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WGSP partners from Ghana, The Gambia, and UK are proud to have been interviewed by the One Neurology podcast ahead of the UN High Level Meeting on non-communicable diseases. Featuring our very own Dr Valentine Akwulpwa, Yayha Njie, and Dr Lucy Sykes - listen to the full episode here:
https://oneneurology.net/episode18/ or wherever you normally get your podcasts
DOREEN: The introduction of a stroke unit at the University Teaching Hospital in Lusaka has significantly improved patient outcomes by providing focused multidisciplinary care for stroke patients, leading to reduced mortality, shorter hospital stays, and improved functional recovery. The unit offers a coordinated approach with specialized medical, nursing, and rehabilitation staff contributing to better diagnosis and treatment. The unit is associated with:
Lower risk of death and a reduced likelihood of poor outcome within a year of the stroke
Specialized neurological care which decreases mortality and hospital complications, leading to lower disability
Improved functional outcomes due to early rehabilitation, thereby helping patients to regain lost function and independence
An amazing multidisciplinary team consisting of medical, nursing, physiotherapy, psychosocial counsellors, and occupational therapy
It is these team members who have participated in the ‘Think Aloud’ sessions for developing the online stroke training modules, identifying issues such as unclear navigation through the material or cultural appropriateness of the content. Participants were invited to complete each module, thinking aloud as they complete the task: “say everything that is going on in your mind”. The team were not shy in offering insights and suggestions! With such feedback we have been able to come up with modules that are not only comprehensive, but simple to use, educative, and fun to look at with very good illustrations.
FRANK: The ‘Think Aloud’ sessions were very impactful with the team members at Chipata Level One Hospital in Lusaka. It was a 1:1 session in formulating the modules and each participant had their own individual experience with each module. The team appreciated the multidisciplinary approach to stroke as shown by the different modules e.g. mood, communication, continence, functional independence, secondary prevention, and discharge planning.
Financial support has been very helpful over the period of the time in which we were reviewing the modules. This included support for data bundles, logistics, food and drinks during the sessions. We are so much grateful for the grants we received. It helped to motivate us and our participants as well.
QUOTES FROM THE TEAMS:
“The mood module has helped me to learn that people with stroke present with different mood swings. I can now safely handle patients with moods knowing that it is part of the presentation for some stroke patients.”
“It’s impactful work. The modules deepened my understanding and empathy for both patients and caregivers, offering a holistic view of stroke’s impact.”
“The modules challenged me to think beyond the clinical treatment, focusing on the human experience.”
“The process taught me kindness, consideration, and deepened my understanding of stroke management in key areas such as mood, speech, and communication.”
The final 2 weeks of the CSC visit to the UK included time spent at Southmead Hospital, University of the West of England, and a visit to the House of Lords hosted by Lord Nigel Crisp:
This report synthesizes key insights into Bristol’s stroke care ecosystem, emphasizing leadership models, clinical innovations research frameworks, and partnership opportunities for transferable strategies to enhance stroke outcomes in Northern Ghana and The Gambia.
Leadership and Service Integration:
Bristol’s stroke units exemplify adaptive leadership and operational efficiency. They support dynamic staff empowerment with nurses trained in NIHSS scoring and therapists empowered to screen for thrombolysis. Daily ‘safety huddles’ enable real-time incident reporting and resource allocation. A ‘dynamic zoning’ model alongside enhanced staff flexibility for their 43 stroke beds eliminates mid-pathway transfers between acute and rehab settings.
Clinical Skills and Knowledge Transfer:
Bristol’s ‘low-tech, high-skill’ philosophy aligns with West African resource reality. Standardized dysphagia screening (bedside water tests/video-fluoroscopy), reduced pneumonia rates by 18%. Early mobilization (<24 hrs post-stroke) using cost-effective tools like bamboo parallel bars promotes positive outcomes. Specialized clinics cohorting groups of patients such as young stroke or TIA enables streamlining of diagnostics and increased awareness of less common aetiologies such as sickle cell disease.
Research and Data-Driven Care:
Bournemouth and Bristol’s research infrastructure both offer templates for evidence-based care in Ghana and The Gambia. The UK Sentinel Stroke National Audt Programme (SSNAP) tracks outcomes (e.g. door-to-needle time), enabling quality improvement. Both Ghana and The Gambia could benefit from a nationalized data approach to stroke care.
