to be necessary in both African and Asian contexts, especially if the consumer demand for rhino horn persists at current high prices.

Background Agricultural worksites are rarely targeted by malaria control programmes, yet may play a role in maintaining local transmission due to workers’ high mobility, low intervention coverage and occupational exposures. Methods A quasi-experimental controlled intervention study was carried out in farming and cattle herding populations in northern Namibia to evaluate the impact of a targeted malaria intervention package. Eight health facility catchment areas in Zambezi and Ohangwena Regions were randomised to an intervention arm and eligible individuals within worksites in intervention areas received targeted drug administration with artemether-lumefantrine, mop-up indoor residual spraying and long-lasting insecticidal nets, combined with distribution of topical repellent in Zambezi Region. Impact on malaria outcomes and intervention coverage was evaluated over a single transmission season using pre-intervention and post-intervention cross-sectional surveys in a random subset of worksites and community incidence from passively detected cases. Entomological collections and residual efficacy assays on canvas and tarpaulin were conducted. Results Delivery of a single intervention round was associated with a reduction in the prevalence of malaria (OR 0.24, 95% CI 0.1 to 0.5; risk difference (RD) −6.0%, 95% CI −9.4 to –2.8). Coverage of at least one intervention increased (RD 51.6%, 95% CI 44.4 to 58.2) among the target population in intervention compared with control areas. This effect was largely driven by results in Zambezi Region, which also observed a decline in community incidence (−1.29 cases/1000 person-weeks, 95% CI −2.2 to –0.3). Residual efficacy of pirimiphos-methyl (Actellic) on tarpaulin and canvas was high at 24hours but declined to 44.6% at 4 months. Conclusion The study shows that targeted delivery of malaria interventions to cattle herders and agricultural workers at worksites has potential to impact local transmission. Findings highlight the need for further research on the role of key populations in Plasmodium falciparum transmission in Namibia. Trial registration number NCT04094727.

Heterogeneous rhodium supported on mesoporous silica (Rhinsitu/mesSiO2) was easily prepared, in one step, by incorporating rhodium units onto the silica framework during the sol–gel process. Rhinsitu/mesSiO2 was revealed to be an excellent active and selective catalyst for the hydrogenation of aromatic, heteroaromatic, aliphatic nitriles, and aliphatic nitriles bearing aromatic or heteroaromatic rings to primary amines, regardless of their steric hindrance. The catalytic system that is efficiently recyclable operates under mild conditions in the presence of ammonia.

Rapid and comprehensive drug susceptibility testing (DST) is essential for diagnosing and treating drug-resistant tuberculosis effectively, and next-generation sequencing can be an effective genotypic DST method. We implemented and evaluated the performance of a nanopore targeted sequencing assay, called the Tuberculosis Drug Resistance Test (TBDR, Oxford Nanopore Diagnostics, Ltd., United Kingdom), which predicts drug resistance to 16 TB drugs, at a South African reference laboratory and a district diagnostic laboratory in Zambia. We compared the sequencing success rates between unprocessed and decontaminated sputum samples and determined the diagnostic accuracy against local DST (Xpert MTB/RIF Ultra, Xpert MTB/XDR, and BD BACTEC MGIT phenotypic DST). We prospectively sequenced 236 samples and have 148 samples with sequencing results from unprocessed and decontaminated sputum. We obtained successful sequencing results from 66.4% (94/148) unprocessed sputum samples and 75% (111/148) decontaminated samples. Sequencing success rates at the two sites differed, with 50.7% (36/71) successful sequencing results from unprocessed sputum in Zambia and 75.3% (58/77) in South Africa. Samples with “low” bacterial load, measured by Xpert MTB/RIF Ultra, tended to produce fewer successful sequencing results. TBDR sequencing predicted resistances in 48 samples, detecting resistance for rifampicin (n = 41) and isoniazid (n = 20), as well as 10 second-line drugs (n = 15). Sensitivity was variable compared to phenotypic DST, ranging from 33 (ethionamide) to 94% (rifampicin), while specificity remained above 90% for all drugs, except clofazimine. The TBDR assay can provide rapid, comprehensive genotypic DST. Technical and operational challenges need to be addressed for its broader implementation in high tuberculosis-burden settings. IMPORTANCE This study illustrates the use of the Tuberculosis Drug Resistance Test (TBDR, Oxford Nanopore Diagnostics, Ltd., United Kingdom) as a rapid drug susceptibility testing (DST) approach for diagnosing drug-resistant TB in the high TB-burden countries of South Africa and Zambia. The TBDR assay predicts resistance to 16 TB drugs, including first- and second-line treatments. By implementing the TBDR assay in a national reference laboratory in South Africa and a district diagnostic laboratory in Zambia, we demonstrate how this technology can provide faster diagnostic results (days) compared to traditional phenotypic DST methods (~2 months), with adequate sensitivity. Missed resistances compared to phenotypic DST indicate that technical improvements are needed. Successful sequencing from unprocessed and decontaminated sputum samples at different sites suggests feasibility in diverse settings, though operational challenges remain. Implementing this rapid, comprehensive DST approach could enhance drug-resistant tuberculosis diagnosis and treatment, ultimately improving patient outcomes and helping to combat tuberculosis in high-burden regions.

