Knowledge, awareness and training needs for stroke care among primary healthcare providers in a Ghanaian municipality: A cross-sectional study

Abstract Background Stroke is a time-sensitive neurological emergency and a growing cause of mortality and disability in low- and middle-income countries. Ghana has been identified among countries with a high burden of ischaemic stroke, yet stroke care often begins in primary-level facilities where provider readiness may determine speed of recognition, referral and early management. Aim To assess stroke knowledge, awareness of stroke management protocols and stroke-related training needs among primary healthcare providers in Kwabre East Municipality, Ghana. Methods A facility-based cross-sectional survey was conducted among 267 primary healthcare providers from public, Christian Health Association of Ghana and private facilities. Participants completed an adapted Stroke Knowledge Test covering demographic characteristics, stroke knowledge, awareness of management protocols and training needs. Descriptive statistics summarised item-level and composite scores. Knowledge and awareness were categorised as poor (< 60%), fair (60–79%) and good ( > = 80%). Group differences were assessed using independent samples t-tests and one-way analysis of variance. Results Participants were mainly nurses (54.3%), aged 25–34 years (54.7%) and employed in government facilities (82.0%). Mean stroke knowledge was 57.0% (SD = 18.2); 50.2% had poor knowledge, 48.7% fair knowledge and only 1.1% good knowledge. Correct responses were high for common stroke type (92.1%) and hypertension as a risk factor (89.1%), but low for atrial fibrillation (42.3%), excessive alcohol use (38.6%) and Ghana-specific ischaemic stroke burden (35.6%). Mean awareness of stroke management protocols was 63.5% (SD = 25.1); 43.1% had poor awareness, 27.3% fair awareness and 29.6% good awareness. Awareness was strongest for rehabilitation and immediate ambulance activation, but weaker for surgery to prevent recurrent stroke. While 75.7% reported feeling adequately trained, more than 84% selected additional training needs across symptom recognition, diagnostic tools, acute treatment and rehabilitation. Workshops were the most preferred training method (95.9%). Conclusion Primary healthcare providers in Kwabre East Municipality demonstrated basic familiarity with stroke but important gaps in risk-factor nuance, local epidemiology and management-protocol readiness. Structured interprofessional continuing professional development, facility-based stroke algorithms, simulation-based triage training and referral-pathway strengthening are needed to improve frontline stroke care.