Stroke remains one of the leading causes of death in the Ilocos Region, prompting health officials, healthcare institutions, and local stakeholders to strengthen prevention, emergency response, treatment, and rehabilitation services to help patients receive timely and appropriate care.

While advances in stroke treatment have improved outcomes for many patients, access to specialized facilities remains uneven across Region 1. Limited public awareness, shortages of specialists, long travel times from remote communities, and fragmented referral systems continue to affect patients’ chances of survival and recovery.

In La Union, stroke has remained among the leading causes of death over the past three years, highlighting its impact on patients, families, 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. She noted that further improvements in referral pathways, specialist availability, public awareness, and integrated stroke management remain important priorities.

These concerns were discussed during a multi-stakeholder roundtable organized by UHC Watch with support from Boehringer Ingelheim. The gathering brought together representatives from government health agencies, healthcare institutions, local government units, professional societies, and other stakeholders to identify practical ways to improve stroke care across the region.

Participants emphasized the need to translate the Department of Health’s National Policy Framework on the Prevention, Control and Management of Acute Stroke into coordinated action at the local level.

When Every Minute Matters

For stroke patients in Region 1, reaching a facility capable of providing specialized treatment can be a race against time. Patients from remote municipalities may spend two to four hours traveling to the nearest appropriate facility, potentially missing the critical 4.5-hour treatment window for certain time-sensitive interventions.

Only a limited number of Acute Stroke-Ready Hospitals currently serve patients in La Union, with smaller healthcare facilities often referring patients elsewhere for specialized 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,” she added.

The challenges extend beyond emergency treatment. Access to neurologists, rehabilitation providers, and long-term follow-up services also varies across the region, particularly in geographically isolated communities. Healthcare professionals stressed that improving outcomes requires a coordinated approach that covers every stage of care, from prevention and early symptom recognition to rehabilitation and secondary prevention.

Dr. Cristina Macrohon-Valdez, Immediate Past President of the Stroke Society of the Philippines, underscored the importance of strengthening the entire care pathway, including emergency medical services, pre-hospital transport, timely hospital treatment, rehabilitation, and long-term support.

Building A More Connected Stroke Care Network

To address gaps in access and coordination, stakeholders are advancing StrokeLiNCS LU (Stroke Linking Institutions for Network Care toward a Stronger La Union), an initiative designed to connect healthcare facilities through a more integrated stroke care pathway using a Hub-and-Spoke model.

Under the proposed system, designated hub hospitals such as ITRMC and LUMC would provide advanced stroke services, while spoke facilities would focus on early recognition, initial stabilization, and rapid referral to hospitals equipped to deliver specialized treatment.

The initiative aims to establish clearer referral pathways, strengthen coordination between hospitals, and support faster transfers for patients requiring urgent care. Standardized protocols, pre-notification systems, workforce development, telemedicine support, and a shared stroke registry are among the measures being pursued to reduce delays and improve continuity of care.

“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 National Policy Into Local Action

StrokeLiNCS LU aligns with the Department of Health’s National Policy Framework on Acute Stroke, which seeks to establish integrated systems of care under the Universal Health Care Act.

According to Dr. Ico, the framework envisions a continuum of services covering 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.”

The Provincial Government of La Union and local stakeholders are also working to strengthen referral systems and incorporate dedicated stroke pathways into the upcoming version of the LU Health Care Provider Network Referral Manual.

Plans for a Level II General Hospital and a Neurological Rehabilitation Center have likewise been included in the proposed La Union Medical Hub. These facilities are expected to complement existing stroke services and expand rehabilitation capacity in the province.

Together, these efforts form part of a broader push to improve health outcomes and address the burden of non-communicable diseases through more accessible and coordinated healthcare services.

A Shared Responsibility In Stroke Care

Participants at the roundtable emphasized that better stroke outcomes depend on sustained collaboration among government agencies, healthcare providers, professional societies, patient advocates, communities, and private-sector organizations.

“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 Alvin Manalansan, Co-Convenor of UHC Watch. He added that the organization advocates for stronger collaboration across healthcare provider networks so patients can receive appropriate care when and where they need it, without experiencing financial hardship.

Boehringer Ingelheim supports these efforts through collaboration with healthcare stakeholders on initiatives that strengthen stroke care pathways, improve access to timely treatment, and promote coordinated action for Filipino patients and their families.

As Region 1 continues to strengthen healthcare delivery under Universal Health Care, stakeholders hope that a more integrated stroke care network will help reduce treatment delays, improve recovery outcomes, and provide a model for collaboration across the region.

The message remains clear: strengthening stroke care requires more than medical advances. It calls for better-connected services, informed communities, and partnerships that help patients reach the right care at the right time. Because when it comes to stroke, every minute matters.