A Growing Need for Inclusion in Stroke Rehabilitation
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Caregiving by family and local community has been part of every society and presumably included those affected by stroke, long before there was any knowledge of what comprised a stroke. In Western societies, changes in family structure and development of health and social services have increased caregiving by professionals, albeit still with a considerable amount of caregiving being delivered by family members.
The rapid change in the pattern of illness globally has led to a dramatic fall in premature deaths from infectious diseases and a rapid rise in noncommunicable diseases, including stroke. This has now led to a major global public health problem with millions of people having a stroke each year, the majority of whom are in low- and middle-income countries (LMICs) that have yet to develop stroke services.1 A significant increase in disability-adjusted life years and deaths because of stroke was seen from 1990 to 2013, particularly in developing countries.2 There are ≈62 million stroke survivors across the world with a third of them with severe disabilities.3
Despite the huge burden, stroke care and rehabilitation services are unavailable to the vast majority of stroke survivors in LMICs. In this context, informal caregivers play a major role in post stroke care. In this review, we describe the current stroke services and rehabilitation in LMICs, role of informal caregiving in stroke rehabilitation, and description of new models of stroke rehabilitation in LMICs.
We used Google scholar and PUBMED to search literature published between January 2000 and January 2016. The search terms used included stroke in Asia, stroke in India, stroke epidemiology, stroke burden, stroke care in developing countries, stroke and economic factors, rehabilitation and stroke, caregiving and stroke, caregiving burden and stroke, caregiving and socioeconomic status, and caregiving and demographic variables. Of 350 articles identified, 245 were …