June 21, 2026
Global MND Awareness Day: Research and Progress
Global MND Awareness Day: Understanding the Challenges and Research Progress Global MND Awa...
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This article offers a comprehensive exploration of stroke in Ghana, detailing its prevalence, the level of community awareness surrounding this debilitating condition, and the existing support systems. We delve into the public health challenges posed by stroke, local risk factors, and the availability of treatment and rehabilitation services across the nation.
A stroke is a critical medical event characterized by rapidly developing clinical signs of focal or global disturbance of cerebral function, with symptoms persisting for 24 hours or longer, or resulting in death, without any apparent cause other than vascular origin. The American Stroke Association further defines stroke as an episode of acute neurological dysfunction presumed to be caused by ischemia or hemorrhage. Strokes are primarily categorized into two main types: ischemic and hemorrhagic strokes. Ischemic stroke occurs when the blood supply to a specific area of the brain is interrupted, leading to a sudden loss of function, while a hemorrhagic stroke results from the rupture of a blood vessel or an abnormal blood vessel within the brain. Globally, ischemic strokes are more common, representing approximately 80% of all cases, whereas hemorrhagic strokes constitute about 20%. Interestingly, in Africa, the distribution is slightly different, with ischemic strokes accounting for 66% and hemorrhagic strokes for 34%, a stark contrast to high-income countries where ischemic strokes represent 91% and hemorrhagic strokes only 9%. This difference underscores a unique aspect of the burden of stroke in Ghana and the broader African population.
Stroke stands as one of the top three leading causes of death and disability in Ghana, presenting a significant public health challenge. Historical and contemporary research consistently indicates a rising prevalence of stroke-related morbidity and mortality within the Ghanaian population, necessitating a coordinated response from healthcare systems. The prevalence of stroke among Ghanaian adults has been reported at 4.6%, and notably, in 2023, stroke tragically became the foremost cause of death in Ghana, surpassing lower respiratory infections and neonatal conditions, with a concerning 4.4% rise in mortality since 2013. Globally, the prevalence of stroke was an astounding 93.8 million in 2021 alone, with an incidence of 11.9 million. In sub-Saharan Africa, an estimated 2.3 million strokes occurred in 2019, underscoring the urgent need for improved emergency response and rehabilitation services. Further illustrating the increasing burden, a 5-year study at Korle-Bu Teaching Hospital found that stroke accounted for 11% of autopsy findings, while a 1-year retrospective examination at Komfo Anokye Teaching Hospital revealed strokes represented 9.1% of total medical admissions for adults. The rate of stroke admissions at Komfo Anokye Teaching Hospital also saw a significant increase, rising from 5.32 per 1000 admissions in 1983 to 13.85 per 1000 admissions by 2010, marking a 260% surge. From 2016 to 2021, the incidence of stroke in Ghana increased by a staggering 61%, with a total of 104,937 confirmed stroke cases reported in health facilities during this period. The share of stroke cases per year rose from 10.2% in 2016 to 21.9% in 2021, and the standardized rate for all age groups increased, particularly for those aged 60+ years and 35–59 years, showing a roughly two-fold increase. These statistics highlight the urgent need for enhanced stroke prevention, awareness, and management strategies in Ghana to address this growing public health crisis.
The incidence of stroke cases in Ghana demonstrates significant regional variations, often correlating with economic activity and geographical zones. Data indicates a higher prevalence of stroke within the Southern Coastal ecological zone and regions characterized by relatively more economic activity. Specifically, from 2016 to 2021, The Middle belt accounted for the highest proportion of stroke cases at 55.7%, followed by the Coastal zone with 26.0%, while the Savannah ecological zone reported the least with 18.4%, highlighting the need for targeted emergency response strategies. When examining regional distribution, the Eastern region bore the highest burden, accounting for 23.0% of cases, closely followed by Ashanti with 19.8%, and then the Greater Accra region with 16.0%. Conversely, the Savannah region reported the fewest cases, representing only 0.2%. The highest burden of stroke cases per 100,000 population was recorded in the Eastern region, with a caseload of approximately 767 per 100,000 people. This was closely trailed by the Volta and Central regions, reporting caseloads of 606 and 533 per 100,000 people, respectively. The minimum caseloads were observed in the Northern, North East, and Savannah regions, prompting a response from local health authorities to address these disparities. These regional disparities in stroke incidence highlight the importance of targeted interventions and tailored public health policies to address the unique challenges and risk factors prevalent in different parts of Ghana, ensuring that stroke prevention and care resources are appropriately allocated across the population.
