Evidence map›Paper›PMID 28450468›Full record

ArticleBMJ open2017

Barriers to evidence-based acute stroke care in Ghana: a qualitative study on the perspectives of stroke care professionals.

Leonard Baatiema, Ama de-Graft Aikins, Adem Sav, George Mnatzaganian, Carina K Y Chan, Shawn Somerset

Open access · goldAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
47citing papers in PubMed, 6 pooled it
4.7field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

47 citing papers in PubMed, 6 syntheses or guidelines pooled it, 98 citations in OpenAlex.

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  7. Article
  8. Time delays in emergency stroke care in a low-resource referral hospital in Ghana.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2025
    Article
  9. Article
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  12. Article
  13. Stroke in Ghana: A Situational Analysis.Stroke research and treatment · 2025
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 2 countries.

Leonard BaatiemaRegional Institute for Population Studies, University of Ghana, Accra, Legon, Ghana.
Ama de-Graft AikinsRegional Institute for Population Studies, University of Ghana, Accra, Legon, Ghana.
Adem SavSchool of Allied Health, Faculty of Health Sciences, Australian Catholic University, Brisbane, Australia.
George MnatzaganianCollege of Science, Health and Engineering, La Trobe Rural Health School, La Trobe University, Melbourne, Australia.
Carina K Y ChanSchool of Psychology, Faculty of Health Sciences, Australian Catholic University, Brisbane, Australia.
Shawn SomersetSchool of Allied Health, Faculty of Health Sciences, Australian Catholic University, Brisbane, Australia.
Australian Catholic University · AUUniversity of Ghana · GHLa Trobe University · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveDespite major advances in research on acute stroke care interventions, relatively few stroke patients benefit from evidence-based care due to multiple barriers. Yet current evidence of such barriers is predominantly from high-income countries. This study seeks to understand stroke care professionals' views on the barriers which hinder the provision of optimal acute stroke care in Ghanaian hospital settings.

designA qualitative approach using semistructured interviews. Both thematic and grounded theory approaches were used to analyse and interpret the data through a synthesis of preidentified and emergent themes.

settingA multisite study, conducted in six major referral acute hospital settings (three teaching and three non-teaching regional hospitals) in Ghana.

participantsA total of 40 participants comprising neurologists, emergency physician specialists, non-specialist medical doctors, nurses, physiotherapists, clinical psychologists and a dietitian.

resultsFour key barriers and 12 subthemes of barriers were identified. These include barriers at the patient (financial constraints, delays, sociocultural or religious practices, discharge against medical advice, denial of stroke), health system (inadequate medical facilities, lack of stroke care protocol, limited staff numbers, inadequate staff development opportunities), health professionals (poor collaboration, limited knowledge of stroke care interventions) and broader national health policy (lack of political will) levels. Perceived barriers varied across health professional disciplines and hospitals.

conclusionBarriers from low/middle-income countries differ substantially from those in high-income countries. For evidence-based acute stroke care in low/middle-income countries such as Ghana, health policy-makers and hospital managers need to consider the contrasts and uniqueness in these barriers in designing quality improvement interventions to optimise patient outcomes.

Indexed as

Attitude of Health PersonnelEvidence-Based PracticeGhanaHealth PersonnelHumansQualitative ResearchQuality of Health CareStrokeSurveys and QuestionnairesAfricabarriersdeveloping countriesevidence-based practiceimplementationStroke carestroke service

Identifiers

PMID28450468
PMCPMC5719663
OpenAlexW2609296656

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.