“To improve epilepsy care services, most developed countries adopted national guidelines at least a decade ago, with these being regularly updated. Whenever possible, such guidelines are evidence-based, relying upon the body of evidence for best care practices in high income, resource rich countries with predominantly moderate climates. However, 80% of people with epilepsy live in so-called ‘developing’, low-income, or resource-poor countries in tropical or subtropical regions. For many reasons including resource restrictions, simply adopting healthcare guidelines created for higher-resourced areas and using these in resource-limited settings is neither appropriate nor feasible.”
In 2011, the World Health Organization’s (WHO) mental health Gap Action Programme (mhGAP) released evidence-based epilepsy-care guidelines for use in low and middle income countries (LAMICs). From a geographical, sociocultural, and political perspective, LAMICs represent a heterogenous group with significant differences in the epidemiology, etiology, and perceptions ofepilepsy. Successful implementation of the guidelines requires local adaptation for use within individual countries. For effective implementation and sustainability, the sense of ownership and empowerment must be transferred from the global health authorities to the local people. Sociocultural and financial barriers that impede the implementation of the guidelines should be identified and ameliorated. Impact assessment and program revisions should be planned and a budget allocated to them. If effectively implemented, as intended, at the primary-care level, the mhGAP guidelines have the potential to facilitate a substantial reduction in the epilepsy treatment gap and improve the quality of epilepsy care in resource-limited settings.