Bristol participates in research showing telehealth efficacy which could be transformational in low resource settings such as Ghana, where 54% of healthcare professionals report knowledge gaps in post-stroke rehab . Dr. Akwulpwa advocates integrating WGSP’s 8 core skills online modules (e.g. swallowing, positioning, continence management) into staff and family training programmes.
Partnership and Collaborative Frameworks:
Opportunities for skills sharing across WGSP partners includes NIHSS stroke assessment training, protocol design/development based on current in-country templates, and telemedical support for decision-making.
Challenges:
Resource limitations: Tamale Teaching Hospital, Ghana’s non-functional MRI scanners delay diagnostics. Variable availability of CT imaging in The Gambia due to cost to patient and scanner reliability restricts treatment options for patients.
Workforce gaps: Neurologist density remains critically low with only 1:4 million population in Northern Ghana. There are no native neurologists in the Gambia (population 2.5 million).
Recommendations:
1. Leadership development: workshops on "crisis leadership" and advocacy to navigate administrative challenges.
2. Frugal innovation: co-develop low cost tools, such as the realistic dysphagia screens in use by WGSP partners, shared via WGSP networks.
3. Tele-mentorship: virtual case discussions between WGSP partners.
4. Joint funding proposals: target grants (e.g. CSC, Global Health Partnerships) for staff training.
“The partnership exemplifies sustainable change through equity.” Dr Valentine Akwulpwa.
WGSP team barbeque
The CSC fellowship programme for Dr Valentine Akwulpwa (Ghana) and Charge Nurse Yahya Njie (The Gambia) has continued with a busy two-week placement at University Hospitals Dorset (UHD, Bournemouth and Poole). Here they summarise the wide range of topics covered since their arrival in the UK, with reflections on potential benefits for stroke care in low- and middle-income countries (LMICs):
Clinical Skills, Knowledge, and Experience:
Hyperacute stroke care including assessment for time critical interventions: thrombolysis and thrombectomy. Emphasis on rapid imaging to treatment pathways
Neurocritical monitoring (e.g. managing raised intracranial pressure, dysautonomia) and post-procedural protocols to reduce haemorrhagic transformation risk
Advanced rehabilitation techniques including hands on experience of ‘Walkerbot’ gait-retraining for patients with severe motor deficits, integrating AI-driven adaptive support into standard stroke care practices
MDT-led early mobilization protocols <24 hours post-stroke, reducing pneumonia risk and length of stay
Complex case management, high-risk TIAs, stroke mimics e.g. seizures, functional disorders, and young stroke clinics addressing rare etiologies
Dysphagia screening with standardized bedside water tests and videofluoroscopy, minimizing aspiration pneumonia
Leadership:
Service consolidation, and culture following a strategic merger of acute / rehab units, enhancing staff flexibility and reducing mid-pathway transfers
Daily safety huddles, incident reporting, resource allocation, and real-time problem-solving
Staff empowerment and fostering psychological safety within the team; cross-discipline training initiatives e.g. nurses trained in NIHSS scoring; therapists empowered for thrombolysis screening
Succession planning: deputy leads shadowing consultants ensuring service continuity for the future
Resource optimization: 43-bed unit with dynamic zoning (hyperacute / rehab), maximizing capacity without new infrastructure
Partnership:
Regional networks including Hub-And-Spoke Model of regional care provision. Witnessed coordinated transfers from Winchester to Southampton for thrombectomy with shared telemedicine consultation
Community integration: witnessed collaboration between the UHD stroke service and Integrated Community Stroke Service (ICSS) for seamless home-based rehab, reducing readmissions by 18%
Global health synergies:
Contextual adaptation: UHD’s ‘low-tech, high-skill’ approach e.g. manual handling techniques which are directly applicable to LMIC resource constraints
Knowledge exchange: we shared WGSP's 8 core skills modules (e.g. swallowing, positioning) for potential integration into UHD training programmes for staff and families alike
Frugal innovation: UHD use of low-cost gait aids (e.g. bamboo parallel bars) aligns with WGSP's philosophy of sustainability
Data-driven care: the national UK electronic stroke registry (SSNAP: Sentinel Stroke National Audit Programme) tracking outcomes such as door-to-needle time, demonstrating potential for improvements in LMIC services and care provision through audit
Appreciation to all the WGSP UK team:
Hospitality: Thank you for the warm reception, accommodation support, and inclusive participation in MDT meetings, ward rounds, and community visits
Mentorship: Special gratitude to all the consultants, rehab therapists, and nurse leaders for their patience in skill demonstrations and case discussions
Collaborative spirit: The willingness to share protocols, governance frameworks, and failures openly has equipped me (Dr Val) to advance stroke care at Tamale Teaching Hospital
This attachment exemplifies the WGSP's mission of sustainable change through equitable partnership
WGSP is proud to be hosting two CSC fellows for a 6-week programme across three stroke centres in our region. Dr Valentine Akwulpwa shares his reactions following his stay in Winchester:
The remarkable team at Wessex Global Stroke Partnership with its unwavering dedication to transforming stroke care in Ghana, particularly at Tamale Teaching Hospital (TTH), is nothing short of inspiring. The partnership has become a beacon of hope, demonstrating how collaboration, innovation, and cultural sensitivity can revolutionize healthcare in resource-limited settings.
