Table 6.

Stroke care in Africa: challenges and solutions

Aspect of stroke care	Challenges	Pragmatic solutions
Surveillance	Valid, reliable data on stroke incidence, prevalence, mortality and disability in Africa are extremely limited; no surveillance system is in place to track trends in the burden of stroke at continental, regional and country levels	Establish stroke surveillance systems to measure and monitor the burden of stroke
Prevention	No robust systems for detection and control of major stroke risk factors such as hypertension, diabetes mellitus and dyslipidaemia; high rates (93%) of uncontrolled hypertension	Increase awareness, screening and control of hypertension, dyslipidaemia, diabetes mellitus and other major stroke risk factors at the primary health-care level in synergy with programmes for NCDs; implement sensitization programme to involve the entire population across the lifespan
Acute care	Scarcity of high-quality hyperacute and acute care services; very low rates of thrombolysis and thrombectomy; few multidisciplinary stroke units	Synergistic action by all stakeholders, including pharmaceutical companies and stroke experts, to improve the availability of services and increase the number of stroke units
Rehabilitation	Few multidisciplinary stroke rehabilitation centres	Increase the number of centres and settings that offer multidisciplinary care; promote recovery and re-integration

NCDs, non-communicable diseases.