Implementation of community-level stroke prevention strategies – A case of Lusaka district
Abstract
Background: Stroke, a major public health issue in developing countries, is the fifth leading cause of death and disability in Zambia. Despite the implemented Non-Communicable Disease Strategic Plan’s aim to reduce stroke-related risks, disability, and mortality, a knowledge gap persists regarding effective community-level prevention strategies. Aim: This study aimed to identify existing community-level stroke prevention strategies, determine key implementers, and explore factors influencing strategy implementation. Setting: The study was conducted in Lusaka district, Zambia’s urban capital, focusing on government-run health facilities across six sub-districts. Methods: A descriptive case study employing a convergent design was conducted. Quantitative data were collected using a structured checklist, while qualitative data were obtained through face-to-face interviews with two NGO leaders and four health promotion staff selected via purposive sampling. Thematic content analysis was applied to qualitative data, and quantitative findings were summarised using descriptive statistics. Results: Three key implementers were identified; Lusaka District Health Office, Zambia Heart and Stroke Foundation, and Public Health and Environmental Promotion Organization of Zambia. Seven prevention strategies emerged, including awareness campaigns, screenings, lifestyle interventions, and stakeholder partnerships. Facilitators included community engagement and partner support, while barriers involved limited health education, financial constraints, and logistical challenges. Conclusion: Community-level stroke prevention in Zambia shows potential but requires stronger partnerships, increased community involvement, and solutions to funding and literacy barriers. Contribution: Findings support policy development and resource allocation, emphasizing the need for literacy-sensitive interventions and sustainable funding to strengthen stroke prevention efforts.