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Quality of stroke guidelines in low- and middle-income countries: a systematic review

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dc.contributor.author Yaria, Joseph
dc.contributor.author Gil, Artyom
dc.contributor.author Makanjuola, Akintomiwa
dc.contributor.author Oguntoye, Richard
dc.contributor.author Miranda, J. Jaime
dc.contributor.author Lazo Porras, María de los Ángeles
dc.contributor.author Zhang, Puhong
dc.contributor.author Tao, Xuanchen
dc.contributor.author Ahlgren, Jhon Alvarez
dc.contributor.author Bernabé Ortiz, Antonio
dc.contributor.author Moscoso-Porras, Miguel
dc.contributor.author Málaga Rodríguez, Germán Javier
dc.contributor.author Svyato, Irina
dc.contributor.author Osundina, Morenike
dc.contributor.author Gianella, Camila
dc.contributor.author Bello, Olamide
dc.contributor.author Lawal, Abisola
dc.contributor.author Temitope, Ajagbe
dc.contributor.author Adebayo, Oluwadamilola
dc.contributor.author Lakkhanaloet, Monkol
dc.contributor.author Brainin, Michael
dc.contributor.author Johnson, Walter
dc.contributor.author Thrift, Amanda G
dc.contributor.author Phromjai, Jurairat
dc.contributor.author Mueller-Stierlin, Annabel S
dc.contributor.author Perone, Sigiriya Aebischer
dc.contributor.author Varghese, Cherian
dc.contributor.author Feigin, Valery
dc.contributor.author Owolabi, Mayowa O
dc.contributor.author Stroke Experts Collaboration Group
dc.date.accessioned 2021-10-04T23:01:00Z
dc.date.available 2021-10-04T23:01:00Z
dc.date.issued 2021
dc.identifier.uri https://hdl.handle.net/20.500.12866/9881
dc.description.abstract Objective: To identify gaps in national stroke guidelines that could be bridged to enhance the quality of stroke care services in low- and middle-income countries.Methods: We systematically searched medical databases and websites of medical societies and contacted international organizations. Country-specific guidelines on care and control of stroke in any language published from 2010 to 2020 were eligible for inclusion. We reviewed each included guideline for coverage of four key components of stroke services (surveillance, prevention, acute care and rehabilitation). We also assessed compliance with the eight Institute of Medicine standards for clinical practice guidelines, the ease of implementation of guidelines and plans for dissemination to target audiences.Findings: We reviewed 108 eligible guidelines from 47 countries, including four low-income, 24 middle-income and 19 high-income countries. Globally, fewer of the guidelines covered primary stroke prevention compared with other components of care, with none recommending surveillance. Guidelines on stroke in low- and middle-income countries fell short of the required standards for guideline development; breadth of target audience; coverage of the four components of stroke services; and adaptation to socioeconomic context. Fewer low- and middle-income country guidelines demonstrated transparency than those from high-income countries. Less than a quarter of guidelines encompassed detailed implementation plans and socioeconomic considerations.Conclusion: Guidelines on stroke in low- and middle-income countries need to be developed in conjunction with a wider category of health-care providers and stakeholders, with a full spectrum of translatable, context-appropriate interventions en_US
dc.language.iso eng
dc.publisher World Health Organization
dc.relation.ispartofseries Bulletin of the World Health Organization
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Quality of stroke en_US
dc.subject low- and middle-income countries en_US
dc.subject systematic review en_US
dc.title Quality of stroke guidelines in low- and middle-income countries: a systematic review en_US
dc.type info:eu-repo/semantics/review
dc.identifier.doi https://doi.org/10.2471/BLT.21.285845
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.25
dc.relation.issn 1564-0604


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