NEW DELHI: A new study reveals that just 25% of India’s population has access to hospitals equipped to handle strokes, despite the country experiencing nearly 1.5 million stroke cases each year. A large proportion of these strokes (85-90%) are caused by clots blocking the major blood vessels in the brain.
Treatment for such strokes often involves injecting clot-dissolving drugs (Intravenous Thrombolysis, or IVT) and/or performing a minimally invasive procedure to remove the clot (Endovascular Treatment, or EVT).
The study, published in the International Journal of Stroke (IJS), assessed the availability of IVT and EVT-capable centers across India. Researchers analyzed data on these centers and used a Google-developed distance matrix to calculate the driving time between population centers and the nearest stroke treatment facilities.
The findings revealed that India has 566 hospitals capable of administering IVT, of which 361 (63%) also offer EVT. However, access to these centers is unevenly distributed across the country. The southern states, such as Andhra Pradesh, Karnataka, Kerala, and Puducherry, have the highest concentration of IVT (37%) and EVT (35%) centers, while western states like Goa, Gujarat, Maharashtra, and Dadra and Nagar Haveli have slightly lower figures (IVT – 29%, EVT – 31%).
In stark contrast, northern India has only 20% of centers capable of IVT and 18% capable of EVT. The central, eastern, and northeastern regions are even more underserved, with just 13.5% of IVT-capable centers and 16% of EVT-capable facilities located there.
Dr. Kaiz S. Asif from Ascension Health, Chicago, and Dr. Arun Mitra from AIIMS Hyderabad, who led the study, found that the median distance to the nearest IVT-capable center was 115 km, and to the nearest EVT-capable center was 131 km. Southern states reported the shortest median distances, while northeastern states had the longest.
Dr. Padma Srivastava, Chair of Neurology at Paras Health in Gurugram, who was also part of the study, compared India’s situation with developed countries like the US, Canada, and Germany, where 90% of the population can access stroke-ready centers within a short time. “Our study shows that only 26% of the population lives within an hour’s drive of an IVT-capable center, and just 21% have access to an EVT-capable facility within the same time frame. States like Chandigarh, Kerala, and Delhi have the best coverage, with over half the population within an hour’s drive. In contrast, states like Jharkhand, Odisha, Bihar, Jammu & Kashmir, Ladakh, and those in the northeastern region have the least coverage,” she said, calling for urgent efforts to bridge this accessibility gap.
Dr. Kameshwar Prasad, a leading neurologist and former director of the Rajendra Institute of Medical Sciences (RIMS) in Ranchi, stressed the impact of delays in stroke care. “Delays in treatment can significantly affect patient outcomes, and the establishment of more stroke-ready centers is critical,” he said. He also highlighted the importance of public awareness and educating primary care professionals on how to recognize stroke symptoms. “At RIMS, it took us a year to start administering clot-dissolving medicine to eligible stroke patients. Even though we were located in the city, around 200 patients would have suffered ischemic strokes during that time. This underscores the need for greater public education on stroke symptoms, so that even when hospitals are nearby, patients receive the right treatment at the right time,” Dr. Prasad added.