Hypertension stands as the most crucial modifiable risk factor for stroke in Ghana, contributing to almost half of all stroke cases in the nation. With over 27% of the adult population in Ghana grappling with high blood pressure, it represents a significant public health challenge that substantially increases the risk of cardiovascular disease and stroke. The high prevalence of hypertension among the general Ghanaian population is a key driver of the overall burden of stroke. Research, such as the SIREN study, underscores the profound effect of hypertension on stroke occurrence within the African population. A cross-sectional study involving 156 stroke survivors in Ghana further emphasized this, reporting hypertension as a risk factor in a staggering 89% of cases, revealing the transient nature of many symptoms. The negative impact of hypertension extends to the Health Related Quality of Life (HRQoL) of stroke survivors, with those living with hypertension experiencing a lower HRQoL. Furthermore, the issue is compounded by a significant number of individuals with undiagnosed hypertension and a low adherence rate to antihypertensive medications, exacerbating the risk and making effective stroke prevention and management more challenging. Hypertension, with its associated disorders, is a critical comorbidity of stroke and a primary factor driving cerebral small vessel disease, negatively impacting cerebral circulation and cognitive function, thus highlighting the urgent need for robust strategies to address this prevalent health concern in Ghana.
Diabetes is a well-established correlate of stroke and a prominent risk factor prevalent in Ghana, significantly contributing to the overall burden of stroke in the country. This chronic metabolic disease can effectively double an individual’s chance of experiencing a stroke, underscoring its critical role in stroke prevention strategies. A cross-sectional study conducted among 156 stroke survivors in Ghana identified diabetes as a risk factor in 29% of cases, highlighting its substantial presence among stroke patients and the need for specialized care options. Diabetes mellitus (DM) is not only an independent risk factor but also a common complication of stroke, further complicating the recovery and long-term care for survivors. Approximately 25% of stroke survivors are diagnosed with DM as a comorbidity, a prevalence that dramatically escalates to about 60% when undiagnosed DM is taken into account. The implications of diabetes extend beyond increasing the direct risk of stroke; it may also elevate the risk of other complications, such as urinary tract infections (UTIs) and various infections, primarily due to compromised immune function caused by hyperglycemia and diabetes-related microangiopathy. Therefore, effective management and prevention of diabetes are essential components of comprehensive stroke prevention and care policies in Ghana.
Lifestyle influences play a significant and growing role in the incidence of stroke in Ghana, with risk factors such as excessive alcohol intake, obesity, and cigarette smoking on the rise across Africa. The increasing adoption of Western lifestyles, driven by urbanization, globalization, and media influence, is contributing to a gradual shift in the predominant type of stroke observed in Ghana, moving from hemorrhagic to ischemic stroke. Research, including the SIREN project, identifies dietary, lifestyle, and psychosocial factors as majorly associated with stroke in Ghana. A cross-sectional study by Donkor et al. Reported alcohol consumption as a stroke risk factor in 28% of survivors and obesity in 24%, emphasizing the pervasive nature of these influences on cardiovascular health. Furthermore, a history of cigarette smoking and physical inactivity were found to be independently associated with stroke, significantly increasing the risk. In Ghana, a concerning 5-7% of the population smokes, and passive smoking further triples the threat of clot formation, highlighting a critical public health challenge. These lifestyle environment factors, including alcohol consumption and a lack of physical exercise, have contributed to a staggering 61% rise in the incidence of stroke in Ghana from 2016 to 2021, particularly among those under 50 years of age, underscoring the urgent need for targeted public health campaigns and policy interventions to promote healthier lifestyles and mitigate the escalating burden of stroke.
Effective stroke management in Ghana hinges significantly on prompt recognition of symptoms, yet research indicates a critical gap in community awareness, contributing to delays in seeking hospital care. Studies in Accra have highlighted that many Ghanaians are unaware of fundamental warning signs of a stroke, such as slurred speech and visual disturbances. To address this, the Ghana Health Service (GHS) actively advocates for the widespread adoption of the FAST mnemonic, a simple yet powerful tool for spotting stroke signs: Face Drooping, Arm Weakness, Speech Difficulty, Time to Call. This educational strategy emphasizes that if any of these presenting symptoms occur, immediate transportation to the nearest hospital is crucial. Other vital symptoms include a severe headache without an apparent cause, sudden loss of sight, dizziness, or loss of balance. It’s particularly important to note that women in Ghana may experience additional symptoms, such as unexplained feelings of exhaustion and nausea, which often go unrecognized and delay essential intervention.
