Stroke rehabilitation services in Africa – Challenges and opportunities: A scoping review of the literature

Tawa, Nassib; Rhoda, Anthea; Brink, Yolandi; Urimubenshi, Gerard; Giljam-Enright, Marlie; Charumbira, Maria Yvonne; Niekerk, Sjan-Mari van; Louw, Quinette

doi:10.4102/aosis.2020.bk85.01

Cited by 5 publications

(11 citation statements)

References 26 publications

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“…In addition to barriers related to health systems factors, personal factors also substantially impact a stroke survivor’s ability to obtain necessary rehabilitation services. In Zambia and other sub-Saharan Africa settings, adult stroke survivors receive few inpatient and outpatient physical therapy sessions not only as a result of inadequate rehabilitation services but also because of individual challenges, such as insufficient finances, long distances to rehabilitation facilities, and lack of transportation 19 …”

Section: Barriers To Stroke Rehabilitation In Lmicsmentioning

confidence: 99%

Stroke Rehabilitation in Low- and Middle-Income Countries

Kayola

Mataa

Asukile

et al. 2023

Am J Phys Med Rehabil

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Stroke remains the second leading cause of global disability with 87% of stroke-related disability occurring in low- and middle-income countries. In low- and middle-income countries, access to acute stroke interventions is often limited, making effective poststroke rehabilitation potentially the best available intervention to promote poststroke recovery. Here, we build on our experience as an illustrative example of barriers individuals with stroke face in accessing rehabilitation services and review the literature to summarize challenges to providing effective rehabilitation in low- and middle-income countries. First, we focus on barriers individuals with stroke face in accessing rehabilitation in low- and middle-income countries, including health system barriers, such as lack of national guidelines, low prioritization of rehabilitation services, and inadequate numbers of skilled rehabilitation specialists, as well as patient factors, including limited health literacy, financial constraints, and transportation limitations. Next, we highlight consequences of this lack of rehabilitation access, including higher mortality, poorer functional outcomes, financial burden, caregiver stress, and loss of gross domestic product at a national level. Finally, we review possible strategies that could improve access and quality of rehabilitation services in low- and middle-income countries, including creation of inpatient stroke units, increased training opportunities for rehabilitation specialists, task shifting to available healthcare workers or caregivers, telerehabilitation, and community-based rehabilitation services.

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Section: Barriers To Stroke Rehabilitation In Lmicsmentioning

confidence: 99%

Stroke Rehabilitation in Low- and Middle-Income Countries

Kayola

Mataa

Asukile

et al. 2023

Am J Phys Med Rehabil

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“…Stroke has been and remains a major cause of adult activity limitation and participation restriction, which poses a challenge to the HRQOL among people with stroke (Donkor 2018 ; Gorelick 2019 ; Odetunde, Akinpelu & Odole 2017 ). Stroke prevalence is estimated at 0.5% globally with lower-middle-income countries recording high numbers of stroke deaths and DALYs (4.85m and 91.4m) as compared to high-income countries (1.6m and 21.5m) (Donkor 2018 ; Odetunde, Akinpelu & Odole 2018 ; Shakya et al 2019 ; Tawa et al 2021 ). The global detrimental effects of stroke on activity and participation are the reason why people with stroke seek rehabilitation services to improve symptoms, function and enhance their well-being (Gbiri & Akinpelu 2013 ; Muralidharan et al 2019 ; Winstein et al 2016 ).…”

Section: Introductionmentioning

confidence: 99%

“…This, therefore, restricts the utilisation of PROMS in multi-ethnic and multicultural contexts (Odetunde et al 2018 ), like that of Kenya. Global sub-cultural populations are typically defined in terms of lifestyle and dialect and hence the complexity of direct administration of PROMs developed elsewhere in other contexts (Beaton et al 2002 ; Tawa et al 2021 ). Either way, modern healthcare practice is appealing for a global response to cultural adaptation of PROMs to enhance the quality of care post-stroke (Hawkins et al 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Translation and adaptation of the stroke-specific quality of life scale into Swahili

