Establishment of Population Based Rural Stroke Registry in Ludhiana (Punjab)

Problem Statement

Disease and health registries involve ongoing data collection about aspects of the health or illness of individual people and can be used for etiologic research; intervention programme evaluation, quality improvement and health policy decision-making at local, state and national levels. Well established population-based stroke registries are lacking in developing countries particularly from rural areas.

Programme Description

The intervention was planned in Sidhwan Bet and Pakhowal in rural Ludhiana. A total of 265 ASHAs and 60 MPWs-Female/ ANMs were trained under this activity. The trained frontline functionaries were the main respondents of all stroke cases in the registry. The cases reported by ASHAs were examined by the Neurologist for confirmation of stroke along with examination of the MRI/CT scan films or reports which were analyzed to assess the sensitivity of the methodology. With refresher training and repeated visits, the ASHAs were able to correctly identify more cases. The ASHAs felt empowered to refer stroke cases promptly to CT/ MRI equipped hospitals. They could call the research team regarding any doubts. The rural registry utilized the presence of ASHAs in the villages to obtain information regarding cases of stroke in the villages. The cases were followed up by the research team at home or in the hospitals where they were admitted and salient information was collected with the help of a simple instrument. Information on stroke deaths was collected from the villages using verbal autopsy.

Programme Outcomes

A total of 436 cases registered (excluding 102 Mimic) from December 2016, of which 359 were first ever strokes. Nearly 226 (52.3%) of cases were registered within 30 days. About 69 cases (15.9%) were registered in the first week, 137 (31.7%) in the first two weeks.

Scalability

A nationally representative populationbased registry can bring quality information and provide insights on incidence, mortality, case fatality and details on disabilities due to stroke. This information combined with risk factors analysis can be used to modify the programme framework to address the stroke patients in the community.

Implementation Partners

CMC Ludhiana and Department of Health and Family Welfare, Punjab.

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