Abstract
Although stroke prevention and treatment strategies have significantly advanced in
recent years, implementation of these care elements in resource-limited settings can
be challenging, since the burden of stroke is higher and access to stroke care is
lower. Barriers to stroke care in resource-limited settings include insufficient prevention,
reduced awareness of stroke symptoms, limited prehospital care and lack of triage
systems, limited access to comprehensive stroke centers, inadequate personnel education,
lack of staff and resources, as well as limited access to neuroimaging, thrombolytics,
mechanical thrombectomy, neurosurgical care, and rehabilitation. Here, we suggest
strategies to improve stroke care in these settings, including public health campaigns,
protocols for prehospital notification, organized flow to specialized stroke centers,
development of dedicated stroke units, and utilization of telemedicine and telerehabilitation.
We also highlight the role of international organizations and governments in reducing
the global burden of stroke.
Keywords
stroke - systems of care - resource limited settings - low- and middle-income countries
