Assessing the Feasibility and Acceptability of Telemedicine for Post-Stroke Rehabilitation in Rural Namibia: A Mixed-Methods Study

Stroke is a leading cause of disability in Namibia, with survivors in remote regions facing significant barriers to accessing specialist rehabilitation. This study assessed the feasibility and acceptability of a synchronous telerehabilitation intervention within rural state healthcare facilities. A concurrent mixed-methods design was employed from 2023 to 2024. Quantitative measures, including recruitment rates, technological reliability, protocol adherence, and resource utilisation, were evaluated among 42 stroke survivors and 15 clinicians across three regions. Qualitative data were gathered via semi-structured interviews with 20 participants (patients, caregivers, and therapists) to explore perceptions of acceptability, cultural relevance, and implementation barriers. Findings demonstrated high feasibility, with an 85% recruitment rate and 92% session completion. Technological challenges, primarily internet instability, were noted but largely mitigated. Acceptability was strongly favoured, with prominent themes highlighting reduced travel burden, increased service equity, and perceived clinical benefit. However, concerns regarding digital literacy and a preference for some in-person assessments were identified. The study concludes that telerehabilitation is a viable and largely acceptable model for extending crucial post-stroke care to underserved populations in Namibia. These findings provide critical, context-specific evidence to inform policy for scaling up integrated telemedicine services, thereby strengthening health system resilience and advancing equitable healthcare access across sub-Saharan Africa.