Our combined efforts led to the creation of two additional stroke units in Ho and Tamale, in addition to the one earlier established at Korle Bu Teaching Hospital in Accra. Through hands-on training, workshops, and online modules, WGSP has equipped Ghanaian clinicians with critical core stroke skills. This has resulted in a significant reduction in stroke morbidity and mortality with heightened confidence in managing stroke patients.
The leadership cultivated through the collaboration has given us the capacity to lead stroke care initiatives independently. The financial contributions of GHP (formerly THET) and the CSC-UK sourced by WGSP have enabled us to be able to come for training in the UK, attesting to the commitment for long term skill development by the UK team.
My heartfelt thanks goes to all WGSP team and partners. My travel to the UK and my first two weeks at Winchester has been a remarkable experience. The reception has been overwhelming and the care both academically and socially has been second to none.
I'm optimistic that all the knowledge, insight, skills and leadership training I'm gaining will go a long way to further improve stroke care in Ghana and TTH. Thank you!
Dr Valentine Akwulpwa, WSGP CSC Fellow; Lead for Stroke and Emergency Medicine, TTH
Two members of the UK team recently had the opportunity to present at the UK Africa Health Summit in London (19th March). The presentation was part of a breakout session in preparation for a high-level meeting to be held by Global Health Partnerships on non-communicable diseases. It was an exciting opportunity to share the progress we have made with our recent grants and give some of our recommendations when working with a non-communicable disease workforce. The presentation was well received by those that attended and the day gave us an opportunity to learn from other partnerships alike.
This week Ho Teaching Hospital in Ghana celebrated the official opening of their new stroke unit. This is an exciting development which will benefit stroke patients in the local area. It is an opportunity to provide personalised and tailored care to people who have had a stroke.
More information about the opening can be found here: https://gna.org.gh/2025/03/ho-teaching-hospital-inaugurates-stroke-and-private-wards/
Members of our Ghanaian team from Ho, Tamale, and Korle Bu Teaching Hospitals recently attended a stakeholder event in Accra (26th February). Our THET / GHP grant period has now come to an end and this was an excellent way to end the project and share learning.
There was some really positive feedback:
“We had…breakout sessions to share our experiences and achievements”
“It was interactive and lots of lessons learnt”
“We had positive outcomes because we had good stakeholder engagement yielding great support from the stakeholders at both sites. Our networking was also good. We had neurologists at both sites fostering the sustainability and success of our project”
“It was a nice session. Listened to others give their testimonies as we also did. Had information on various organisations and how they have helped in one way or another”
On 26th February WGSP Zambian partners were delighted to greet representatives from GHP (formerly THET) at UTH, to showcase their stroke unit and developments related to our ongoing GHP grant. They were able to demonstrate the development of our online training modules including hosting discussions about how these will enable sustainability and ensure high quality training is maintained. The GHP team were pleased with progress and complimentary about WGSP work.
L-R Doreen Kawalenga (Physiotherapist), Anne Buglass (GHP Head of Programmes), Muleba Matafwali (GHP Country Director Zambia), Megan Jones (GHP Programmes Coordinator / WGSP Grant Manager), Prof Deanna Saylor (Zambian lead doctor), Malango Goma (Stroke Sister-in-Charge)
The UK team were delighted to recently present at the UK Stroke Forum in Liverpool. Our poster was well received and it was a great opportunity to share the hard work that has been taking place in both the UK and Ghana over the past year.
