LA UNION, Philippines – A Stroke remains one of the leading causes of death in the Ilocos Region, underscoring the urgent need for continued action by government, healthcare institutions, and communities to strengthen prevention, treatment, referral, and rehabilitation services to help patients access timely and appropriate care.
Health officials and healthcare leaders noted that advances in stroke treatment have improved
outcomes for many patients; however, challenges related to timely and equitable access to stroke-ready facilities, public awareness, specialist availability, travel times from remote communities, and fragmented referral systems continue to affect patient outcomes.
According to regional health data, stroke has consistently ranked among the leading causes of mortality in Region 1 in recent years. In La Union, it has remained a leading cause of death over the past three years, highlighting the significant burden of stroke on patients, families, communities, and the healthcare system.
“Stroke is not only a major health problem. It also places a significant financial burden on patients, families, and communities,” said Dr. Ivy Ico of the Provincial Department of Health Office – La Union. “While progress has been made in strengthening healthcare delivery, opportunities remain to further enhance referral pathways, specialist availability, public awareness, and integrated stroke management.”
UHC Watch and Boehringer Ingelheim organized a recent multi-stakeholder roundtable discussion focused on these challenges and opportunities. The discussion brought together representatives from regional and local government health agencies, healthcare institutions, professional societies such as the Stroke Society of the Philippines, local government units, and other stakeholders to explore practical approaches to strengthening stroke care across the region.
Participants emphasized the importance of translating the Department of Health’s National Policy Framework on the Prevention, Control and Management of Acute Stroke into coordinated local action through stronger collaboration and partnerships and more integrated systems of care.
“Reducing the burden of stroke requires addressing the entire continuum of care, beginning with prevention and community recognition of stroke symptoms, followed by organized emergency medical services, pre-hospital transport, timely acute hospital treatment, rehabilitation, and long-term support and secondary prevention,” said Dr. Cristina Macrohon-Valdez, immediate past president of the Stroke Society of the Philippines.
When every minute matters
For many stroke patients in Region 1, access to timely treatment remains a challenge.
Patients from remote municipalities may spend two to four hours traveling to the nearest facilities capable of providing specialized stroke care, often missing the critical treatment window of 4.5 hours, during which life-saving interventions can be administered.
Currently, only a limited number of Acute Stroke-Ready Hospitals are available to serve patients in La Union, many of whom are referred from smaller healthcare facilities that do not have specialized stroke services.
“Many patients arrive beyond the critical treatment window because of delayed recognition of symptoms, long travel times, and challenges in referral pathways and coordination,” said Dr. Mary Grace Fabia-Mistica, MD, FPNA, Stroke Program Head of the Ilocos Training and Regional Medical Center (ITRMC) Brain and Spine Center and the La Union Medical Center (LUMC).
“Some families still mistake stroke symptoms as a temporary episode of high blood pressure or initially seek treatment at home. Every delay can affect a patient’s chances of survival and recovery.”
Healthcare professionals noted that the challenges extend beyond emergency treatment. Access to neurologists, rehabilitation providers, and long-term follow-up services remains uneven across the region, particularly in geographically isolated communities, reinforcing the importance of a more coordinated approach to stroke care.
Building more connected stroke care
To help address these challenges, stakeholders are advancing the development of StrokeLiNCS LU (Stroke Linking Institutions for Network Care toward a Stronger La Union), an initiative that seeks to strengthen coordination among healthcare facilities and support a more integrated stroke care pathway through a Hub-and-Spoke model.
The model aims to establish clearer referral pathways among healthcare facilities, improve coordination between hospitals, and facilitate the timely transfer of stroke patients to facilities equipped to provide specialized care.
Under the system, designated hub hospitals such as ITRMC and LUMC would provide advanced stroke services, while spoke facilities would focus on early stroke recognition, initial stabilization, and rapid referral.
Through standardized protocols, pre-notification systems, workforce development, telemedicine support, and a shared stroke registry, stakeholders hope to reduce treatment delays and improve continuity of care from emergency response through rehabilitation, and ultimately improve outcomes for stroke patients throughout the province.
“The model does more than move patients,” Dr. Mistica said. “It helps bring expertise closer to where patients are. By reducing delays and creating faster, more coordinated referrals, we can improve outcomes and help save more brain function when every minute counts.”
Turning policy into action
The initiative aligns with the Department of Health’s National Policy Framework on Acute Stroke, which seeks to establish integrated stroke systems of care under the Universal Health Care Act.
According to Dr. Ico, the framework envisions a continuum of care spanning prevention, acute treatment, rehabilitation, and long-term recovery, supported by stronger healthcare provider networks, data systems, training programs, and financing mechanisms.
“The policy framework relies on a highly coordinated health system,” she said. “Improving stroke care requires a whole-of-government, whole-of-society approach involving national agencies, local governments, hospitals, healthcare professionals, patient advocates, and communities.”
Local government leadership
Recognizing stroke as a major health concern in the province, the Provincial Government of La Union and local stakeholders are working to strengthen referral systems and integrate dedicated stroke pathways into the upcoming version of the LU – Health Care Provider Network Referral Manual.
The province has also incorporated plans for a Level II General Hospital and a Neurological Rehabilitation Center within the proposed La Union Medical Hub, which is expected to complement existing stroke services and expand rehabilitation capacity in the province.
Provincial leaders described these efforts as part of a broader commitment to improving health outcomes and addressing the growing burden of non-communicable diseases.
A shared responsibility
Participants at the roundtable agreed that improving stroke outcomes will require sustained action across the entire continuum of care, from prevention and public awareness to emergency response, acute treatment, rehabilitation, and long-term follow-up.
“The Universal Health Care Law recognizes that achieving better health outcomes is a shared responsibility among government, healthcare institutions, healthcare professionals, civil society, patient groups, and the private sector,” said Mr. Alvin Manalansan, co-convenor of UHC Watch. “As a civil society organization, UHC Watch advocates for stronger collaboration and integration across healthcare provider networks to ensure that stroke patients receive appropriate care, when and where it is needed, without experiencing financial hardship.”
As Region 1 continues to strengthen healthcare delivery under Universal Health Care, stakeholders expressed optimism that a more integrated stroke care pathway can help reduce treatment delays, improve patient outcomes, and provide a model for collaboration across the region.
Supporting these efforts are partnerships among government agencies, healthcare institutions, professional societies, patient advocates, and private-sector organizations. As part of its long-standing commitment to improving outcomes for people affected by stroke, Boehringer Ingelheim collaborates with healthcare stakeholders in support of initiatives that strengthen stroke care pathways, improve access to timely care, and foster collaboration among stakeholders working toward better health outcomes for Filipino patients, families, and communities.
For stakeholders across Region 1, the message is clear: while stroke remains one of the region’s most pressing health challenges, stronger partnerships, coordinated systems, and sustained commitment can help ensure that more patients receive the right care at the right time.
Because when it comes to stroke, every minute matters.
