Bridging the accountability gap between commitments and action on NCDs

Accountability involves monitoring of commitments and how governments are using resources, and tracking policies and actions of public and private sector to identify what works and why and where increased action is needed for them to fulfil the health needs and rights of all people.

Mr. Michael U., a person living with Stroke/NCD demand accountability on action taken by governments in Africa on NCDs.(African Stroke Organization, ASO)

Governments have committed to many targets for NCD prevention and control through the UN. We can all help ensure that commitments translate into targets met, to turn back the tide on the NCD epidemic. Civil society, academia and private sector, all have a role to play. Greater accountability actions across sectors can help bridge the glaring accountability gap for progress on NCDs.

A decade of global commitments on NCDs

Noncommunicable diseases, or NCDs, are the cause of 70% of deaths globally – many of them preventable or premature – and they also carry a crippling economic burden for countries, communities and families. Both the health and economic burdens of NCDs fall heaviest on low- and middle-income countries (LMICs), making NCDs a major development issue as well. Historically, NCDs have been overlooked by governments, but since 2015 when the Sustainable Development Goals (SDGs) were adopted, they have – finally – been recognised as a global health issue in need of an urgent response.

NCDs have made their way onto international development agendas, and global targets have been set by the United Nations and the World Health Organization, starting with the 2011 UN Political Declaration on NCD Prevention and Control, which resulted from the first United Nations High-Level Meeting (UN HLM) on NCDs in 2011. There is also the WHO Global Action Plan for the Prevention and Control of NCDs 2013-2020, with its overarching goal to reduce the number of premature deaths from NCDs by 25% by 2025. In September 2015, the United Nations General Assembly formally adopted the universal 2030 Agenda for Sustainable Development, along with a set of 17 Sustainable Development Goals (SDGs). SDG 3.4 addresses NCDs specifically, and world leaders committed to a one-third reduction in deaths between 30 and 70 years of age from four key NCDs – cancer, cardiovascular disease, chronic respiratory disease, and diabetes – by the year 2030.

Other commitments to address NCDs and the risk factors driving them – such as unhealthy diets, lack of physical activity, and alcohol and tobacco use – have been made at subsequent UN meetings of Heads of State in recent years. Since 2018, mental health has been added to the NCDs requiring urgent global action and air pollution has been recognised as a fifth major global risk factor.

Thanks to plans and commitments like these, the world now has a global agenda based on concrete targets for prevention and control of NCDs. Unfortunately, more than half of the world’s countries are likely to miss the targets for SDG 3.4.

According to the latest NCD Countdown report, only 17 countries for women and 15 countries for men are on track to achieve the goal. Meanwhile, NCD mortality has stagnated or increased since 2010 for women in 15 countries and men in 24 countries.

Worldwide, deaths from stroke, heart disease and stomach cancer are falling. However, deaths from diabetes, lung cancer, colon cancer and liver cancer are stagnating or rising in many countries.

Despite this critical situation, an alarming number of countries are lacking even the most fundamental building blocks of a national response. According to the WHO’s NCD Progress Monitor, 26% of all countries do not have a multisectoral national NCD plan in place, and one-third of countries lack time-bound national NCD targets to drive and monitor progress.

One key factor behind this lack of progress at national level is a lack of accountability, defined as a cyclical process of monitoring (data collection), review (analysis) and action (advocacy and dissemination of messages). In other words, looking at what your local or national government has promised to do alongside what they have actually done and achieved. It also analyses actions taken in order to learn more about what works, what doesn’t, and why. Although accountability is often neglected or overlooked, when accountability actions are carried out well, they can result in real, tangible action. The International Accountability Panel for Every Woman Every Child advocates use this framework.

 

Accountability success stories

One example can be found in the Caribbean, where the Healthy Caribbean Coalition and its members conducted a benchmarking exercise of NCD commitments by governments, assessed national NCD commissions, built obesity scorecards and developed a strategic plan for internal and external accountability. These tools are used to develop roadmaps, identify priorities and advocate for policies and systems at the country and regional levels. As a result, the obesity scorecard and regional report on national NCD commissions have triggered action on key issues.

There have also been several concrete wins in the region, like the sugar-sweetened beverage tax imposed in Barbados, the anti-tobacco legislation passed in Guyana, and the development of a standardised hypertension treatment project now being scaled up in Barbados and possibly throughout the region.

As another example, the East Africa NCD Alliance undertook a regional benchmarking exercise in 2014, in which NCDA’s benchmarking tool was adapted to the East African context for data collection.  It examined the level of priority given to NCDs in development and health plans; the strength of national capacity, multi-sectoral action and partnerships for NCDs; progress on the reduction of NCD risk factors and social determinants; progress and reorienting health systems to address NCDs; and progress on establishing NCD monitoring and evaluation targets.

The findings were used to develop a civil society NCD charter as an evidence-based advocacy tool to demand universal health coverage including NCDs, the integration of NCDs in national development plans, and integrated primary care for NCDs.

Finally, in Latin America, the NCD Alliance Peru noticed that tobacco companies were among the sponsors in a series of UN Global Compact (UNGC) symposiums in the region relating the achievement of SDGs. Various actions were carried out. For example, the alliance sent letters to the organizers in Peru, the UNDP, and the president of the UNGC. Letters were also sent from international civil society networks, and a press conference was held on the issue. As a result, the UNGC Board announced the exclusion of tobacco companies from its work. Internationally, the initiative has led to vigilance regarding events across countries.

World Heart Day 2020 is Here!!!!

Join Stroke Association Supportnetwork-Ghana (SASNET-GHANA) to commemorate this year’s event in Ghana.

