Community-implemented stroke support intervention in Malawi

08 Sep 2025 Stroke support

In Malawi, the general shortage of rehabilitation personnel, lack of follow up after hospital discharge, high travel costs and long waiting times contribute to poor outcomes for stroke survivors (Chimatiro & Rhoda, 2019; Fielder et al. 2013; Kalavina, 2019).

Stroke Support Organisation (Malawi) was established in 2021 with the mission to partner with the government to reduce the stroke burden through prevention, treatment, and long-term care. Given the poor outcomes for community dwelling stroke survivors, the SSO has recognised the urgent need to develop, test and implement context-sensitive and resource-appropriate responses.

Led by Dr Emmie Malewezi and Dr George Chimitiro, the SSO has established a Life after Stroke Centre (LASC) based at the Mission Hospital in Likuni. The choice of Likuni is to target stroke survivors residing in both rural and semi-urban parts of Lilongwe district where gaps in long term support exist. The SSO has engaged with key stakeholders including Lilongwe District Health and Social Services, rehabilitation departments at Kamuzu Central Hospital and Bwaila Hospital and other health facilities in Lilongwe.

With funding from the Population Health Research Institute (PHRI), Canada, Dr Malewezi and Dr Chimitiro are leading a study to determine whether a community-implemented stroke support intervention at the LASC can improve the functional abilities of adult stroke survivors compared to usual care. Conducting this study at Likuni LASC will offer important insights into the barriers and enablers to ensure scalability of this low-cost intervention across Malawi. Dr Chimitiro says ‘This is a promising, structurally competent project with both local and international support. I hope the results favour the need for scaling-up, towards better community living for stroke survivors and guardians in different parts of the country’.

The project in Malawi is part of a collaboration with the Organised Stroke Care Across Income Levels (OSCAIL) research group. This group is exploring whether SSOs can fill the gap in community rehabilitation and long-term support in low resource settings by augmenting rather than replacing government services.

Alongside this study in Malawi, PHRI is also supporting implementation of this novel community-based research project in sites in Nigeria with OSCAIL collaborator Stroke Action Nigeria. This is led by Dr Rita Melifonwu who established the first LASC in Africa in 2015. Co-principal investigator of OSCAIL, Professor Jackie Bosch says ‘In a resource poor area, use of resources has to address the needs effectively. Dr Malewezi, Dr Chimitiro and Dr Melifonwu are not only creating LASCs, they are testing the effectiveness of these centres in dealing with issues that are relevant to stroke survivors in Malawi and Nigeria’.

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