Cross-cultural studies are crucial for investigating the cultural variability and universality of cognitive developmental processes. However, cross-cultural assessment tools in cognition across languages and communities are limited. In this article, we describe a gaze-following task designed to measure basic social cognition across individuals, ages, and communities (the Task for Assessing iNdividual differences in Gaze understanding-Open-Cross-Cultural; TANGO-CC). The task was developed and psychometrically assessed in one cultural setting and, with input of local collaborators, adapted for cross-cultural data collection. Minimal language demands and the web-app implementation allow fast and easy contextual adaptations to each community. TANGO-CC captures individual- and community-level variation and shows good internal consistency in a data set of 2.5- to 11-year-old children from 17 diverse communities. Within-communities variation outweighed between-communities variation. We provide an open-source website for researchers to customize and use the task ( https://ccp-odc.eva.mpg.de/tango-cc ). TANGO-CC can be used to assess basic social cognition in diverse communities and provides a roadmap for researching community-level and individual-level differences across cultures.

This study aimed to assess the organization, infrastructure, workforce, and adherence to protocols in neurocritical care across low- and middle-income countries (LMICs), with the goal of identifying key gaps and opportunities for improvement. We conducted a cross-sectional survey of 408 health care providers from 42 LMICs. The survey collected data on the presence of dedicated neurointensive care units, workforce composition, access to critical care technologies, and adherence to evidence-based protocols. Data were analyzed using descriptive statistics, and comparisons were made across different geographical regions (East Asia and the Pacific, Europe and Central Asia, Latin America and the Caribbean, the Middle East and North Africa, and South Asia and sub-Saharan Africa) and economic strata [low-income countries (LICs), lower middle-income countries (LoMICs), and upper middle-income countries (UMICs)]. Only 36.8% of respondents reported access to dedicated neurointensive care units: highest in the Middle East (100%), lowest in sub-Saharan Africa (11.5%), highest in LoMICs (42%), and lowest in LICs (13%). Access to critical care technologies, such as portable computed tomography scanners (9.3%; UMICs 11%, LICs 0%) and tele-intensive care unit services (14.9%; UMICs 19%, LICs 10%), was limited. Workforce shortages were evident, with many institutions relying on anesthesia residents for 24-h care. Adherence to protocols, including those for acute ischemic stroke (61.7%) and traumatic brain injury (55.6%), was highest in Latin America and the Caribbean (72% and 73%, respectively) and higher in UMICs (66% and 60%, respectively) but remained low in LICs (22% and 32%, respectively). The study highlights critical gaps in infrastructure, workforce, and technology across LMICs, yet it also underscores the potential for improvement. Strategic investments in neurointensive care unit capacity, workforce development, and affordable technologies are an unmet need in resource-limited settings. These findings offer a road map for policymakers and global health stakeholders to prioritize neurocritical care and reduce the disparities in patient outcomes globally.