Barriers to accessing stroke rehabilitation and initiatives to enhance access to stroke rehabilitation in Southeast Asia: a scoping review.

Abstract

To identify barriers to, and initiatives for, access to stroke rehabilitation in Southeast Asia (SEA). We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews and synthesised the evidence with Levesque's patient-centred access framework. We searched Embase, CINAHL, Web of Science, PubMed, and Scopus until 8 August 2025. Of 2,322 records retrieved, 53 reports from seven countries in SEA (2008-2025) were included, with most from Malaysia (<i>n</i> = 18), Singapore (<i>n</i> = 14) and Thailand (<i>n</i> = 9). Common barriers include low awareness among communities and healthcare professionals, preference for traditional and complementary medicine (T&CM), workforce shortages, workforce maldistribution, and long distances. Additionally, limited insurance coverage, high therapy costs, gaps in the continuum of care, survivor comorbidities, lack of motivation and the lack of psychosocial support are prevalent. Reported initiatives included integration of T&CM with biomedical care, inter-country partnerships, community-based rehabilitation, technology-based rehabilitation, use of volunteers and public subsidies. Barriers to accessing stroke rehabilitation in SEA are substantial. Practical, in-country resource actions include inclusive multilingual awareness checklists, clear care protocols, and supervised training of carers and volunteers. Additional implementations should include SMARTER survivor-led plans, basic psychosocial training for professionals, and structured channels for ongoing stakeholder engagement.