Educating Women about Neurological Diseases in India

27 Feb 2023 Stroke awareness

Educating Women about Neurological Diseases in India – the EDuWAND Project is an education initiative by the stroke support organisation, the Dr. Bindu Menon Foundation.

Globally, each year 53% of all strokes occur in women and women account for just over half (56%) of all persons who have experienced a stroke[1]. Biological sex and sociocultural gender contribute to differences in stroke risk factors, assessment, treatment, and outcomes[2]. In addition, in many socio-cultural contexts, including India, women have a key caregiver role within the family for elderly and disabled family members[3] [4]. In a study by Menon et al. (2017) to understand stress of caregivers of stroke survivors, three quarters of caregivers were females, especially spouses[5]. Women play an important role in the Indian household and can be a support system in their homes to prevent risk factors, identify stroke and take immediate action against stroke.

The Bindu Menon Foundation developed the EDuWAND project with the goal to address both the burden of stroke for women and to leverage their role within the family. The EDuWAND project involves targeted education on stroke for women and focuses on increasing their participation in the drive to reduce the stroke burden.

Programme Approach

Accessible and Appropriate

The project takes place in the community, including in home settings, which removes barriers to women’s participation.

The project targets women exclusively, which enables shared experiences to be discussed in a women only space and for the questions raised to be relevant to other women.

The programme works in partnership with women’s organisations including: Arya mahila vibhag, Accredited Social Health Activist- ASHA, Anganwadi workers, Mahila University and Trusts. These partnerships have enabled the project to reach women and to facilitate their engagement through their existing relationships with these women’s organisations.

Activities include awareness raising sessions focused on primordial and primary prevention of stroke and early stroke recognition:

Risk factor identification. Use of electronic blood pressure monitors, glucometer, a BMI app and the Stroke Riskometer in home settings. The home setting allows for privacy and also for learning to be shared with other female household members.
Risk factor prevention. This includes a discussion on diet focusing on anaemia and the proportion of salt in the diet, weight, stressing the importance of exercise aside from routine household work, smoking (passive smoking), tobacco, OTC medication especially oral contraceptive use and the relationship to stroke, migraine and the relationship with stroke in later life, and the importance of recognition of peripartum hypertension
Knowledge of stroke warning signs. FAST and local language (Telugu stroke mnemonic).
Preparedness during a stroke attack. Importance of time is brain with emphasis on thrombolytic therapy at the nearest stroke ready hospital.
To increase understanding of the importance of stroke and that it is as serious as a heart attack. Women are most often the first responders at home for stroke, hence understanding the importance of “time is brain” is imperative.

Ongoing engagement

Participants are signposted to the Dr. Bindu Menon foundation EDuWAND Facebook page and invited to be members. Weekly updates will be continued on the Facebook page and serve as motivation for members.

It is envisaged that as the participants gain knowledge about stroke risk factors in general and those specific to women, they will share this within the household and among their female peers.

Changes to date

There has been a growing interest and inclination to know about neurological health among women which we feel is the first step towards awareness. We have received a number of requests for EDuWAND sessions.

We are also noting some changes in the diet regarding salt intake. Members of the organisations have updated us with their salt intake and a few of the women have initiated health check-ups.

We look forward to making positive and sustained changes in women’s neurological health and that of their families as the programme continues.

[1] Global Burden of Disease Stroke Statistics Worldwide for the year 2019 (http://ghdx.healthdata.org/gbd-results-tool).

[2] Rexrode, K.M., Madsen, T.E., Yu, A.Y.X., Carcel, C., Lichtman, J.H. & Miller, E.C. 2022, "The Impact of Sex and Gender on Stroke", Circulation research, vol. 130, no. 4, pp. 512.

[3] Bhattacharjee M, Vairale J, Gawali K, Dalal PM. Factors affecting burden on caregivers of stroke survivors: Population-based study in Mumbai (India) Ann Indian Acad Neurol. 2012;15:113–9.

[4] Gupta R, Rowe N, Pillai VK. Perceived caregiver burden in India: Implications for social services. Affilia. 2009;24:69–79.

[5] Menon B, Salini P, Habeeba K, Conjeevaram J, Munisusmitha K. Female Caregivers and Stroke Severity Determines Caregiver Stress in Stroke Patients. Ann Indian Acad Neurol. 2017 Oct-Dec;20(4):418-424.

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