Health challenges
Primary health care for older people: a participatory study in 5 Asian countries
Health care services in Asia cannot address the growing threat of chronic illnesses
Authors:
Publisher:
HelpAge International Asia, Pacific Regional Development Centre, 2008
This study documents the perceptions of older people, care-givers, and health service providers in terms of knowledge of active and healthy ageing, access and quality of Primary Health Care (PHC) services. It particularly looks at the increasing experiences of older people in managing stroke and diabetes conditions. Recommendations to improve PHC services are provided to support policy development in the Asian context.
The five countries in the study are Cambodia, India, Indonesia, Singapore, and Vietnam. These countries represent the variety of socioeconomic conditions in the region. This study also examines the conditions in rural, urban and tsunami affected areas (in India and Indonesia) in order to provide additional insight into possible geographical discrepancies in provision of PHC services for older people.
The research teams found that the majority of the disadvantaged older participants in the study had low expectations of the access and quality of PHC services. Most experienced their conditions with a sense of fate, and were not aware of the interventions that could improve their health conditions. There were also socio-cultural factors, such as education and ethnicity, which lent to a mind-set of accepting existing conditions as part of their life struggle.
The study highlights the need for governments and civil society to work together to support the delivery of comprehensive primary healthcare. It recommends:
- eliminating physical barriers to accessing primary healthcare by ensuring that there are enough easily accessible centres reducing the cost of accessing primary healthcare by ensuring national-level budgeting of services for older people, improving income security of older people, and mainstreaming ageing into community health and disaster risk reduction planning
- improving the quality of primary healthcare services through training, provision of age-friendly services and exchange of experience among health professionals
- integrating age-specific medical and social support services into institutions and communities.
- in the case of older persons with stroke, informal caregivers should be trained in fall
prevention, rehabilitation exercises and disease management due to the frequent occurrence of
falls in the older population. It is estimated the older the person, the more likely they will fall - in the case of an older person with diabetes, health education should be focused on the early signs
of complications, as well as eating a regular, balanced and nutritious diet. For those with more
advanced disease, the informal caregiver in the home should be trained to provide insulin
injections at regular intervals while making sure that the older person eats at regular intervals.
