Improving the quality of care for people who had a stroke in a low‐/middle‐income country: A qualitative analysis of health‐care professionals’ perspectives

Abstract

Background and Objective Efforts to improve the adoption of evidence‐based interventions for optimal patient outcomes in low‐/middle‐income countries (LMICs) are persistently hampered by a plethora of barriers. Yet, little is known about strategies to address such barriers to improve quality stroke care. This study seeks to explore health professionals’ views on strategies to improve quality stroke care for people who had a stroke in a LMIC. Methods A qualitative interview study design was adopted. A semi‐structured interview guide was used to conduct in‐depth interviews among forty stroke care providers in major referral centres in Ghana. Participants were from nursing, medical, specialist and allied health professional groups. A purposive sample was recruited to share their views on practical strategies to improve quality stroke care in clinical settings. A thematic analysis approach was utilized to inductively analyse the data. Results A number of overarching themes of strategies to improve quality stroke care were identified: computerization and digitization of medical practice, allocation of adequate resources, increase the human resource capacity to deliver stroke care, development of clinical guideline/treatment protocols, institutionalization of multidisciplinary care and professional development opportunities. These strategies were however differentially prioritized among different categories of stroke care providers. Conclusion Closing the gap between existing knowledge on how to improve quality of stroke care in LMICs has the potential to be successful if unique and context‐specific measures from the views of stroke care providers are considered in developing quality improvement strategies and health systems and policy reforms. However, for optimal outcomes, further research into the effectiveness and feasibility of the proposed strategies by stroke care providers is needed.

The characteristics of stroke and its rehabilitation in Northern Tanzania

“…Another study in South Africa [ 24 ] showed that stroke patients received only limited rehabilitation therapies through CBR, which did not exceed five sessions over a period of six months. The rehabilitation of patients with various forms of disabilities has not been prioritised in SSA because governments focus primarily on the burden of communicable diseases [ 10 , 25 ], but the increasing rate of non-communicable diseases calls upon the countries of SSA to respond to the growing trends of these diseases [ 1 , 10 , 26 ].…”

Knowledge of acute stroke management and the predictors among Malaysian healthcare professionals

“…Training HCPs on stroke management is one of the strategies to improve the quality of care for stroke patients ( Rababah, Al-Hammouri & AlNsour, 2021 ; Baatiema et al, 2020 ). As a part of a nationwide initiative to improve stroke care in Malaysia, an online stroke e-learning module was launched to raise awareness of AIS management among HCPs ( Docquity.com, 2021 ).…”

Contextualising clinical reasoning within the clinical swallow evaluation: A scoping review and expert consultation

“…This is particularly true for LMICs all over the world, who are haunted by political and economic injustices (Browne et al, 2016 ; Lavoie et al, 2018 ; Umeh & Feeley, 2017 ; Ziltener & Künzler, 2013 ). These injustices have resulted in several consequences such as severe inequity, high unemployment rates and insufficient health systems (Baatiema et al, 2020 ; Browne et al, 2016 ; Ruelas, Gómez-Dantés, Leatherman, Fortune, & Gay-Molina, 2012 ). This in turn has caused unsurmountable personnel and resource constraints, high patient numbers, as well as a complex burden of disease (Ludwick, Morgan, Kane, Kelaher, & McPake, 2020 ; Mayosi et al, 2012 ; Meng et al, 2020 ; Puchalski Ritchie et al, 2016 ).…”

“…This in turn has caused unsurmountable personnel and resource constraints, high patient numbers, as well as a complex burden of disease (Ludwick, Morgan, Kane, Kelaher, & McPake, 2020 ; Mayosi et al, 2012 ; Meng et al, 2020 ; Puchalski Ritchie et al, 2016 ). These constraints have forced HCPs to practice in a creative and flexible manner to combat the effect of these inequities on their patients (Baatiema et al, 2020 ; Saito et al, 2016 ; Van Graan, Williams, & Koen, 2016 ). For perceived non-essential services such as speech therapy, these difficulties are often compounded because of their lack of priority when disseminating resources (Andrews & Pillay, 2017 ; Bright, Wallace, & Kuper, 2018 ; Rech, Hugo, Schmidt, Goulart, & Hilgert, 2019 ).…”