Headache care around the world: a review of access, equity, and system-level solutions

Headache disorders are the leading cause of neurological disability globally, yet their management remains marked by profound inequities in access to diagnosis, evidence-based treatment, specialist care, and policy prioritization. This review examines current regional disparities in headache care delivery and highlights emerging system-level approaches aimed at reducing the global treatment gap.

High-income regions in Western and Northern Europe, East Asia, and North America have developed advanced care models but continue to face inequities related to socioeconomic gradients, insurance coverage, and fragmented care pathways. In contrast, Eastern Europe, South and Central Asia, Latin America, and much of Africa experience substantial limitations in workforce capacity, diagnostic infrastructure, and medication availability, with population-based surveys indicating high prevalence but minimal health-system readiness. Transitional health systems, including Türkiye and the MENA region, demonstrate increasing awareness and partial integration of structured headache pathways, though coverage remains insufficient. Across regions, telemedicine, digital health tools, community-based initiatives, and workplace programs have shown promise in expanding access, reducing stigma, and improving continuity of care, while reinforcing the central role of primary care.

Collectively, these developments signal a shift toward more coordinated and equity-oriented headache service models. Sustainable progress will require strengthened global collaboration, integration of AI-supported decision tools, expansion of cross-border registries and real-world data platforms, and the systematic inclusion of headache disorders within national noncommunicable disease frameworks to ensure high-quality care across diverse populations.