#BeatCVD

#Beat Stroke

Contact +233555886912

 

 

A Collective action void of Politics is required to win the Fight against COVID19 in Ghana

 

A Collective action void of Politics is required to win the Fight against COVID19 in Ghana

A national effort to get the COVID-19 health crisis under control is largely dependent on everyone wearing masks and by practicing strict personal hygiene. Stroke Association Supportnetwork-Ghana (SASNET-GHANA) stands with like-minded Ghanaians who have shown patriotism to contribute their quota in order to reduce the spread of the virus in the country especially our front line workers including Stroke Health Professionals who are committed to their call to service and to improve the lives of those affected with strokes in Ghana. To elevate and reinforce the messages on adhering to all safety protocols by the President Nana Addo Dankwah Akuffo-Addo and the former President John Dramani Mahama, Stroke Association Supportnetwork-Ghana is urging all Ghanaians to be focus and not to lose sight on Fight Against the Novel Corona Virus (COVID19).We are all at risk of being infected with virus if only we lose guard of ourselves. What must be done and what need to be done in order to protect ourselves from being infected with the virus mustn’t be ignored. We call on social commentators, showbiz pundits, political communicators, religious leaders, traditional leaders, journalist presenters, etc to elevate COVID19 preventive messages and make it a number priority for discussions, especially to educate the public on  wearing of face mask to protect oneself and other people from the deadly virus must be a number one concern for all.

About 39,075  Ghanaians could have been  saved from being infected with virus if everyone would be wearing a face mask.

There is no doubt of the achievements chalked by the government in terms of recovery rate and measures to put in place to reducing further spread of the virus. The country could get the spread of the novel coronavirus “under control” within a matter of weeks if everyone wore face mask. Research findings available shows that ,masks are among the most effective measures to prevent the spread of the virus.

Yet, COVID19 and facemask issue has been politicized, and as a result, there is ongoing resistance to the idea of wearing face mask  by a section of Ghanaians. Wearing of face mask is currently mandatory in the country, unfortunately politics has made it an option for some Ghanaians! What do we all (especially politicians) stand to gain if more lives are lost as a result of the COVID19? We must campaign to save lives, for lives are precious in the sight of the Almighty creator rather than focusing and  campaigning to get votes or  to win election at this time #Livesmatter #WearAMask #Campaigntosavelife.

SASNET-GHANA goal  for Ghanaians is  to let everyone sort through their own lives ,to think of others and  buy-in to this call in order to  help save thousands of lives by accepting to wear face mask wherever they may be.

Call the National Stroke Helpline

Email: helpline@sasnetghana.org

WhatsApp:0262463986

www.care.sasnetghana.org

 

Establishing a National Stroke Registry (NSR) to help in the  improvement of quality of care delivery to stroke patients in Ghana is very crucial

Establishing a National Stroke Registry (NSR) to help in the  improvement of  quality of care delivery to stroke patients in Ghana is very crucial

Stroke is among the major causes of death and disability in Ghana.  Stroke is currently one of the top five causes of deaths in Ghana and a major cause of disability (CDC Global Ghana). Stroke and Cardiovascular Disease (CVD) disease contribute more than ≤ 19.5 % of the total 43% (94,000) of Non Communicable Diseases (NCDs) deaths recorded annually in Ghana. Ghana must therefore institute measures in order to improve the quality of care delivery to stroke patients in the country. It’s very crucial to establish a national stroke registry now if the country is focus to win the battle against stroke and reduce the burden associated with it. There is an urgent need for surveillance on stroke to collect and analyze data on the scale of burden of stroke in the country. A stroke registry if established will collect detailed information about stroke patients and assess their progress with respect to the kind of treatment they are receiving and to identify the gaps that hinders quality of stroke delivery to persons living with/affected stroke and their carers in Ghana.

The registry will provide information on the epidemiology of stroke, diagnosis, management, prevention strategies,etc. (Tanne et al.). Analyzed data collected could be shared to better inform policy makers on a comprehensive stroke prevention and treatment plan for the country. The data collected may also be use to identify groups of people who are getting stroke within specific regions in the country where the incidence might be either increasing or decreasing to ascertain the cause of stroke among the population in that region.

Researchers and Stroke Health Professional could easily have access and use the information collected in their work to address problems which may be identified.

There is an urgent need to establish a national stroke registry in Ghana as accurate data sources are inaccessible or not available.

 

The national Stroke Registry for Ghana will be use to collect, store and analyze data on persons with/affected stroke in order to generate an accurate  incidence, prevalence, trends, mortality, post stroke discharge feedbacks , rehabilitation, recovery where these information could serve as an accurate source of information in developing  a comprehensive Stroke guideline and treatment plan for Ghana .Data at the registry could also be used to evaluate the impact of prevention, early treatment and post discharge  programs (Life After Stroke Programs) in the country.

.The Registry core function would be, to capture stroke cases diagnosed and treatment within Ghana, to facilitate and inform policy makers in the processes of developing a stroke policy and evaluation program guideline for an effective treatment, care and support for persons affected with strokes which will be line with the World Stroke Organization (WSO) global stroke services guideline and action plan. Ghana must learn from other countries implemented best stroke services practices in order to better improve the quality of care delivery to stroke patients in the country.

It’s long overdue for Ghana to have a national stroke registry. Stroke Association Supportnetwork-Ghana (SASNET-GHANA) led by the executive director, Secretary for the steering committee of the African Stroke Organization (ASO) and a board of director of the World Stroke Organization (WSO), Ad Adams Ebenezer is advocating and call on government and partners to support the call and raise the needed resources for the establishment of a national stroke registry.

