In the year 2023-2024, the SIRAS Program convened twice, with the initial meeting held in April, chaired by the Principal Secretary of Health and Family Welfare. This gathering served as a review session for the SIRAS Programme, underscoring its innovative approach and potential to serve as a model for other states. The meeting emphasized the critical need for timely care for stroke patients, particularly during the acute phase, advocating for the establishment of primary stroke care units. Attendees were urged to enhance the standards of these units, with a focus on the Tezpur model of Physician-based stroke care units in Assam. The meeting also highlighted the significance of robust database management systems, exemplified by the stroke care quality registry established by ESO-EAST (European Stroke Organisation - Enhancing and Accelerating Stroke Treatment) (RES-Q).

In the year 2023-2024, the SIRAS Program convened twice, with the initial meeting held in April, chaired by the Principal Secretary of Health and Family Welfare. This gathering served as a review session for the SIRAS Programme, underscoring its innovative approach and potential to serve as a model for other states. The meeting emphasized the critical need for timely care for stroke patients, particularly during the acute phase, advocating for the establishment of primary stroke care units. Attendees were urged to enhance the standards of these units, with a focus on the Tezpur model of Physician-based stroke care units in Assam. The meeting also highlighted the significance of robust database management systems, exemplified by the stroke care quality registry established by ESO-EAST (European Stroke Organisation - Enhancing and Accelerating Stroke Treatment) (RES-Q).

Furthermore, discussions addressed the challenges faced by neurologists in District/General Hospitals regarding resource availability and operational efficiency within their stroke units. Decisions were made following thorough

deliberation, including the urgent development of an action plan for dedicated primary stroke care units and the drafting of guidelines to establish minimum standards for their operation. Additionally, gap analyses for all primary stroke care units, as well as the formulation of standard operating procedures (SOPs) and training modules for staff, were prioritized. To ensure effective policymaking and review of program-related SOPs and guidelines, a core committee comprising designated officers was established. This comprehensive approach aims to enhance the quality of stroke care delivery across the region, addressing challenges and fostering continuous improvement in primary stroke care services.

In connection with the ICMR project titled "Upscaling of Kerala's Primary Stroke Care Units into Certified Stroke Care Centres -Implementation research", a meeting was conducted on. 28th February 2024 at SHSRC-K. The meeting was led by Dr. Jithesh. V, Executive Director, SHSRC-K, PI of the study and Dr. Sylaja PN, Professor, Head of the Department of Neurology, in charge of the Comprehensive Stroke Care Unit, one of the Co-Pls of the study.

Mrs. Anjali Krishnan R. Research Officer, SHSRC-K, Co-PI of the study, described the details of the proposal approved by ICMR. She explained the importance of the 'SIRAS Programme and the need for the up gradation of the program. , Dr. Jithesh. V, the Pl of the study presented the research proposal and explained the objectives, methodology and timelines of the project. Following this, Dr. Sylaja P N did a presentation which mainly covered the importance of timely care for stroke patients, the significance of Primary Stroke Care Units and encouraged the participants to improve the standard of Primary

Stroke Care Units in their institutions. During the presentation, the World Stroke Organization (WSO) certification process was explained in detail and Dr. Sylaja P N motivated the participants to make sincere efforts to get their Stroke Care Unit certified by WSO. The participants from coch hospital described the facilities available in their stroke care units and the challenges they are facing for the efficient functioning of stroke care units.