Translation into clinical practice for the use of intravenous thrombolysis (IVT) for the management of ischemic stroke remains a challenge especially across low- and middle-income countries, with regional inconsistencies in its rate. This project aimed to identify factors that influenced the provision of IVT and the variation in its rates in Malaysia. A multiple case study underpinning the Tailored Implementation of Chronic Diseases framework was carried out in three public hospitals with differing rates of IVT using a multiple method design. Twenty-five in-depth interviews and 12 focus groups discussions were conducted among 89 healthcare providers, along with a survey on hospital resources and a medical records review to identify reasons for not receiving IVT. Interview data were analysed using reflective thematic method, before triangulated with quantitative findings and document reviews. Publications: Hwong WY, Ng SW, Tong SF, Ab Rahman N, Law WC, Kaman Z, Wong SK, Puvanarajah SD, Sivasampu S. Stroke thrombolysis in a middle-income country: A case study exploring the determinants of its implementation. Front Neurol. 2022 Nov 24;13:1048807. doi: 10.3389/fneur.2022.1048807. Hwong WY, Ng SW, Tong SF, Ab Rahman N, Law WC, Wong SK, Puvanarajah SD, Mohd Norzi A, Lian FS, Sivasampu S. Identifying factors in the provision of intravenous stroke thrombolysis in Malaysia: a multiple case study from the healthcare providers' perspective. BMC Health Serv Res. 2024 Jan 5;24(1):34. doi: 10.1186/s12913-023-10397-8.