An estimated 70 per cent of strokes occur in low and middle-income countries


The World Health Organisation South-East Asia Region today said it was committed to strengthening health care services in its member countries, including Nepal, to prevent, treat, and manage stroke, and to provide quality rehabilitative care for stroke-related disability.

Issuing a press statement on the occasion of World Stroke Day, it warned that stroke was the second leading cause of death and the third leading cause of disability globally.

One in four people are at risk of stroke in their lifetime.

Lifestyle risk factors for stroke include obesity, physical inactivity, tobacco intake and alcohol abuse. Similarly, medical risk factors include high blood pressure, high cholesterol, diabetes and a personal or family history of stroke or heart attack.

According to the statement, an estimated 70 per cent of strokes occur in low and middle-income countries, which also account for 87 per cent of stroke-related deaths and disability-adjusted life years.

"Several countries continue to lead globally on tobacco control efforts, with India, Nepal, Maldives Thailand and Timor-Leste among the world's top 10 countries with the largest graphic warnings on tobacco packaging," WHO Regional Director for South-East Asia Dr Poonam Khetrapal Singh said in a statement.

Amid the pandemic response, the region continues to promote healthy lifestyles by facilitating physical activity and healthy eating, and tackling harmful use of alcohol and substance abuse.

Increased taxation on unhealthy products will not only change unhealthy behaviour, but can also enhance budgetary allocations on health, including on services to prevent, detect, treat and manage stroke and other non-communicable diseases.

By the end of this year, the region will have completed the second year of its multi-country support for stroke care improvement initiative. The programme aims to support countries to strengthen stroke management and referrals through the development and training of multi-disciplinary teams consisting of doctors, nurses and rehabilitation therapists.

During the first year of implementation, which started in April 2021, Bhutan, Maldives, Myanmar and Timor-Leste participated in the care improvement programme. Since then, it has been expanded to Nepal and Sri Lanka.

As per the statement, several interventions can be applied to all the countries of the region in a bid to achieve immediate progress in strengthening stroke care services.

First, integrating stroke prevention and detection into preventive and promotive health interventions, especially at the primary level can be path-altering when it comes to strengthening stroke care services.

Community intervention, e-health and appropriate medication and lifestyle modification can prevent at least 50 per cent of stroke events.

Second, stroke care services can be expedited by strengthening the existing pathways of care from the primary level so as to enable access to rehabilitation, ensure that gaps are identified and addressed using a hub and spoke model.

Third, making essential stroke medicines accessible to all is the need of the hour.

Fourth, identifying and implementing high-impact innovations can make a difference so as to strengthen stroke care services.

A version of this article appears in the print on October 29, 2021, of The Himalayan Times.