A description of functional needs of community-dwelling stroke survivors in Rwanda: a prospective observational cohort study

Stroke survivors in low- and middle-income countries have different needs compared to those in high-income countries. Our aim was to describe the unmet functional needs of Rwandan stroke survivors at discharge and three months after stroke. A study using an adapted modified Needs Assessment Questionnaire (mNAQ) was conducted at six hospitals in Rwanda. Moderate or severe needs are described using descriptive statistics and logistic regression models. A total of 337 participants, with a mean age of 61 years, were recruited. Most were female (59%), and 70% had an ischemic stroke, while 71% had hypertension. At discharge, 97% of participants had moderate to severe needs. Follow-up at three months was available for 78% of participants and 22% died. At three months, over 70% of participants continued to have moderate to severe needs. Almost all Rwandan stroke survivors have moderate to severe needs and disability at the time of discharge, and for those that survive, over 70% continue to have moderate to severe needs at 3 months. This estimate is much higher than previously reported. Improving functioning in the community is essential for Rwandan stroke survivors. Post-stroke disability is common in low-and middle-income countries, like Rwanda.Rwandan stroke survivors are more disabled than stroke survivors in high income countries and may have different needs.With limited resources, it is essential to focus support on the needs that are most important to stroke survivors. Post-stroke disability is common in low-and middle-income countries, like Rwanda. Rwandan stroke survivors are more disabled than stroke survivors in high income countries and may have different needs. With limited resources, it is essential to focus support on the needs that are most important to stroke survivors.