Access, stigma and community engagement: implementation strategies for rural and underserved populations

Parkinson's disease remains one of the fastest growing neurodegenerative disorder. Optimal care for the patients may include proper medication dispensation and adjustment, physiotherapy, speech and swallowing therapy, and in some cases advanced device-aided therapy. These may incur a high cost and rendered unaffordable, especially in lower socioeconomic countries where government subsidies maybe limited. Moreover, gaining access to care may be difficult and expensive, especially among those in rural areas. Additionally, cultural contexts may delay care-seeking, especially in Asia where the concept of "face" plays a prominent role in society. Here, we briefly review the current status of access to care in Asia, stigma in the context of Asian patients, and how community engagement can help reduce the barriers to care of people with Parkinson's. We provide various ways to engage the community, their barriers and how they could be overcome, and two real-life examples of community engagement done in India and Thailand to reduce the gap in care, stigma and increase public awareness of Parkinson's.