Executive Summary:

Prevention of Stroke in Nigeria

Mission:
We strive to expand the public awareness of stroke in Nigeria in hopes of decreasing the
prevalence/incidence. We aim to provide aid and capacity based intervention to get Nigeria
on track in terms of any/all stroke related topics.
Vision:
We will prevent strokes in Nigeria through proper education, awareness and healthcare,
funded by the government and other organizations so as to help make things more
affordable and accessible.
Background:
A stroke, also known as a cerebrovascular accident (CVA), is a non-communicable
disease that occurs when blood supply to the brain is interrupted or extremely reduced,
either through a blocked artery or leaking/bursting of a blood vessel. It causes brain tissue to
undergo oxygen and nutrient deprivation, ultimately leading to brain cell death within
minutes. Its a medical emergency condition which needs immediate attention in order to
minimize brain damage and other complications (Mayo Clinic Staff, 2016).
On a global scale, stroke is ranked as the second leading cause of death and third
leading cause of disability-adjusted life-years (DALYs) measure of overall disease burden,
expressed as the number of years lost due to ill-health, disability or early death worldwide
(Feigin et al., 2014). In addition, its the leading cause of disability. Every year, 15 million
people suffer a stroke while nearly six million die and another five million are left
permanently disabled (World Heart Federation [WHF], n.d.). Most of the deaths and
disabilities occur in low-income and middle-income countries like Nigeria where the
incidence of stroke is increasing (Feigin et al., 2014).
Nigeria is poverty-stricken as the GDP per capita is ranked 158th in the world at
$6,400 with seventy percent of the population being below the poverty line. Oil is their main
source of income and government revenues but they are still very poor as GDP growth has
fallen due to lower oil prices. Only 3.9% of Nigerias GDP is spent on health care and their
life expectancy is quite grim at 53.02 years (Central Intelligence Agency [CIA], 2016).
Hypertension is the number one risk factor for stroke in Nigeria and is present in as
high as 79% of all cases. Most of the victims of stroke dont even know their blood pressure
is high before suffering from the disease (Wahab, 2008). The prevalence of hypertension in
Nigeria may have a substantial impact on the total burden in Africa, and the world, due to

the large population of 181,562,056 people (CIA, 2016). Even though the prevalence of
hypertension is increasing, the pooled awareness rate was only about 17.4% (Adeloye,
Basquill, Aderemi, Thompson, & Obi, 2015). Furthermore, there was a higher prevalence of
hypertension in urban areas than in rural areas of Nigeria, which may be due to different
lifestyle patterns. In general, awareness, treatment, and control of hypertension and other
chronic diseases is low in Nigeria, as it is in most developing countries (Ogah et al., 2012).
Due to this low level of education regarding these risk factors for stroke, stroke is becoming
an increasing problem.
Impact:
Stroke is an additional burden to the countries that are still devastated by HIV/AIDS,
tuberculosis, and malaria. WHO projected that in 2030, approximately 80% of all strokes will
occur in people living in low and middle-income countries similar to Nigeria. Nigeria will
experience economic and health challenges due to the disease if nothing is done to curb the
increasing incidence/prevalence (Ogah et al., 2012).
Intervention:
Nigeria has implemented some interventions in terms of their health such as creating
national health policies and even going as far as to recognize stroke specifically, seen with
the inauguration of the Nigeria Stroke Reference Group (NSRG). Some of the NSRGs main
objectives are to develop a national stroke strategy and improve stroke education and
training for healthcare professionals (Imam, 2015). They, with the help of the government,
funding agencies, healthcare facilities, and the public, want to prevent stroke. Since its a
preventable disease, preventive care remains the number one intervention (Ogbebo &
Okeke, 2015).
Preventive measures in Nigeria would benefit from both aid-based and capacitybased interventions in which both require some sort of funding. Options for international aid
are hosting personal fundraisers and participating in events. Also, the National Stroke
Association seeks grant funding from corporations in order to be able to implement
evidence-based medical education programs that are accredited for doctors and nurses, and
rehabilitation and public health professionals (National Stroke Association, n.d.). An option
for domestic aid is to advertise runs/walks for money, which would not only get the
community active but may also inspire lifestyle changes, which could decrease the risk of
stroke.
Of the different measures that need to be taken in order to prevent strokes, one of
which is that the education system needs to improve. By doing so, there will be more
doctors and medical personnel that can, in turn, educate the general population about non-

