Improving Stroke care in India

Stroke is a worldwide health problem and, with heart disease, is now the most common cause of death globally. In low to middle-income countries (LMICs) like India, the number of people having and dying from stroke is increasing. India now has the third-highest number of people dying from stroke of any country. People in India also tend to have strokes younger than people in wealthier countries like the UK – in their 50s rather than in their 70s. This often causes immense hardship for them and their family. There has been great progress in stroke audit and research in the UK in the past 20 years, which has led to major improvements in stroke service organisation and care. These improvements have reduced death and disability from stroke.

The George Institute is a member of NIHR Global Health Research Group, a partnership across the UK and India (with support from key colleagues in Australia) to improve stroke care in India. The group brings together multidisciplinary researchers with expertise in a range of methodological approaches, with differing professional backgrounds, experience, at different stages of their research careers, and with expertise in truly collaborative global health research and development.

We are co-designing, developing, supporting and undertaking a programme of research relevant to the needs of patients, carers and health professionals in India. Whilst this research will work with India’s current stroke services and systems, it will have the potential to support system change and through implementing research findings in practice will reduce the burden of stroke in India. This research will gain global recognition and inform stroke care across the world.

There are 3 key stages: –

1.) We have worked in partnership and agreed research priorities using co-developed criteria. The areas selected aim to benefit as many people as possible, and are affordable and achievable in acute stroke setting in India.  We will develop and explore the feasibility and acceptability (staff, patients and carers) of delivering these evidence-based interdisciplinary care bundles for the management of stroke.

We have now agreed on the three care bundles, which are: –

  1. Assessment and management of swallowing problems;
  2. Monitoring and management of neurological and physiological signs and symptoms;
  3. Education and training of relatives in supporting acute stroke care.

2.) We are assessing the feasibility of implementing the care bundles at the three centres in India. We are working together to develop new systems for collecting research data in India. We are providing opportunities for healthcare staff in India who wish to develop their skills and experience in undertaking research, and interested in implementing findings in practice.

3.) We are reinforcing our partnership through developing a longer-term, sustainable, programme of stroke research and service development with teams in India and other LMICs. We will pursue further funding, and ensure that the research findings are available to healthcare staff and policy makers

This research was commissioned by the National Institute for Health Research (NIHR) [Global Health Research Group on Improving Stroke Care, University of Central Lancashire (16/137/16)] using Official Development Assistance (ODA) funding. The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.

 

 

Further reading