Nyanumba

Matheri

Tawa

et al. 2023

South African Journal of Physiotherapy

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Background: Stroke care requires a patient-centred, evidence-based and culturally appropriate approach for better patient clinical outcomes. Quality of life necessitates precise measuring using health-related quality measures that are self-reported and language appropriate. However, most of the self-reported measures were devised in Europe and therefore not considered contextually appropriate in other settings, more so in Africa.Objectives: Our study aimed to produce a Swahili version by translating and adapting the stroke-specific quality of life (SSQOL) scale among people with stroke in Kenya.Method: We used a questionnaire translation and cross-cultural adaptation. The pre-validation sample of 36 adult participants was drawn from 40 registered people with stroke, from the Stroke Association of Kenya (SAoK). Quantitative data were collected using both English and Swahili versions of the SSQOL scale. The mean, standard deviation (s.d.) and overall scores were calculated and are presented in tables.Results: The back translation revealed a few inconsistencies. Minor semantic and equivalence alterations were done in the vision, mood, self-care, upper extremity function and mobility domains by the expert review committee. Respondents indicated that all questions were well-understood and captured. The stroke onset mean age was 53.69 years and the standard deviation was 14.05.Conclusion: The translated version of the Swahili SSQOL questionnaire is comprehensible and well-adapted to the Swahili-speaking population.Clinical implication: The SSQOL has the potential to be a useful outcome measure for use in Swahili-speaking patients with stroke.

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“…Stroke is the second most common cause of death [ 3 ], accounts for 102 million disability-adjusted life years (DALYs) globally [ 4 ], and is ranked as the third most common cause of DALYs worldwide [ 5 ]. In Africa specifically, stroke is increasingly “becoming a public health problem...as it causes high rates of disability and mortality” [ 6 ]. Motor-sensory dysfunction that impairs functioning, such as activities of daily living, transfers, and mobility, are concerning sequalae of stroke.…”

Section: Introductionmentioning

confidence: 99%

“…Meeting the need for effective and efficient health and rehabilitation services poststroke is imperative to optimize functioning poststroke and to reduce the burden of care [ 7 ]. A recent review found that stroke rehabilitation services in Africa are generally poor, with challenges including “fragmented services, lack of trained personnel, and infrastructure limitations,” which lead to incomplete social and community reintegration of people with stroke in these resource-constrained settings [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Descriptive Review of Online Information Resources for People With Stroke: Protocol for a Scoping Review

Inglis-Jassiem¹,

Grimmer²,

Conradie³

et al. 2021

JMIR Res Protoc

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Background People with stroke and their caregivers experience numerous information needs; internet-based resources may offer cost-effective ways to improve access to information about this condition and its management, including the availability of resources and support. The quality of online health information is, therefore, an important consideration for both developers and consumers of these online resources. Objective This study aims to map and evaluate the content, readability, understandability, design, and quality characteristics of freely available online information resources (ie, websites) that empower people with stroke and their caregivers with information and self-help strategies poststroke. Methods This descriptive review will follow the five systematic and rigorous methodological steps that are recommended for scoping reviews, which include the following: (1) identifying the research question, (2) identifying relevant studies, (3) selecting the studies, (4) charting the data, and (5) collating, summarizing, and reporting the results. Data will then be synthesized and analyzed thematically. Results As of February 2021, the scoping review is in the data extraction stage. Data will be synthesized, and the first results are expected to be submitted for publication in an open-access peer-reviewed journal in August 2021. In addition, we will develop an accessible summary of the results for stakeholder meetings. Ethical approval is not required for this review, as it will only include publicly available information. Conclusions This study is novel and will evaluate the typology, content, and design-related criteria, including accessibility, aesthetics, navigability, interactivity, privacy, and data protection, of online information resources for stroke. The review will be limited to online resources published in English. International Registered Report Identifier (IRRID) DERR1-10.2196/23174

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Stroke rehabilitation services in Africa – Challenges and opportunities: A scoping review of the literature

Abstract: Collaborative capacity development to complement stroke rehabilitation in AfricaPublished by AOSIS Books, an imprint of AOSIS Publishing.

Cited by 5 publications

References 26 publications

Stroke Rehabilitation in Low- and Middle-Income Countries

Stroke Rehabilitation in Low- and Middle-Income Countries

Translation and adaptation of the stroke-specific quality of life scale into Swahili

Descriptive Review of Online Information Resources for People With Stroke: Protocol for a Scoping Review

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