Call the National Stroke Helpline for Assistance 0594989495

Email: helpline@sasnetghana.org

www.care.sasnetghana.org

Twitter : @adadams10 , @ghbeatstroke

Facebook : FightStroke SasnetGhana

WhatsApp:+233262463986

 

COVID19: Use the “F.A.S.T.” test to Spot Stroke Signs and know when to call 1-9-3

Spot Stroke F.A.S.T.  before it Strikes

By learning and sharing the F.A.S.T. warning signs with others , you just might save yourself and others life from  stroke.

Use the letters in “F.A.S.T.” to spot stroke signs and know when to call 1-9-3 (Ghana).

F for Face Drooping

Does one side of the face droop or is it numb? Ask the person to smile. Is the person’s smile uneven or lopsided?

A for Arm Weakness

Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?

S for Speech

Is speech slurred? Is the person unable to speak or hard to understand? Ask the person to repeat a simple sentence.

T for Time to Call 1-9-3 (Ghana)

If the person shows any of these symptoms, even if the symptoms go away, call 1-9-3 and get them to the hospital immediately.

Additional Symptoms of Stroke

If someone shows any of these symptoms, call 1-9-3 or emergency medical services immediately

Sudden Numbness

Sudden NUMBNESS or weakness of face, arm, or leg, especially on one side of the body.

Sudden Confusion

Sudden CONFUSION, trouble speaking or understanding speech.

Sudden Trouble Seeing

Sudden TROUBLE SEEING in one or both eyes.

Sudden Trouble Walking

Sudden TROUBLE WALKING, dizziness, loss of balance or coordination.

Sudden Severe Headache

Sudden SEVERE HEADACHE with no known cause.

Be prepared. Learn more about the signs and symptoms of stroke by signing up to the “Pros” and receive  information on stroke and have your questions answered.

Register for free support online here :

care.sasnetghana.org/ask-charway/

Sign up to care.sasnetghana.org

Call the National Stroke Helpline 0594989495

Ambulance: 193

Email: helpline@sasnetghana.org

WhatsApp us +233262463986

Sign up to  Ask Dr Charway –Felli Platform for more  support from the Professionals

Register for free support online here :  care.sasnetghana.org/ask-charway/

 

 

 

 

Covid-19 causes sudden strokes in young adults, doctors say

(CNN)The new coronavirus appears to be causing sudden strokes in adults in their 30s and 40s who are not otherwise terribly ill, doctors reported

They said patients may be unwilling to call 911 or (other emergency line) because they have heard hospitals are overwhelmed by coronavirus cases.
There’s growing evidence that Covid-19 infection can cause the blood to clot in unusual ways, and stroke would be an expected consequence of that.
Dr. Thomas Oxley, a neurosurgeon at Mount Sinai Health System in New York, and colleagues gave details of five people they treated. All were under the age of 50, and all had either mild symptoms of Covid-19 infection or no symptoms at all.
“The virus seems to be causing increased clotting in the large arteries, leading to severe stroke,” Oxley told CNN

How can I protect myself from exposure to the  new novel corona virus?

Observing personal hygiene  and adhering to protocol or directives including physical distancing , frequent and thorough handwashing and wearing of facemask

If you have heart or CVD or have had a stroke, these are factors to consider during physical distancing:

Make sure you have a list of contacts – caregivers, healthcare providers,  as family members and friends who could help you.
Ensure you have a  three months supply of  prescriptions (drugs) .
In stocking up on non-perishable foods, give priority to healthy choices(diet with more fruits and vegetables)

COVID19

Coronavirus disease  is an infectious disease caused by severe acute respiratory syndrome coronavirus 2. It was first identified in December 2019 in Wuhan, Hubei, China, and has resulted in an ongoing pandemic.

SYMPTOMS OF COVID19

People with COVID-19 have had a wide range of symptoms reported – ranging from mild symptoms to severe illness. Symptoms may appear 2-14 days after exposure to the virus. People with these symptoms may have COVID-19:

Fever or chills
Cough
Shortness of breath or difficulty breathing
Fatigue
Muscle or body aches
Headache
New loss of taste or smell
Sore throat
Congestion or runny nose
Nausea or vomiting
Diarrhea

 

What can you do to prevent a Stroke or a Second Stroke?

You can’t reverse the years or change your family history, but there are many other stroke risk factors that you can control(modifiable) —provided that you’re aware of them. **Knowledge is power**. If you know that a particular risk factor is sabotaging your health and predisposing you to a higher risk of stroke, you can take steps to alleviate the effects of that risk.

Globally, stroke is a leading cause of mortality and disability and there are substantial economic costs for post-stroke care(Global Burden of Disease ,GBD)

Stroke, the sudden death of some brain cells due to lack of oxygen when the blood flow to the brain is lost by blockage or rupture of an artery to the brain, is also a leading cause of dementia and depression. Globally, 70% of strokes and 87% of both stroke-related deaths and disability-adjusted life years occur in low- and middle-income countries.(Walter Johnson, et al.)

7 ways  to Prevent a Stroke or a Second Stroke

Here are seven ways to start reining in your risks today to avoid stroke, before a stroke has the chance to strike.

1.  Lower blood pressure

High blood pressure is a huge factor, doubling or even quadrupling your stroke risk if it is not controlled. High blood pressure is the biggest contributor to the risk of stroke in both men and women. Monitoring blood pressure and, if it is elevated, treating it, is probably the biggest difference people can make to their vascular health.

Your ideal goal: Maintain a blood pressure of less than 120/80(with respect to your age) if possible. For some older people, this might not be possible because of medication side effects or dizziness with standing.

How to achieve it:

Reduce the salt in your diet, ideally to no more than 1,500 milligrams a day (about a half teaspoon).

Increase polyunsaturated and monounsaturated fats in your diet, while avoiding foods high in saturated fats.

