Stroke systems of care in the Philippines: Addressing gaps and developing strategies

Maria Epifania Collantes, Jose Navarro, Allan Belen, and Robert Gan

I. Summary
The Philippines, with a population of 109 million and only 5.7% above age 65, faces a high
rate of stroke mortality, accounting for 86% of global stroke deaths and 89% of stroke-related
DALYs. Despite advancements in science and government health programs, the mortality rate
remains high, and the real burden of the disease remains unknown. Stroke, along with
cardiovascular diseases, is the biggest pandemic, and many Filipinos suffer from it. Despite the
increasing prevalence, prevention and treatment, including emergency care, are inadequately
funded and poorly prioritized. The implementation of primary and secondary stroke prevention
is difficult without sufficient government funding, and reperfusion therapies are not accessible to
the majority of Filipino stroke victims. To improve stroke systems of care, coordinated efforts
from the government, healthcare workers, and community are needed. Mortality will remain high
without improvements in infrastructures, access to essential medicines, community education,
and stroke training among health workers. In low resource areas, greater resources should be
allocated for stroke prevention.

II. Nursing Implications

A. To Nursing Practice
It is critical to remember in this study that we are both educators and advocates for our
patients. Strategies to enhance stroke care systems need collaborative efforts from the
government, healthcare staff, and the community. Without improvements in infrastructure,
availability to key medicines, community education, and stroke training for health staff, mortality
will remain high. Greater resources should be directed to stroke prevention in low-resource areas.
Nurses are responsible for educating patients and family members/caregivers about their stroke
care, including stroke pathogens, treatment provided, personal risk factors, medications, stroke
signs and symptoms, use of emergency medical services, and strategies to reduce future stroke
risk.

B. To Nursing Education
This journal will aid nursing education by providing material that will increase
understanding about stroke awareness. This journal may help to raise teaching standards because
it will provide updates within the body of knowledge required to be learned by nursing students,
the knowledge which will come from clinical instructors will be equipped with ideas of innovation,
and student nurses will be implementing timely, high standard, and quality care to patients.

C. To Nursing Research
There will be a continuity of knowledge and goal project advancement within the nursing
healthcare practice because there will be baseline data like this journal that will alleviate the need
to constantly conduct researches, literature reviews, and journal readings because these are the
very foundation of reliability, standard, effective, and efficient patient care.

III. Personal Insights

I highly agree this this journal highlighted the importance of continuing to pursue project
goals in the midst of experiencing odds from opposing factors. This is necessary for planning,
implementing, and evaluating the effective and efficient preventative, acute care of stroke at the
health settings and rehabilitation programs at their home for those with developed disabilities.
Gaps in stroke systems of care include a lack of neurologist, insufficient CT scan machines, a lack
of stroke training among health workers, stroke protocols and pathways, a lack of EMS
infrastructure, and insufficient acute stroke ready hospitals, stroke units, and rehabilitation
facilities. Other LMICs' innovations, such as the use of technology to reach geographically distant
places and the deployment of mobile stroke units, can be replicated in the Philippines. Non-
neurologists can be taught to assist in the treatment of stroke victims. Upgrading PhilHealth
insurance to cover reperfusion treatments, establishing suitable stroke infrastructure and
networks, and increasing community stroke awareness are all opportunities for improvement in
the Philippine stroke care systems.