Transcending Social and Cultural Barriers to Transform Global Stroke Care: An SVIN Mission Thrombectomy Initiative

Stroke is a leading cause of neurological disability and mortality worldwide, with acute ischemic strokes caused by large-vessel occlusions presenting significant health care challenges. While endovascular thrombectomy has emerged as a gold standard treatment, access to timely stroke care remains severely limited, especially in low- and middle-income countries. This review examines the multifaceted social, cultural, and systemic barriers that impede effective stroke care globally. We performed a comprehensive search of PubMed from 2004 to 2024, using keywords of acute stroke care, low-middle-income countries, social barriers, cultural barriers, and access. There are several recognized obstacles to stroke treatment, especially in the acute settings, including health fatalism, spiritual and religious beliefs that discourage medical intervention, and widespread lack of public awareness about stroke symptoms and urgency. Cultural misconceptions often lead individuals to delay or avoid seeking medical care, with some communities attributing stroke to supernatural forces or divine punishment. Language barriers, insufficient health care infrastructure, and socioeconomic challenges further compound these issues, particularly in regions such as sub-Saharan Africa and parts of Asia. Furthermore, there are critical infrastructural barriers to delivering acute stroke in a timely manner, including limited transportation to health care facilities and inadequate stroke centers in rural areas. A comprehensive strategy to address these challenges should focus on culturally sensitive education, community engagement, and infrastructure development. Recommendations include cooperating with religious and community leaders, developing targeted awareness campaigns, and creating inclusive health care approaches that respect local cultural contexts. Overall, addressing the global stroke burden not only requires technological interventions but also demands a holistic approach that bridges cultural understanding, challenges misconceptions, and empowers communities to recognize and respond to stroke as a critical medical emergency.

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Publication Details

Journal
Stroke Vascular and Interventional Neurology
Published
2026-04-17
DOI
https://doi.org/10.1161/svin.125.002243
Primary Topic
Acute Ischemic Stroke Management
Type
article
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article

Transcending Social and Cultural Barriers to Transform Global Stroke Care: An SVIN Mission Thrombectomy Initiative

Mohammad El‐Ghanem, Eris Spirollari, Jonathan Crowe, Dileep R. Yavagal et al.
Stroke Vascular and Interventional Neurology
Acute Ischemic Stroke Management
article

Transcending Social and Cultural Barriers to Transform Global Stroke Care: An SVIN Mission Thrombectomy Initiative

Mohammad El‐Ghanem, Eris Spirollari, Jonathan Crowe, Dileep R. Yavagal, Karol P. Budohoski, Santiago Ortega‐Gutiérrez, Fazeel Siddiqui, Krishna Amuluru, Zurab Nadareishvili, Pankajavalli Ramakrishnan, Fawaz Al‐Mufti, P Khandelwal, Nishita Singh, Nabeel Herial, Eric Feldstein, Viktor Szeder, Aarti Kishore Jain, Victor Urrutia, T Kass-Hout, Kaustubh Limaye, Hesham Masoud, Shashvat M. Desai, Gabor G. Toth, Hazem S. Ghaith, Hamza Shaikh, Kaiz Asif, Sushanth R. Aroor, Mohamed Elfil, on behalf of the Mission Thrombectomy Collaborative, Nimrod Gozum, Andre Calixte
article en

Abstract

Stroke is a leading cause of neurological disability and mortality worldwide, with acute ischemic strokes caused by large-vessel occlusions presenting significant health care challenges. While endovascular thrombectomy has emerged as a gold standard treatment, access to timely stroke care remains severely limited, especially in low- and middle-income countries. This review examines the multifaceted social, cultural, and systemic barriers that impede effective stroke care globally. We performed a comprehensive search of PubMed from 2004 to 2024, using keywords of acute stroke care, low-middle-income countries, social barriers, cultural barriers, and access. There are several recognized obstacles to stroke treatment, especially in the acute settings, including health fatalism, spiritual and religious beliefs that discourage medical intervention, and widespread lack of public awareness about stroke symptoms and urgency. Cultural misconceptions often lead individuals to delay or avoid seeking medical care, with some communities attributing stroke to supernatural forces or divine punishment. Language barriers, insufficient health care infrastructure, and socioeconomic challenges further compound these issues, particularly in regions such as sub-Saharan Africa and parts of Asia. Furthermore, there are critical infrastructural barriers to delivering acute stroke in a timely manner, including limited transportation to health care facilities and inadequate stroke centers in rural areas. A comprehensive strategy to address these challenges should focus on culturally sensitive education, community engagement, and infrastructure development. Recommendations include cooperating with religious and community leaders, developing targeted awareness campaigns, and creating inclusive health care approaches that respect local cultural contexts. Overall, addressing the global stroke burden not only requires technological interventions but also demands a holistic approach that bridges cultural understanding, challenges misconceptions, and empowers communities to recognize and respond to stroke as a critical medical emergency.

Stroke Vascular and Interventional NeurologyVol. 6(3)
Rutgers, The State University of New Jersey (US), Wyoming State Department of Health (US), Cleveland Clinic (US), Westchester Medical Center (US), University of California, Los Angeles (US), Al-Azhar University (EG), SUNY Upstate Medical University (US), University of Utah (US), Metro Health Hospital (US), University of Iowa Hospitals and Clinics (US), University of Chicago (US), Endeavor Charter School (US), Jackson Health System (US), MidHudson Regional Hospital (US), Mount Sinai Hospital (US), Anna Needs Neuroblastoma Answers (US), Utah Department of Health (US), HonorHealth (US), Virginia Hospital Center (US), Houston Medical Center (US), University of Utah Health Care (US), Johns Hopkins Hospital (US), Cooper University Health Care (US), Campbell Collaboration (NO), University of Manitoba (CA), University of Virginia (US), Indiana University – Purdue University Indianapolis (US), Jefferson College (US), The University of Texas Health Science Center at Houston (US)
Partnerships for the goals
Openalex Percentile: Top 24%
Acute Ischemic Stroke Management
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