communicable diseases such as stroke and how to decrease the risk of having one. In order
for education to improve, however, the government needs to invest more into it so there are
effective professors and increased overall outcomes (Olade, 2016). The government also
needs to make health a larger priority than it is as of now. There is no organized funding,
which leaves the cost of treating and caring for stroke victims restrictive. In addition, funding
is needed as the stroke care facilities are mismanaged and run by medical personnel with
poor training (Imam, 2015). They oftentimes skip the basics and purchase sophisticated
equipment with little knowledge of how to use it (Olade, 2016). Lastly, little research is done
regarding the size of the issues involving stroke and how to solve them, which also needs to
be addressed (Imam, 2015).
As formal education of Nigeria needs to improve, so does public education. In Nigeria,
there is a negative stigma attached to visiting the hospital so people dont go until theyre
very sick. Unfortunately, this ends up costing them a lot more money as diseases are much
cheaper to treat if diagnosed earlier rather than later (Olade, 2016). The culture does not
focus on preventing disease, but they are also largely unaware that there is a disease, such
as stroke, to prevent. Public awareness and education on the importance of preventive care
needs to be expanded upon. Stroke wont ever be well-controlled unless the public has
knowledge about the causes and prevention of the disease (Imam, 2015).
When it comes to prevention, there are different possibilities in regards to how to get
information out to the public. Some examples include educating those involved in media,
such as local newspapers, television hosts, and celebrities in order to increase public
awareness. Public education regarding stroke should be addressed at all levels by
introducing them in schools, churches, sports, etc. Stroke Action Nigeria, an NGO, has held
stroke assemblies that raised massive public awareness and recruited stroke ambassadors in
order to scale the country and increase awareness about stroke and ways to prevent it
(9jahealth, 2013). Any group/organization can take Stroke Action Nigerias lead in order to
spread information about the prevention of stroke through things like brochures, talks,
TV/radio broadcasts, posters, social media posts, and commercials.
References:

9jahealth. (2013, September 16). In Facebook [Business Page]. Retrieved June 14, 2016 from
https://www.facebook.com/9jahealth/posts/663829506970338

Adeloye, D., Basquill, C., Aderemi, A. V., Thompson, J. Y., & Obi, F. A. (2015). An estimate of
the prevalence of hypertension in Nigeria. Journal of Hypertension, 33(2), 230-242.
doi:10.1097/hjh.0000000000000413
Central Intelligence Agency. (2016, May 06). The World Factbook: Nigeria. Retrieved May 30,
2016, from https://www.cia.gov/library/publications/the-world-factbook/geos/ni.html
Feigin, V. L., Forouzanfar, M. H., Krishnamurthi, R., Mensah, G. A., Connor, M., Bennett, D.A., .
. . Murray, C. (2014). Global and regional burden of stroke during 1990-2010: Findings from
the global burden of disease study 2010. The Lancet, 383(9913), 245-54.
doi:http://dx.doi.org/10.1016/S0140-6736(13)61953-4
Imam, I. (2015, October 27). Time for a comprehensive strategy on stroke service delivery in
Nigeria. Retrieved June 12, 2016, from http://nigeriahealthwatch.com/time-for-acomprehensive-strategy-on-stroke-service-delivery-in-nigeria/
Mayo Clinic Staff. (2016, May 28). Stroke. Retrieved June 02, 2016, from
http://www.mayoclinic.org/diseases-conditions/stroke/home/ovc-20117264
National Stroke Association. (n.d.). Sponsorships & Grants. Retrieved June 14, 2016 from
http://www.stroke.org/ways-give/sponsorships-grants?gclid=Cj0KEQjw1v66BRCV-6rh6sBiu8BEiQAelpui3xncPXagWHfPLW_SqYlvzPihNMbVKnwA0nyuKTEyHcaAp6P8P8HAQOgah, O. S., Okpechi, I., Chukwuonye, I. I., Akinyemi, J. O., Onwubere, B. J., Falase, A. O., . .
.Sliwa, K. (2012). Blood pressure, prevalence of hypertension and hypertension
related complications in Nigerian Africans: A review. World Journal of Cardiology WJC, 4(12),
327-340. doi:10.4330/wjc.v4.i12.327
Ogbebo, W., & Okeke, V. (2015, October 30). 39% Of Stroke Survivors In Nigeria Die Within 3
Months FG. Retrieved June 12, 2016, from http://leadership.ng/news/470792/39-of-strokesurvivors-in-nigeria-die-within-3-months-fg
Olade, R., Dr. (2016, June 11). 'Nigerians take care of their cars more than their health'.
Retrieved June 13, 2016, from http://www.nigeriatoday.ng/2016/06/nigerians-take-care-oftheir-cars-more-than-their-health/

Wahab, K. W. (2008, November). The Burden of Stroke in Nigeria. International Journal of

Stroke, 3(4), 290-292. doi:10.1111/j.1747-4949.2008.00217.x
World Heart Federation. (n.d.). Stroke. Retrieved June 02, 2016, from http://www.world-heartfederation.org/cardiovascular-health/stroke/