Evidence map›Paper›PMID 40852524›Full record

ArticleFrontiers in neurology2025

Toward improved stroke care in Nepal: insights from a qualitative study on barriers and success factors.

Christine Tunkl, Raju Paudel, Lekhjung Thapa, Shirsho Shreyan, Alexandra Krauss, Ashim Subedi, Balgopal Karmacharya, Pankaj Jalan, Nima Haji Begli, Patrick Tunkl and 13 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Frontiers in neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Article
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

23 authors.

Christine TunklDepartment of Neurology, University Hospital Heidelberg, Heidelberg, Germany.
Raju PaudelGrande International Hospital, Kathmandu, Nepal.
Lekhjung ThapaNational Neuro Center, Kathmandu, Nepal.
Shirsho ShreyanRajshahi Medical College, Rajshahi, Bangladesh.
Alexandra KraussDepartment of Neurology, University Hospital Heidelberg, Heidelberg, Germany.
Ashim SubediManipal Teaching Hospital, Pokhara, Nepal.
Balgopal KarmacharyaManipal Teaching Hospital, Pokhara, Nepal.
Pankaj JalanNorvic International Hospital, Kathmandu, Nepal.
Nima Haji BegliDepartment of Neurology, University Hospital Heidelberg, Heidelberg, Germany.
Patrick TunklTunkl Consulting, Heidelberg, Germany.
Sunanjay BajajDepartment of Neurology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States.
Andrea KosinskiPraxis Meertens, Geilenkirchen, Germany.
Christoph KosinskiRhein-Maas Klinikum, Teaching Hospital University RWTH, Aachen, Germany.
Pradesh GhimireBharatpur Hospital, Bharatpur, Nepal.
Bhupendra ShahB.P. Koirala Institute of Health Sciences, Dharan, Nepal.
Avinash ChandraAnnapurna Neuro Center, Kathmandu, Nepal.
Mahesh Raj GhimireDevdaha Medical College, Devdaha, Nepal.
Bikram Prasad GajurelTribhuvan University Teaching Hospital, Kathmandu, Nepal.
Jessica GoleniaDepartment of Neurology, University Hospital Heidelberg, Heidelberg, Germany.
Jan van der MerweAngels Initiative, Ingelheim, Germany.
Christina StangDepartment of Neurology, University Hospital Heidelberg, Heidelberg, Germany.
Rupal SedaniHealth Management Institute z.u., NGO, Brno, Czechia.
Christoph GumbingerDepartment of Neurology, University Hospital Heidelberg, Heidelberg, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The Nepal Stroke Project (NSP) aims to improve stroke care in a resource-limited setting. This qualitative study explores healthcare professionals' experiences and perceptions of barriers and success factors in implementing stroke care in Nepal. Methods: Semi-structured interviews were conducted with eight healthcare professionals (six physicians, two nurses) involved in the NSP. Interviews were analyzed using qualitative content analysis, following a constructivist approach. Results: Success factors encompassed the dedication of healthcare professionals, involvement of hospital boards, effective training initiatives, and the formation of stroke teams. Positive developments noted were increased thrombolysis availability, improved stroke awareness, and growing interest in stroke care among medical professionals. Key barriers identified included lack of government ownership in stroke care advocacy, financial constraints for patients, inadequate public awareness, and challenges in implementing quality monitoring. Conclusion: While the NSP has initiated positive changes in Nepal's stroke care landscape, significant barriers persist. The study highlights the importance of addressing systemic issues such as government involvement and financial accessibility of treatments. Success factors, particularly the motivation of healthcare professionals and local ownership of the project, provide a foundation for future improvements. These findings can inform strategies for enhancing stroke care delivery in other resource-limited settings and guide ongoing initiatives within the NSP.

Indexed as

implementation researchNepalpublic awarenessqualitative researchquality monitoringstrokestroke care advocacy

Identifiers

PMID40852524
PMCPMC12367502

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.