Eat 4 to 5 cups of fruits and vegetables every day, one serving of fish two to three times a week, and several daily servings of whole grains and low-fat dairy.

Get more exercise — at least 30 minutes of activity a day, and more, if possible. Quit smoking, if you smoke.

Contact your Doctor on your blood pressure medicines and report any side effects when taking  these drugs.

2.  Lose weight

Obesity, as well as the complications linked to it (including high blood pressure and diabetes), raises your odds of having a stroke. If you’re overweight, losing as little as 10 pounds can have a real impact on your stroke risk.

Your goal: While an ideal body mass index(BMI)  is 25 or less, that may not be realistic for you. Work with your doctor to create a personal weight loss strategy.

How to achieve it:

Try to eat no more than 1,500 to 2,000 calories a day (depending on your activity level and your current BMI).

Increase the amount of exercise you do with activities like walking, golfing, or playing tennis, and by making activity part of every single day.

3.  Exercise more

Exercise contributes to losing weight and lowering blood pressure, but it also stands on its own as an independent stroke reducer.

Your goal: Exercise at a moderate intensity at least five days a week.

How to achieve it:

Take a walk around your neighborhood every morning after breakfast. Start a fitness club with friends.

When you exercise, reach the level at which you’re breathing hard, but you can still talk. Take the stairs instead of an elevator when you can.

If you don’t have 30 consecutive minutes to exercise, , break it up into 10- to 15-minute sessions a few times each day.

4.  If you drink Stop

Drinking  alcohol as a person living with Stroke or NCDs is not SAFE to your health. Substitute alcohol  with sugar free fruit drink and water . Its not advisable to take alcohol as a person living with Stroke /NCDs .

Your goal: Don’t drink alcohol .

How to achieve it:

Take a lot of water every day and substitute alcohol for sugar free fruit drink  .

Seek support from a doctor , a psychologist or support group.

5.  Treat atrial fibrillation

Atrial fibrillation is a form of irregular heartbeat that causes clots to form in the heart. Those clots can then travel to the brain, producing a stroke. Atrial fibrillation carries almost a fivefold risk of stroke.

Your goal: If you have atrial fibrillation, get it treated.

How to achieve it:

If you have symptoms such as heart palpitations or shortness of breath, see your doctor for an exam.

You may need to take an anticoagulant drug (blood thinner) such as warfarin (Coumadin) or one of the newer direct-acting anticoagulant drugs to reduce your stroke risk from atrial fibrillation. Your doctors can guide you through this treatment.

6.  Treat diabetes

Having high blood sugar damages blood vessels over time, making clots more likely to form inside them.

Your goal: Keep your blood sugar under control.

How to achieve it:

Monitor your blood sugar as directed by your doctor.

Use diet, exercise, and medicines to keep your blood sugar within the recommended range.

7.  Quit smoking

Smoking accelerates clot formation in a couple of different ways. It thickens your blood, and it increases the amount of plaque buildup in the arteries. Along with a healthy diet and regular exercise, smoking cessation is one of the most powerful lifestyle changes that will help you reduce your stroke risk significantly.

Your goal: Quit smoking.

How to achieve it:

Ask your doctor for advice on the most appropriate way for you to quit.

Use quit-smoking aids, such as nicotine pills or patches, counseling, or medicine.

Don’t give up. Most smokers need several tries to quit. See each attempt as bringing you one step closer to successfully beating the habit.

Identify a stroke using the  F-A-S-T  test

Too many people ignore the signs of stroke because they question whether their symptoms are real. “My recommendation is, don’t wait if you have any unusual symptoms,” Dr. Rost advises. Listen to your body and trust your instincts. If something is off, get professional help right away.”

Signs of a stroke include:
weakness on one side of the body.
numbness of the face.
unusual and severe headache.
vision loss.
numbness and tingling.
unsteady walk.

Harvard Health Publishing  (June 2013). 7 things you can to to prevent stroke.

GET FREE SUPPORT : Person living with stroke and their carers can  have answers to their mind boggling questions and access information on stroke care and support  by signing up to the Post Discharge Stroke Support(PDSS) Program by the Stroke Association Supportnetwork-Ghana (SASNET-GHANA).

Visit our  website below for more information

http://:care.sasnetghana.org    or email us : info@sasnetghana.org

Helpline + 233594989496 or  WhatsApp us +233262463986

Sign up to  Ask Dr Charway –Felli Platform for more  support from the Professionals

Register for free support online here :  care.sasnetghana.org/ask-charway/

NATIONAL STROKE HELPLINE (GHANA) LAUNCHED

CALL 0594989495

Email: helpline@sasnetghana.org

 

 

NEWS RELEASE : Urgent Call to Action on WHO in Relation to COVID-19-Related VTE

A SYSTEMATIC APPROACH FOR MANAGING VENOUS THROMBOEMBOLISM IN PATIENTS WITH COVID-19

A Systematic Approach for Managing Venous Thromboembolism in Patients with COVID-19: A Multinational Consensus Statement from the International Society on Thrombosis and Haemostasis (ISTH) on Behalf of the International Thrombosis Community

Introduction

With more than 6.7 million confirmed cases worldwide[i] and nearly 400,000 deaths to date (7th June 2020) during 2020,[ii] the COVID-19 pandemic is one of the most significant healthcare crises of our time. The spread of COVID-19 has been varied, with some regions having sporadic transmission and relatively few hospitalized patients with COVID-19 pneumonia, and others where significant transmission has overwhelmed health services. While the disruption to health services continues, it is vital for the World Health Organization (WHO) to share the lessons of how best to prevent, diagnose, and treat patients with COVID-19 with health systems globally, and to learn about agreed clinical best practice approaches, which may improve patient outcomes.

The WHO should be congratulated on the publication of interim guidance on the Clinical Management of hospitalized patients with COVID-19[iii], the second iteration of which was published by the WHO in late May, which serves as a useful first step resource for health systems internationally. However, more must be done to meet the needs of front-line clinicians caring for patients with COVID-19 to ensure quality care, by addressing significant gaps in expert clinical guidance surrounding the prevention and management of venous thromboembolism (VTE) in COVID-19 patients.

COVID-19 and Venous Thromboembolism (VTE)

Venous thromboembolism (VTE) is a condition in which a blood clot forms most often in the deep veins of the leg, groin or arm (known as deep vein thrombosis , DVT) and travels in the circulation, lodging in the lungs (known as pulmonary embolism, PE). Together, DVT and PE are known as VTE – a dangerous, potentially deadly, medical condition.[iv] Hospital-associated VTE (describes VTE occurring in hospital and 90 days post discharge) accounts for 60% of all VTE.

Emerging research indicates that:

  • People with COVID-19, especially those hospitalized with the moderate (requiring supplementary oxygenation) and severe (requiring mechanical ventilation) COVID-19 pneumonia have a high incidence of VTE[v]
  • COVID-19 pneumonia is associated with a marked hypercoagulability, including high levels of fibrinogen and very high D-dimer levels;
  • In patients with COVID-19 pneumonia, there is a major inflammatory response which can lead to micro-clots – immunothrombosis – within the lungs. This likely contributes to the high levels of mortality seen in patients with COVID-19 pneumonia;
  • Some countries are facing difficulties in accessing low molecular weight heparins (blood thinners), a WHO essential medicine, that is a vital prophylactic and treatment for VTE in hospitalized patients with COVID-19.

Call to Action on WHO in Relation to COVID-19-Related VTE

To reduce harm from COVID-19 associated VTE, the International Society on Thrombosis and Haemostasis, together with the undersigned national, continental and international clinical representative organizations, urgently calls on the WHO to endorse and share the application of a system-wide approach to VTE management on a global scale, as part of the international COVID-19 response that seeks to:

  • Highlight the importance of a systematic approach to VTE prevention, diagnosis and treatment for patients with COVID-19; including those isolating at home, those hospitalized and those post discharge;
  • Meet the needs of front-line clinicians caring for patients with COVID-19 to ensure quality care by improving health worker education about VTE in COVID-19 management that incorporates up-to-date consensus recommendations in the next iterations of WHO interim guidance on the Clinical Management of COVID-19 (ensuring a VTE expert(s) is enlisted to the Guideline Development Group);
  • Signpost hospitals to accredited up-to-date evidence based clinical information portals on VTE related COVID-19 clinical guidance, such as the ISTH COVID-19 Resource Page;
  • Highlight to member states the importance of making available all WHO Essential Medicines, in particular low molecular weight heparins (blood thinners), which provides vital prophylactic and treatment for VTE;
  • Improve COVID-19 VTE data collection and research to support regular updates of evidence-based clinical recommendations; and
  • Encourage the implementation of a global VTE risk assessment tool for hospitalized patients.

VTE not only can kill, but can also have devastating co-morbidities, which significantly impact the quality of life for patients who survive COVID-19 and an associated VTE[vi] .

Until there is a vaccine for COVID-19, there is no better way to address this public health challenge than for the WHO to prioritize the development of systematic and integrated approaches to COVID-19-related VTE prevention that can be implemented in secondary and tertiary settings globally.

We urge the WHO to act now and offer our collective resources and expertise to assist in such an endeavor.

Link to ISTH and 70 organizations around the world  that have signed the Consensus statement

Website: https://www.isth.org/news/517212

Signed on behalf of ISTH

Claire McLintock ( President) Jeffrey Weitz (President -Elect)  Beverley Hunt, O.B.E.(Chair, World Thrombosis Day)

REFERENCES

[i] https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200527-covid-19-sitrep-128.pdf?sfvrsn=11720c0a_2

[ii] Ibid

[iii] https://www.who.int/publications-detail/clinical-management-of-covid-19

[iv] www.worldthrombosisday.org/issue/vte/

[v] “Clinical Guidance on the Diagnosis, Prevention and Treatment of Venous Thromboembolism in Hospitalized Patients with COVID-19,” Journal of Thrombosis and Haemostasis (JTH).

[vi] Ibid

 

Depression, a big Challenge to Recovery/Rehabilitation after a Stroke

 

Depression, a big Challenge to Recovery/Rehabilitation after a Stroke

“About one in eight survivors of stroke have suicidal ideation, according to a study published online in the Journal of Neurology,”. Depression affects the survivor’s quality of life after a stroke. It also make it more challenging for those affected with stroke to recover. Findings from current studies shows that, depression can also increase the risk of cardiovascular disease (CVDs), which in turn increases the risk of experiencing a second stroke. Mortality rates are 10 times higher in people who experience depression after a stroke (Ginta et al).

Depression is a common experience for persons living with stroke and their carers . It’s commonly caused by biochemical changes in the brain. When the brain is injured, the survivor may not be able to feel positive emotions as a result of the effect from the injury. Depression can also be a normal psychological reaction which may be experienced by persons living with stroke and their carers.

Possible causes of depression may include a combination of biological, psychological and social sources of distress. Research suggest that these factors may cause changes in brain function, including altered activity of certain neural circuits in the brain (AHA).