A critical aspect of reducing the burden of stroke in Ghana lies in implementing robust prevention strategies within local communities, especially considering that a startling 80% of all strokes are preventable. Key strategies involve stringent control of blood pressure, aiming for levels below 140/90 mmHg, with readily available free screenings at Community-based Health Planning and Services (CHPS) compounds and National Health Insurance Scheme (NHIS) clinics. Dietary modifications are paramount; adopting a heart-smart Ghanaian diet enriched with traditional foods like waakye, beans, kontomire stew, and local fruits such as mangoes, pawpaw, bananas, and oranges is highly recommended. Limiting sugar intake is crucial to prevent diabetes, a significant stroke risk factor, alongside managing calorie intake to 1,500-2,000 calories daily for individuals who are overweight, as recommended by specialists at the University of Ghana. Engaging in regular physical activity, such as brisk walks or floor dances for 30-45 minutes daily, can significantly reduce the risk of stroke by up to 25%. Furthermore, public health campaigns emphasize stopping smoking, reducing alcohol intake, and utilizing GHS quit-smoking programs. Managing chronic conditions through annual screening for diabetes and cholesterol is also vital. Community action, including churches and market associations offering FAST workshops, is actively encouraged to empower the Ghanaian population with knowledge and tools for stroke prevention.
The significant prevalence of stroke in Ghana is, in part, directly attributable to a pervasive lack of community awareness regarding the risk factors and critical warning signs associated with the condition. Numerous research efforts, including a pivotal study conducted in Accra, have consistently revealed that a substantial portion of the Ghanaian population is unable to accurately identify hypertension or other primary stroke risk factors, such as high cholesterol, diabetes, excessive alcohol consumption, and smoking. This profound educational gap extends beyond risk factors to the very recognition of a stroke itself, as many individuals remain unaware of fundamental warning signs. This deficiency in public knowledge about stroke, its causes, and its immediate indicators creates a formidable challenge for timely diagnosis and effective treatment, thereby exacerbating the impact of stroke and contributing to higher rates of mortality and long-term disability within the Ghanaian healthcare landscape. Addressing these awareness gaps through targeted health education campaigns is a crucial step in mitigating the escalating burden of stroke in Ghana, enhancing survival rates among affected individuals.
In Ghana, the availability and quality of healthcare infrastructure significantly impact stroke care and accessibility, with tertiary hospitals generally offering more advanced services than regional facilities. There is a concerted effort to enhance specialized stroke care, evidenced by the establishment of a dedicated stroke unit in the largest teaching hospital in Accra, and the inauguration of a specialized stroke and private ward at Ho Teaching Hospital in March 2025. Furthermore, the Tamale Teaching Hospital is actively developing its own stroke unit to address regional disparities in care, ensuring that trained nurses and specialists are available for emergency response. Despite these advancements, significant challenges persist, including the scarcity of beds, limited resources, and a shortage of therapists, which hinder adequate care for stroke patients. Diagnostic services such as CT and MRI scans, crucial for timely stroke diagnosis, suffer from limited functional and operational availability across the country, particularly in northern Ghana, with only a small percentage of hospitals offering 24/7 access. While the National Health Insurance Scheme (NHIS) covers many services, essential healthcare for non-communicable diseases (NCDs) like stroke was not fully covered until the proposed Ghana Medical Trust Fund in 2025 aimed to address these financial barriers, though its implementation is pending.
The quality of stroke rehabilitation services in Ghana faces substantial challenges, primarily due to a poor understanding of stroke rehabilitation among health professionals and inconsistencies in management guidelines and resources across different health facilities. Factors such as inadequate healthcare facilities, the absence of a standardized stroke care protocol, insufficient staffing levels, limited opportunities for staff development, and a lack of inter-professional collaboration severely impact rehabilitation outcomes. Furthermore, a broader issue is the limited knowledge of effective stroke care interventions among health professionals and a perceived lack of political will to implement comprehensive national health policies. Currently, medical aid and physiotherapy are the main available rehabilitation services for stroke patients in Ghana. A significant concern is that Many stroke survivors, despite undergoing rehabilitation and reporting improved functionality, are unable to return to work or fully engage in social activities due to persistent mobility impairments, which can be addressed with specialized rehabilitation options. Financial constraints also heavily influence stroke patients’ and their caregivers’ decisions regarding both conventional and complementary rehabilitation choices, creating a significant barrier to optimal recovery and reintegration into society.
