Applicability of stroke-unit care to low-income and middle-income countries

Stroke units have become established as the central component of modern stroke services. However, most stroke-unit trials and service developments have been done in high-income countries, which raises the question of whether such care is relevant and applicable to low-income and middle-income settings. To address this question, we first need to show that stroke units are likely to provide important health gains to populations. Second, we need to identify those components of stroke units that could be important for a low-technology unit, and to learn from examples of stroke units in low-income and middle-income countries. Finally, we need to understand how barriers to the establishment of stroke units could be overcome. Although substantial challenges are present to the development of stroke units more widely across the world, the potential gains from such developments are substantial.