How we do it

Establishing stroke ready hospitals

In Nepal, stroke is the third leading cause of death and disability – and the outcome of a stroke often depends on how and where you are treated! Since 2021 the Nepal Stroke Project works on improving access to acute stroke care in Nepals’ tertiary healthcare sector.

We originally included nine tertiary care centers in six different provinces of Nepal as partner hospitals with the aim of establishing essential stroke centers in line with the WSO Roadmap. 

More than 1000 health care professionals have participated in 26 stroke-related workshops, monthly webinars, regular case discussions and interdisciplinary exchange. Stroke Teams were built in five hospitals and ten stroke team leaders have attended an Angels’ Initiative “Train-The-Trainers”-Workshop empowering them as trainers and local stroke advocates. Four special nurse workshops and monthly educational newsletters were provided to over 100 nurses.

For practical guidance, checklists, flowcharts, posters and pocket cards were designed and handed out in English and Nepali. Additionally, the use of online tools and resources from the World Stroke Academy and Angels Initiative were encouraged.

In February 2023, 70 doctors and nurses from 23 hospitals attended our 2-day Symposium in Kathmandu, providing an opportunity collaboration and sharing of experiences.

We guide the hospitals with the following steps: (1) Building a multidisciplinary stroke team, (2) Assessment with the WSO Roadmap (3) Defining goals and action plans, (4) Continuous training and “Training-the-Trainers”, (5) Providing hands-on-protocols, (6) Stroke care advocacy with hospital boards.

Click here to read more: 

Experiences from the Nepal Stroke Project after 2 years

Raising public awareness of strokes

When somebody has a stroke, every second that goes by is crucial. As brain tissue and neurons begin to fade away, time could not be more precious.” 

(World Stroke Day Campaign, 2021). 

“When somebody has a stroke, every second that goes by is crucial. As brain tissue and neurons begin to fade away, time could not be more precious.”

(World Stroke Day Campaign, 2021).

Our goal is that every person in Nepal knows how to recognize a stroke (BE-FAST) and knows to get the affected person to a hospital as fast as possible. We are part of the World Stroke Organization’s #Precioustime campaign and participated in the 2023 World Stroke Day campaign #greaterthan Stroke.

Over the past two years we have reached 3 million people in Nepal through social media campaigns using platforms like Instagram®, Facebook®, Tiktok® and Twitter®.

Read our blog post in the International Journal of Stroke.

We have delivered the stroke message to people in everyday situations: Health camps were held in three major cities of Nepal with distribution of information materials, lectures, and counselling of vascular risk factors. Videos in the Nepali language were created and displayed on digital billboards in five public places. A walkathon was organized in Kathmandu. 10,000 flyers were distributed with the food delivery BHOJ. printed banners were placed in 25 partner restaurants.

We conducted a prospective study to evaluate the feasibility and effectiveness of our Public Awareness Campaign on Stroke Awareness of the population in Nepal:

Are digital social media campaigns the key to raise stroke awareness?

Quality Monitoring

Our goal is to continuously enter patient data in RES-Q  to provide an evidence base for targeting gaps in stroke care and define areas to be improved.

To ensure quality monitoring, 22 participating hospital stroke teams have received a “hands-on”-training on RES-Q, a tool aiming to monitor, analyze and improve stroke care quality.

Additionally, printed checklists containing all relevant patient information were distributed to facilitate data entry.

Stroke care advocacy

In 2022, a stroke care task force was established between the project partners and the World Health Organization Country Office Nepal (WHO), the Ministry of Health and Population (MOHP) and the Department of Health Services (DOHS) with regular meetings.

The finalization of a nationwide stroke protocol and the accreditation of training manuals represent first steps, while key components of a comprehensive National Road Map for Stroke Care are presently in progress.

A systematic literature review on the status of stroke care was performed in the absence of a national stroke registry: 

Systematic literature review on stroke care in Nepal

Plese send me the free “Stroke Knowledge” materials: