Stroke Care in Sri Lanka: The Way We Were, the Way We Are, and the Way Forward

Abstract

Sri Lanka is a lower-middle–income country with a high Human Development Index. Stroke is a primary cause of death and disability in the country, and demographic and epidemiological transitions are likely to lead to a large increase in the burden of stroke. Although impressive health indicators have been achieved due to an excellent primary health-care structure, Sri Lanka has been slow to develop and expand modern stroke care. A majority of the patients with acute strokes are treated in state-sector hospitals where facilities for state-of-the-art acute stroke care are limited. Neurologists are low in number, and general physicians provide acute stroke care for most of the patients. Epidemiological data on stroke in Sri Lanka are scarce. Previous studies have shown low quality of stroke care and significant gaps in stroke awareness. Noteworthy gains have been made since the turn of the century, and recent trends in development of stroke care are promising. There is a clear need to improve manpower, infrastructure, and training that will lead to improvements in the existing services in terms of acute care, rehabilitation, and community support. More research data are needed to guide strategies to minimize the burden of stroke, and more concerted efforts are needed to make stroke care in Sri Lanka ready to face the challenges of the 21st century.