BACKGROUND: The Nepal Stroke Project (NSP) aims to improve stroke care in a resource-limited setting. This qualitative study explores healthcare professionals' experiences and perceptions of barriers and success factors in implementing stroke care in Nepal. METHODS: Semi-structured interviews were conducted with eight healthcare professionals (six physicians, two nurses) involved in the NSP. Interviews were analyzed using qualitative content analysis, following a constructivist approach. RESULTS: Success factors encompassed the dedication of healthcare professionals, involvement of hospital boards, effective training initiatives, and the formation of stroke teams. Positive developments noted were increased thrombolysis availability, improved stroke awareness, and growing interest in stroke care among medical professionals. Key barriers identified included lack of government ownership in stroke care advocacy, financial constraints for patients, inadequate public awareness, and challenges in implementing quality monitoring. CONCLUSION: While the NSP has initiated positive changes in Nepal's stroke care landscape, significant barriers persist. The study highlights the importance of addressing systemic issues such as government involvement and financial accessibility of treatments. Success factors, particularly the motivation of healthcare professionals and local ownership of the project, provide a foundation for future improvements. These findings can inform strategies for enhancing stroke care delivery in other resource-limited settings and guide ongoing initiatives within the NSP.

Angels Initiative Ingelheim Germany

Annapurna Neuro Center Kathmandu Nepal

B P Koirala Institute of Health Sciences Dharan Nepal

Bharatpur Hospital Bharatpur Nepal

Department of Neurology McGovern Medical School University of Texas Health Science Center at Houston Houston TX United States

Department of Neurology University Hospital Heidelberg Heidelberg Germany

Devdaha Medical College Devdaha Nepal

Grande International Hospital Kathmandu Nepal

Health Management Institute z u NGO Brno Czechia

Manipal Teaching Hospital Pokhara Nepal

National Neuro Center Kathmandu Nepal

Norvic International Hospital Kathmandu Nepal

Praxis Meertens Geilenkirchen Germany

Rajshahi Medical College Rajshahi Bangladesh

Rhein Maas Klinikum Teaching Hospital University RWTH Aachen Germany

Tribhuvan University Teaching Hospital Kathmandu Nepal

Tunkl Consulting Heidelberg Germany

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