UK Stroke Forum 2025 | Technological solutions to address gaps in stroke care in low-resource settings

I would like to start off with my own experience, so when I was working in India, I was able to only experience that there was no system – you know, there’s no multidisciplinary team that was available, not just for stroke care, but for any person with a disability. And then I moved to Nepal, worked during an emergency situation there; people were not getting the services that they needed during conflict situations, and there were children with problems, there were adults with problems in rural, remote regions where they have to get to walk to the bus stop, they have to basically walk for about half a day. And then to reach the capital city, they have to actually travel by bus for two days. So this is not going to be applicable or feasible for a condition like stroke, where they are talking about door-to-needle time in the context of the UK here. So technology can definitely be an amazing driver and a solution to address these issues. But technological solutions have to be systematically developed. It’s not just that we have technology, we can do anything we want, but we also have to look at small innovations. Say, for example, I have developed an innovation that enables people to educate themselves about what to do after a stroke at home with just the information that is available related to rehabilitation. And I’ve done a randomized controlled trial of that specific innovation for the past five years, funded by the Wellcome Trust and DBT India Alliance. And I found that this specific innovation, if provided to people, even during the times when COVID was very prevalent, this was able to actually produce or reduce disability and have a protective effect on people who are affected by stroke, 40% compared to anybody who’s getting standard rehabilitation in these settings, even not during the COVID context, I would say, pre-COVID context. So technology can certainly help. But what happened was, with this information, with the technological solution that is feasible, acceptable, and effective, this was taken to the stroke survivors themselves. And then I asked them, would you like to have this intervention scalable? Do you think it is scalable? Do you think people like you can access it in the future? They said, I don’t think it’s easy to do that. And when I asked them, what’s the reason? They said, if there is nothing that’s available for us in a primary health center, from a government hospital setting, or even in villages where we live, how do you think that this innovation is going to be scalable? So that’s the target. So basically, technology can help if you look at it from the perspective of integrating such technology from a scalability perspective. So technological solutions are brilliant to address these gaps, but you have to look at how best to integrate these kinds of innovations in the existing health and social care system to ensure that anybody with any kind of problems following a stroke will be able to actually live as a productive member of society through that innovation.

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