EHS-COVID (456) World Stroke Day 29 October (2)

2 November, 2021

Below is an extract from a statement on the WHO South East Asia Regional Office website and a few comments from me. Read in full: https://www.who.int/southeastasia/news/detail/28-10-2021-world-stroke-day

28 October 2021 Statement SEARO

By Dr Poonam Khetrapal Singh, WHO Regional Director for South-East Asia

'In all countries of the Region, several interventions can be applied to achieve immediate progress in strengthening stroke care services. First, integrating stroke prevention and detection into preventive and promotive health interventions, especially at the primary level. Community intervention, e-health and appropriate medication and lifestyle modification can prevent at least 50% of stroke events. Alongside increased public literacy in the FAST method (Facial drooping, Arm weakness, Speech difficulty and Timely emergency service) they can significantly reduce the incidence and impact of stroke. Second, strengthening existing pathways of care from the primary level up, and through to rehabilitation, ensuring that gaps are identified and addressed using a hub and spoke model. Specific focus is needed to improve fast-track referrals and enhance emergency stroke services. Third, making essential stroke medicines accessible to all. Thrombolytic medicines and other medicines for stroke are now included in WHO’s Essential Medicines List and should be integrated into national lists. Fourth, identifying and implementing high-impact innovations. Virtual capacity building in particular holds great promise, alongside tele-networking within and between countries to improve skills and share knowledge and resources.'

COMMENTS (NPW):

1. In the context of our WHO-supported discussion on Essential health services during COVID, can anyone share experience on the availability of quality health servioces for people with stroke? I suspect many people will have had delayed or absent care, and that a negative outome (death or permanent diability) will have been increased.

2. The fact that thrombolytic medicines and other medicines for stroke are now included in WHO’s Essential Medicines List should be reflected in a rapid inclusion on national lists. Why is this not happening?

3. To what extent is the general public able to recognise and appropriately act on FAST symptoms (Facial drooping, Arm weakness, Speech difficulty and Timely emergency service)? How can this be improved. (Indeed, is it appropriate to call this 'public literacy' as above? Recognition of danger signs is surely an issue of basic healthcare knowledge, which is distinct from literacy?

Neil Pakenham-Walsh, HIFA Coordinator, neil@hifa.org www.hifa.org