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Strategies to Improve Stroke Care Services in Low- and Middle-Income Countries : A Systematic Review
- Source :
- Neuroepidemiology, 49(1-2), 45-61, Neuroepidemiology 49 (2017) 1-2
- Publication Year :
- 2017
-
Abstract
- Background: The burden of stroke in low- and middle-income countries (LMICs) is large and increasing, challenging the already stretched health-care services. Aims and Objectives: To determine the quality of existing stroke-care services in LMICs and to highlight indigenous, inexpensive, evidence-based implementable strategies being used in stroke-care. Methods: A detailed literature search was undertaken using PubMed and Google scholar from January 1966 to October 2015 using a range of search terms. Of 921 publications, 373 papers were shortlisted and 31 articles on existing stroke-services were included. Results: We identified efficient models of ambulance transport and pre-notification. Stroke Units (SU) are available in some countries, but are relatively sparse and mostly provided by the private sector. Very few patients were thrombolysed; this could be increased with telemedicine and governmental subsidies. Adherence to secondary preventive drugs is affected by limited availability and affordability, emphasizing the importance of primary prevention. Training of paramedics, care-givers and nurses in post-stroke care is feasible. Conclusion: In this systematic review, we found several reports on evidence-based implementable stroke services in LMICs. Some strategies are economic, feasible and reproducible but remain untested. Data on their outcomes and sustainability is limited. Further research on implementation of locally and regionally adapted stroke-services and cost-effective secondary prevention programs should be a priority.
- Subjects :
- medicine.medical_specialty
Pediatrics
Telemedicine
Nutrition and Disease
Epidemiology
Alternative medicine
Developing country
Indigenous
03 medical and health sciences
0302 clinical medicine
Voeding en Ziekte
medicine
Humans
Life Science
030212 general & internal medicine
Developing Countries
Quality of Health Care
VLAG
Evidence-Based Medicine
business.industry
Stroke Rehabilitation
Subsidy
Evidence-based medicine
Private sector
medicine.disease
Stroke
Sustainability
Neurology (clinical)
Medical emergency
business
Delivery of Health Care
030217 neurology & neurosurgery
Subjects
Details
- Language :
- English
- ISSN :
- 02515350
- Database :
- OpenAIRE
- Journal :
- Neuroepidemiology, 49(1-2), 45-61, Neuroepidemiology 49 (2017) 1-2
- Accession number :
- edsair.doi.dedup.....c70416e9c888783995045746c03198d0