Common symptoms of depression Includes:

  • Thoughts of death or suicide, or suicide attempts.
  • Feelings of hopelessness, pessimism, guilt, worthlessness or helplessness.
  • Persistent sad, anxious or “empty” mood.
  • Restlessness and irritability.
  • Loss of interest or pleasure in hobbies and activities.
  • Decreased energy and fatigue, and feeling “slowed down”.
  • Difficulty concentrating, remembering and making decisions.
  • Insomnia, early morning awakening , oversleeping.
  • Appetite, overeating or weight changes.

Caregivers/carers must be aware of the emotional state of those living with stroke in order to provide the needed support at all times.

Category of persons with stroke who are at risk for depression

  • Those who have had previous mental illness.
  •  Females.
  • Those with  previous  traumatic brain injury.
  • Those with history of  Parkinson’s disease or other neuromuscular disorders.
  • Those who live alone.

It’s very important to seek help from professionals such as; Clinical psychologist, psychologist , psychiatrist, clinicians.  Treating depression improves mood,  boost physical, cognitive and intellectual recovery. Social support for persons living with stroke is very crucial in the treatment of depression.

Several studies shows that, depression goes hand in hand with lower levels of support (AHA).  Look to your family, friends, stroke support group such as SASNET GHANA’s stroke support community, etc  for help. Health professionals, carers, family members, friends, etc, involved in recovery processes must be aware of the survivor’s depressed condition and  respond to it appropriately. It is very important we  note that ,when we provide the right treatment and support to persons living with stroke, it helps to ease the pain and move the survivor down the road to recovery.

Register for free to receive psychological support online  :  care.sasnetghana.org/ask-charway/

ACCESS FREE SUPPORT : Person living with stroke and their carers can  have answers to their mind boggling questions and access information on stroke care and support  by signing up to the Post Discharge Stroke Support(PDSS) Program by the Stroke Association Supportnetwork-Ghana (SASNET-GHANA).

Visit our  website below for more information

http://:care.sasnetghana.org    or email us : info@sasnetghana.org

Helpline + 233594989496 or  WhatsApp us +233262463986

Sign up to  Ask Dr Charway –Felli Platform for more  support from the Professionals

Register for free support online here :  care.sasnetghana.org/ask-charway/

More Women are Dying from Stroke

More Women are Dying from Stroke 

 

Stroke is a leading cause of death and number  one cause of serious long-term disability (cdc) globally. Stroke reduces mobility in more than half of stroke survivors and imposes greater burden on families, society, etc. Stroke is the third leading cause of death in women. Stroke also kills more women than men each year especially in Africa. A stroke can permanently disable a person. But many strokes are preventable and treatable. Every woman can take steps to prevent stroke by knowing her risk factors and making healthy changes.

According to studies, 60 percent of women who have stroke will die from it, compared to 40 percent of men who may live with some forms of disability for awhile as a result their  strokes. Women and men are different, and so are their signs and symptoms for stroke,. 27% of women could name more than two of the six primary stroke symptoms.

7 out of 10 women according to studies, said they are not aware they are more likely to have a stroke than men, and were not at all or only somewhat knowledgeable about risk factors (memorialcare).

Stroke in Women

A stroke can happen in different parts of the brain in women. The brain is divided into four main parts:

  • The right hemisphere.
  • The left hemisphere.
  • The cerebellum, which controls balance and coordination.
  • The brain stem, which controls all of our body’s functions that we don’t think about, such as heart rate, blood pressure, sweating, or digestion.

A stroke in the right half of the brain can cause:

  • Problems moving the left side of your body.
  • Problems judging distances. You may misjudge distances and fall. Or you might not be able to guide your hands to pick something up.
  • Impaired judgment and behavior. You may misjudge your ability to do things. You may also do things you would not normally do, such as leave your house without getting fully dressed.
  • Short-term memory loss. You may be able to remember events from 30 years ago, but not how to get to the place where you work today.

A stroke in the left half of the brain can cause:

  • Problems moving the right side of your body.
  • Speech and language problems. You may have trouble speaking or understanding others.
  • Slow and cautious behavior. You may need a lot of help to complete everyday tasks.
  • Memory problems. You may not remember what you did 10 minutes ago. Or you may have a hard time learning new things.

A stroke in the cerebellum can cause:

  • Stiffness and tightness in the upper body that can cause spasms or jerky movements.
  • Eye problems, such as blurry or double vision.
  • Balance problems.
  • Dizziness, nausea (feeling sick to your stomach), and vomiting.

Strokes in the brain stem are very harmful. Since impulses that start in the brain must travel through the brain stem on their way to the arms and legs, patients with a brain stem stroke may also develop paralysis (Womenshealthgov)

Stroke is no friend to women. It kills more women than men.The higher stroke risk in women might be due to:

  • Pregnancy –The risk of stroke in pregnant women is 21 per 100,000, with the highest stroke risk during the third trimester and post-partum. Those with high blood pressure should be treated with medications and monitored closely.
  • Preeclampsia – This is high blood pressure that develops during pregnancy. Preeclampsia doubles the risk of stroke later in life. If you have any history of hypertension, talk to your healthcare provider about taking low-dose aspirin starting in the second trimester.
  • Birth control pills – Birth control pills have become much safer over time, but women who are already at risk of stroke should take extra precautions. Get screened for high blood pressure before the pill is prescribed. And never smoke while taking oral contraceptives.
  • Hormone replacement therapy – This type of therapy should never be used to prevent stroke in post-menopausal women.

  • Migraines with aura –Migraine with aura is associated with ischemic stroke in younger women, particularly if they smoke or use oral contraceptives. Smokers with migraines accompanied by aura should quit immediately.
  • Atria fibrillation and Heart diseases – This increases stroke risk among women.

Women are at a higher risk for a stroke, it is therefore important for women to take care of themselves. Especially, getting lots of rest to ease tension or stress, eating the right foods and being physically active, Avoiding tobacco smoking, secondary smoking or Shisha (electronic smoking), avoid intake of alcohol.

