Evaluating the clinical effectiveness and implementation outcomes of the nurse-led stroke transition care model in Tanzania: a study protocol for effectiveness-implementation design

BackgroundStroke remains a leading cause of death and disability worldwide, imposing a significant burden on individuals, and healthcare systems. Globally, low- and middle-income countries (LMICs) bear over 80% of stroke-related deaths that occur soon after hospital discharge. This highlight an urgent need for a well-coordinated, transition care model that ensures continuity of care, supports patients and caregivers at home, and bridges the critical gap between hospital discharge and home care. The current study aims to evaluate the clinical effectiveness and implementation outcomes of a nurse-led stroke transition care model within the Tanzanias healthcare system. Materials and methodsThis study adopts an effectiveness-implementation design hybrid type 1 with mixed-methods approach. About 77 pairs stroke survivors and caregivers, as well as 77 pairs of clinical nurses and physicians will be recruited in the pre-implementation phase and implementation phase from September 2024 to March 2025, and June to December, 2025 respectively at Muhimbili National Hospital-Mloganzila, a national stroke center in Tanzania. Descriptive statistics will be conducted using Independent Samples T-test, One-way ANOVA, Chi-Square Test (X2), Fishers Exact Test, Linear Mixed Models, Kaplan-Meier and Cox regression using STATA software. Furthermore, audio-recorded in-depth interviews will be conducted from November to December, 2025 among 10-20 triads of stroke survivors, caregivers and healthcare providers, to evaluate the implementation outcomes of the model. Transcribed data will be entered in Dedoose software for analysis using a thematic analysis with an inductive approach. The study has obtained approval from Muhimbili University of Health and Allied Sciences Institution Review Board (MUHAS-REC-04-2024-2139). ConclusionGiven the rising burden of stroke and the gaps in continuity of care after hospital discharge, implementing a structured, nurse-driven approach could enhance patient outcomes, support caregivers, and reduce the risk of complications or readmissions.