Strengthening Healthcare System in India to Reduce the Economic Burden Due to Strokes

With immense focus on educating people about life-threatening situation and ways to deal with them, Stryker India, DoMR, GoP, IIHMR and Consocia Advisory came together to conduct a webinar on 28^th October 2022 at 4:00 pm. The topic of this discussion was ‘Minimizing avoidable mortality and disabilities – Brain Stroke’ on pertinent health issue with availability and adoption of new technology barriers’ to adoption of new technologies. The webinar aimed at highlighting the situation of brain stroke in India and ponder over the available healthcare facilities and systems to treat the patients. Many industry experts and veterans came together on one platform to discuss solutions to minimize avoidable mortality and disability due to brain strokes, leading to increase in economic burden of the country.

Dr. PR Sodani, President, IIHMR University welcomed the key speakers that participated in the webinar. The list includes Dr. Sandeep Singh, Nodal Officer, NPCDCS – DHS, Govt. of Punjab; Dr. Padma Srivastava, Head of Department of Neurology, AIIMS Delhi; Dr. Ranjit Singh Ghotra, Director Health Services (Family welfare – Govt. of Punjab) and Dr. Avnish Kumar, Director, Research & Medical Education (DMER) – Govt. of Punjab. However, the technical sessions were moderated by Dr. Manorama Bakshi, Health – Public Health & Advocacy, Consocia Advisory and the Dean of IIHMR University, Col. (Dr.) Mahender Kumar. Speech of Gratitude was delivered by Mr. Faisal Shah Mohd, Business Unit Director, Stryker, Neurovascular Unit, India.

In India approximately 1.7 million new stroke cases occur annually. Many Stroke survivors face significant challenges that include physical disability, communication disabilities, changes in how they think and feel, loss of work & income, as well as caregiver burden. This opportunity also addressed the sheer frailty of the gap between the capacity building and training of medical practitioners, especially in stroke prevention. This brings attention to address the absence of awareness that could save a person from a potential disability, paralysis, or even death.

The webinar focused on the lack of management during the initial stage of stroke occurrence and that how an early diagnosis can prevent one. According to Dr. Padma Srivastava, Head of the Department of Neurology, AIIMS Delhi, “All sectors including primary, secondary, and tertiary, stroke healthcare systems require their own set of amenities and requires a team work. We are heading towards a stroke epidemic and that Stroke is the number 1 cause of death in north-eastern states in the country. Further, talking about thrombolytic care provided in the country,” she said that “it is given at a dismal rate of 0.5%. We need to map the gaps in the stroke chain of survival and take steps towards acute stroke care,” she added.

Dr. Sandeep Singh, Nodal Officer, NPCDCS – DHS, Govt. of Punjab, stated, “At least 9 stroke units have been established in the state of Punjab, 3 of them being situated in government facilities. Cardiovascular issues are taking the lead besides cancer. Every 3^rd person in Punjab is hyper-tense and 90% of uncontrolled hypertension cases lead to strokes. Looking at the pace with which this problem is rising, amenities for prevention are being implemented. For instance, special ambulances with ‘Fastag’ capabilities are being introduced.”

Talking about financial constraints in providing stroke care for a large population, Dr. Ranjit Singh Ghotra, Director Health Services (Family welfare – Govt. of Punjab), said that, “Management of stroke prevention is extremely crucial to reduce the overall economic burden of the country, however, the state needs to have adequate budgets to build the required infrastructure to treat patients in large number. There is no doubt that mechanical thrombectomy procedure is a very good intervention, however, it can only be applied to build standard treatment procedures for all only when there are neuro-interventionists available in the city care hospitals, required infrastructure like cath-labs is in place and above all there are sufficient budgets to build all these facilities that are crucial to the procedure.”

Dr. Avnish Kumar, Director, Research & Medical Education (DMER) – Govt. of Punjab, emphasised on, “Importance of endorsing the public-private partnership model and how this incorporation can be beneficial for business leaders while saving millions of lives preventing one stroke at a time. A significant change in health promotion through behavioural change is required.”

While delivering his keynote address, he mentioned about the roadmap framework towards steps for stroke prevention. In the said roadmap, acute patient care, prevention of recurrent strokes, and stroke rehabilitation were the stringent measures to be adhered to.

Clearly, there is paucity in terms of adequate awareness of stroke in India which emphasizes a dire need for a focused effort at both the state and national levels to provide quick assistance to patients of stroke in India. This exercise would need planning policies and programmes for the primary prevention of stroke and addressing the existing magnitude of stroke-related disability in the country.