The impact of stroke extends profoundly beyond the physical body, disrupting the body-self and creating significant challenges for stroke survivors in Ghana, affecting their economic circumstances, social and family relationships, cognitive function, nutrition, and overall lifestyle. Caregivers, who often bear the primary responsibility for post-stroke care and long-term rehabilitation, also experience considerable disruption to their physical health, economic stability, social life, nutrition, psychological state, and overall life circumstances. The health of stroke survivors is intricately linked to that of their caregivers, indicating a shared burden of the disease. A substantial proportion of stroke survivors, nearly 48%, fall within the working-age population, which places an enormous financial and emotional strain on families, particularly when the primary breadwinner is affected. The prevalence of pluralistic healthcare practices among stroke survivors and their caregivers, combined with poor healthcare accessibility and financial constraints, further complicates effective stroke management and highlights the critical need for robust social and emotional support systems to enhance recovery and quality of life for all involved.
Stroke remains a critical public health concern in Ghana, consistently ranking among the top three leading causes of death, and is likely the foremost contributor to disability across the nation. Both historical and contemporary research unequivocally indicate a rising prevalence of stroke-related morbidity and mortality, prompting calls for more trained nurses in the field. Alarmingly, in 2023, stroke ascended to the number one position as the primary cause of death in Ghana, surpassing traditionally prevalent threats like lower respiratory infections and neonatal conditions. The Global Burden of Disease (GBD) 2023 estimates for Ghana underscore this dire trend, showing stroke as the leading cause of death, progressing from its second position in 2013, with a notable 4.4% rise in mortality. A 5-year study at Korle-Bu Teaching Hospital revealed that stroke accounted for 11% of autopsy findings, with males showing a higher likelihood of dying from hemorrhagic stroke, highlighting the need for targeted emergency response measures. At Komfo Anokye Teaching Hospital, stroke mortality rates have climbed significantly over three decades, from 3.40 to 6.66 per 1000 deaths, with the average 28-day mortality rate reported as high as 41.1%, further emphasizing the severe burden of stroke in Ghana.
The burden of stroke in Ghana is multifaceted, impacting not only mortality but also contributing significantly to morbidity, leaving approximately 50% of survivors chronically disabled. This substantial disability-adjusted life years (DALYs) attributable to stroke in sub-Saharan Africa, including Ghana, are estimated to be about seven times greater than in high-income countries, highlighting a severe public health crisis. The economic impact of stroke in Ghana is particularly substantial because nearly 48% of stroke survivors are within the working-age population, placing an enormous financial burden on families, especially when breadwinners are affected. The cost of care, including weighted average medication and treatment, imposes a huge financial strain on both individual families and the national health system. The high lifetime cost associated with complications of hypertension, including stroke, underscores the profound financial challenge. Furthermore, the prevalence of pluralistic healthcare, coupled with poor accessibility and financial constraints, complicates effective stroke management. The public health implications are compounded by an increasingly early onset of stroke, which often implies shorter life expectancy, with a significant percentage of patients dying within five years and experiencing a decade lower lifespan than their peers.
Addressing the escalating burden of stroke mortality in Ghana necessitates a comprehensive review of existing government health policies and stakeholder initiatives to enhance the quality of stroke care. Key policy recommendations emphasize the critical need for the government and relevant stakeholders to build robust research capacity, particularly in herbal medicines for stroke treatment, advocating for strengthening the Centre for Plant Medicine Research of the Council for Scientific and Industrial Research (CSIR). There is also an urgent call to increase the number of trained health professionals, including nurses and specialists, in stroke care and rehabilitation services to bridge the significant workforce gap. Expanding the coverage of national health insurance policies to include comprehensive stroke management and rehabilitation is crucial to mitigate challenges like delayed diagnosis, treatment, and non-adherence to therapies. The 2022 update of Ghana’s National Policy for the Prevention and Control of Chronic NCDs underscores the importance of multisectoral collaboration, involving government, the private sector, civil society organizations, and development partners. Initiatives like the Ghana Heart Foundation’s health education programs are vital, and researchers further recommend developing national guidelines, establishing additional stroke units, and launching widespread public awareness campaigns to emulate successes seen in managing other diseases like malaria.
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