Addressing the deficiencies in stroke care in Pakistan

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Addressing the deficiencies in stroke care in Pakistan

• Saad Javed
• Dua Abbas Zaidi
• Eesha Yaqoob

Published:August 17, 2024DOI:https://doi.org/10.1016/S0140-6736(24)01443-0

Stroke is one of the leading causes of death and disability worldwide. In Pakistan, the response to stroke care(NOT RECOVERY!) is currently inadequate, presenting substantial challenges to the health-care system. Despite being the sixth most populous country, Pakistan lacks comprehensive stroke care(NOT RECOVERY!), leading to preventable morbidity and mortality.

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According to WHO, stroke is responsible for about 9·7% of all deaths in the country, translating to approximately 141 432 deaths annually.

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The incidence of stroke in Pakistan is estimated to be around 250 per 100 000 people per year, which means roughly 350 000 new cases of stroke occur each year.

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The health-care system in Pakistan is not equipped to handle the acute and long-term needs of stroke patients effectively. There is a crucial shortage of stroke units, neurologists, and rehabilitation facilities essential for proper stroke management. For instance, there are only about ten stroke units across the country, and fewer than six centres offer intravenous thrombolysis, a crucial treatment for acute ischaemic stroke.

The current health-care infrastructure is not equipped to handle the needs of stroke patients. There is a scarcity of imaging machines available, with only 80 CT scanners and 19 MRI machines that are mostly concentrated in major cities.

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Additionally, the absence of a national registry for stroke patients hampers the collection of accurate data, which is crucial for planning and improving services. Pakistan needs more neurologists, stroke specialists, and trained health-care providers. The country has fewer than 200 neurologists, which is far too few for its large population.

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There is also a shortage of allied health professionals, such as physiotherapists and speech therapists, who are essential for the rehabilitation of stroke survivors.

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Investing in more stroke units, especially in rural and underserved areas, is essential. Ensuring that all major hospitals have the necessary diagnostic equipment, such as CT and MRI scanners, and establishing quick triage and treatment protocols can improve patient outcomes. Increasing the number of trained neurologists and health-care providers through targeted training programmes and incentives can help fill the gap in specialised care(NOT RECOVERY!). Collaborating with international institutions for training and certification programmes can enhance the skills of local health-care professionals.

Improving stroke care(NOT RECOVERY!) in Pakistan requires joint efforts from the Government, health-care providers, and the community. By addressing the current gaps and implementing strategic interventions, Pakistan can substantially enhance the quality of stroke care(NOT RECOVERY!), reduce mortality, and improve the quality of life for stroke survivors.