Stroke sudden symptoms of stroke

Sudden numbness or weakness of face, arm or leg, especially on one side of the body.

Sudden confusion, trouble speaking, or understanding.

Sudden trouble seeing in one or both eyes.

Sudden trouble walking, dizziness, loss of balance or coordination sudden severe headache with no known cause.

Stroke symptoms in Women

Ideally women may report symptoms that are different from the common symptoms of stroke, they may include;

  • Loss of consciousness or fainting.
  • General weakness.
  • Difficulty or shortness of breath.
  • Confusion, unresponsiveness or disorientation.
  • Sudden behavioral change.
  • Agitation.
  • Hallucination.
  • Nausea or vomiting.
  • Pain.
  • Seizures.
  • Hiccups.

Women group(s)/ individuals are invited to sign up to the “Ask Dr Charway –Felli ” to receive more information on stroke prevention.

Register for free support online here :  care.sasnetghana.org/ask-charway/

FREE SUPPORT : Person living with stroke and their carers can  have answers to their mind boggling questions and access information on stroke care and support  by signing up to the Post Discharge Stroke Support(PDSS) Program by the Stroke Association Supportnetwork-Ghana (SASNET-GHANA).

Visit our  website below for more information

http://:care.sasnetghana.org    or email us : info@sasnetghana.org

Helpline + 233594989496 or  WhatsApp us +233262463986

Sign up to  Ask Dr Charway –Felli Platform for more  support from the Professionals

Register for free support online here :  care.sasnetghana.org/ask-charway/

7 THINGS TO DO IN ORDER TO PREVENT A STROKE IN THIS ERA OF COVID19

7 THINGS TO DO IN ORDER TO  PREVENT A STROKE IN THIS ERA OF COVID19

Stroke prevention can start today. Protect yourself and avoid stroke, regardless of your age or family history. It’s very important to  safe guide yourself from being infected with the novel Corona virus ,COVID19, it’s  equally important to prevent a  stroke in this challenging times of COVID19.

What can you do to prevent a stroke?

You can’t reverse the years or change your family history, but there are many other stroke risk factors that you can control(modifiable) —provided that you’re aware of them. **Knowledge is power**. If you know that a particular risk factor is sabotaging your health and predisposing you to a higher risk of stroke, you can take steps to alleviate the effects of that risk.

Globally, stroke is a leading cause of mortality and disability and there are substantial economic costs for post-stroke care(Global Burden of Disease ,GBD)

Stroke, the sudden death of some brain cells due to lack of oxygen when the blood flow to the brain is lost by blockage or rupture of an artery to the brain, is also a leading cause of dementia and depression.Globally, 70% of strokes and 87% of both stroke-related deaths and disability-adjusted life years occur in low- and middle-income countries.(Walter Johnson, et al.)

How to prevent stroke

Here are seven ways to start reining in your risks today to avoid stroke, before a stroke has the chance to strike.

1.  Lower blood pressure

 High blood pressure is a huge factor, doubling or even quadrupling your stroke risk if it is not controlled. High blood pressure is the biggest contributor to the risk of stroke in both men and women. Monitoring blood pressure and, if it is elevated, treating it, is probably the biggest difference people can make to their vascular health.

Your ideal goal: Maintain a blood pressure of less than 120/80(with respect to your age) if possible. For some older people, this might not be possible because of medication side effects or dizziness with standing.

How to achieve it:

 Reduce the salt in your diet, ideally to no more than 1,500 milligrams a day (about a half teaspoon).

Increase polyunsaturated and monounsaturated fats in your diet, while avoiding foods high in saturated fats.

Eat 4 to 5 cups of fruits and vegetables every day, one serving of fish two to three times a week, and several daily servings of whole grains and low-fat dairy.

Get more exercise — at least 30 minutes of activity a day, and more, if possible. Quit smoking, if you smoke.

Contact your Doctor on your blood pressure medicines and report any side effects when taking  these drugs.

2.  Lose weight

 

Obesity, as well as the complications linked to it (including high blood pressure and diabetes), raises your odds of having a stroke. If you’re overweight, losing as little as 10 pounds can have a real impact on your stroke risk.

Your goal: While an ideal body mass index(BMI)  is 25 or less, that may not be realistic for you. Work with your doctor to create a personal weight loss strategy.

How to achieve it:

 Try to eat no more than 1,500 to 2,000 calories a day (depending on your activity level and your current BMI).

Increase the amount of exercise you do with activities like walking, golfing, or playing tennis, and by making activity part of every single day.

3.  Exercise more

Exercise contributes to losing weight and lowering blood pressure, but it also stands on its own as an independent stroke reducer.

Your goal: Exercise at a moderate intensity at least five days a week.

How to achieve it:

 Take a walk around your neighborhood every morning after breakfast. Start a fitness club with friends.

When you exercise, reach the level at which you’re breathing hard, but you can still talk. Take the stairs instead of an elevator when you can.

If you don’t have 30 consecutive minutes to exercise, , break it up into 10- to 15-minute sessions a few times each day.

4.  If you drink Stop

Drinking  alcohol as a person living with Stroke or NCDs is not SAFE to your health. Substitute alcohol  with sugar free fruit drink and water . Its not advisable to take alcohol as a person living with Stroke /NCDs .

Your goal: Don’t drink alcohol .

How to achieve it:

Take a lot of water every day and substitute alcohol for sugar free fruit drink  .

Seek support from a doctor , a psychologist or support group.

5.  Treat atrial fibrillation

Atrial fibrillation is a form of irregular heartbeat that causes clots to form in the heart. Those clots can then travel to the brain, producing a stroke. Atrial fibrillation carries almost a fivefold risk of stroke.

Your goal: If you have atrial fibrillation, get it treated.

How to achieve it:

 If you have symptoms such as heart palpitations or shortness of breath, see your doctor for an exam.

You may need to take an anticoagulant drug (blood thinner) such as warfarin (Coumadin) or one of the newer direct-acting anticoagulant drugs to reduce your stroke risk from atrial fibrillation. Your doctors can guide you through this treatment.

6.  Treat diabetes

Having high blood sugar damages blood vessels over time, making clots more likely to form inside them.

Your goal: Keep your blood sugar under control.

How to achieve it:

 Monitor your blood sugar as directed by your doctor.

Use diet, exercise, and medicines to keep your blood sugar within the recommended range.

7.  Quit smoking

Smoking accelerates clot formation in a couple of different ways. It thickens your blood, and it increases the amount of plaque buildup in the arteries. Along with a healthy diet and regular exercise, smoking cessation is one of the most powerful lifestyle changes that will help you reduce your stroke risk significantly.

Your goal: Quit smoking.

How to achieve it:

 Ask your doctor for advice on the most appropriate way for you to quit.

Use quit-smoking aids, such as nicotine pills or patches, counseling, or medicine.

Don’t give up. Most smokers need several tries to quit. See each attempt as bringing you one step closer to successfully beating the habit.

Identify a stroke using the  F-A-S-T  test

Too many people ignore the signs of stroke because they question whether their symptoms are real. “My recommendation is, don’t wait if you have any unusual symptoms,” Dr. Rost advises. Listen to your body and trust your instincts. If something is off, get professional help right away.”

Signs of a stroke include:

  • weakness on one side of the body.
  • numbness of the face.
  • unusual and severe headache.
  • vision loss.
  • numbness and tingling.
  • unsteady walk.

Harvard Health Publishing  (June 2013). 7 things you can to to prevent stroke.

GET FREE SUPPORT : Person living with stroke and their carers can  have answers to their mind boggling questions and access information on stroke care and support  by signing up to the Post Discharge Stroke Support(PDSS) Program by the Stroke Association Supportnetwork-Ghana (SASNET-GHANA).

Visit our  website below for more information

http://:care.sasnetghana.org    or email us : info@sasnetghana.org

Helpline + 233594989496 or  WhatsApp us +233262463986

Sign up to  Ask Dr Charway –Felli Platform for more  support from the Professionals

Register for free support online here :  care.sasnetghana.org/ask-charway/

 

EATING, SWALLOWING AND TOOTH /MOUTH CARE FOR A PERSON LIVING WITH STROKE – HOME CARE /SUPPORT

EATING, SWALLOWING AND TOOTH /MOUTH CARE FOR A PERSON LIVING WITH STROKE – HOME CARE /SUPPORT

HOW CAN I HELP THE PERSON EAT?

The person must do the following:

  • Sit up for all meal.
  • Sit up straight.
  • Keep the head slightly forward.
  • Look at the food.
  • Rest arms on a table.
  • Keep the feet flat on the footrest of the wheelchair or on the floor.
  • Take small bites and sips.
  • Move the chewed food to the middle of the tongue before swallowing.
  • Drink from a full glass or use a straw to prevent the head from tipping back.
  • Sit up for at least 20-30 minutes after eating for food to be digested.

VERY IMPORTANT:

If the person often coughs or chokes when eating, ask to see a speech therapist. He/she can check whether the person can swallow food and drink safely, and give the necessary advice to improve swallowing.

The carer must do the following:
  • Sit up for all meal.
  • When standing, put your foot on a low support, such as a wooden block or low bench.
  • Always keep your back straight; don’t bend it.
  • Use your arm closet to the person to support his/her head.
  • Place food between the teeth, on the stronger side of the person’s mouth.
  • Give thick fluids and food with a smooth Yogurt, custard and thick soups are easiest to swallow.

  VERY IMPORTANT:

  • Don’t let the person’s head tip to the side or back.
  • Don’t let the weak arm dangle or fall off the table, armrest or tray.
  • Don’t let the foot slip off the footrest of the wheelchair.

 

HOW CAN I HELP THE PERSON DRINK?  

 

  • Put your finger on the person’s cheek, chin and lower jaw to help him/her close the lip or mouth. Take care not to tilt the head back.
  • When using a straw, always out it on the strong sides of the mouth against the check.
  • If the person cannot drink from a cup or use a straw, use a syringe (injection, consult a nurse or speech therapist first) without the needle to put fluid into the mouth.
  • Pace it on the strong side of the mouth, against the cheek. Squirt fluid in the direction of the cheek.

 

HOW CAN I HELP THE PERSON BRUSH HIS/HER TEETH?

 

  • Let the person sit in front of a mirror.
  • The person must sit up straight.
  • Keep the head upright.
  • Let the weak arm rest on a table or on the edge of a
  • Stand behind the person and look in the mirror.

IMPORTANT : Person living with stroke and their carers could also receive answers to the above stated problems by signing up to the Post Discharge Stroke Support(PDSS) Program by the Stroke Association Supportnetwork-Ghana (SASNET-GHANA).

E.S, S., & J.S, V. (2015). Stroke Care at Home. Western Cape South Africa: Center for Rehabilitation Studies Stellenbosch University.

http://:care.sasnetghana.org   online or email: info@sasnetghana.org

Helpline + 233594989496 or on WhatsApp +233262463986

Sign up to  Ask Dr Charway –Felli Platform for more  support .

Register for free support online here :  care.sasnetghana.org/ask-charway/

 

Stroke Association Supportnetwork-Ghana (SASNET-GHANA) Rebuilding Lives After Stroke.