Abstract
Background: People across the world are living longer. This advantageous trend is escorted by an increased prevalence of chronic diseases, making healthcare needs more complex. Non-communicable diseases induce a sharply rising economic and societal cost, particularly in low- and middle-income countries (LMIC), where most older people reside. In this context, the access of older people to primary health care (PHC) is vital because it brings solutions to the aforementioned issues. Furthermore, evidence strongly suggests that this approach to health ensures universal health coverage and enables health systems to adapt to rapid economic, technologic, and demographic changes. PHC improves health outcomes, health system efficiency, and health equity. Given their distinctive needs, older people face financial, geographical, social, cultural, structural, and organisational barriers, affecting their equitable access to PHC services. Therefore, many interventions have been implemented to maximise their access to PHC. This paper outlines the protocol for a scoping review that addresses the central question: What is the scope and nature of available evidence on older peoples’ access to PHC in LMICs? This includes the experience of older people having access to PHC, enabling and hindering access, outcomes of the lack of access, interventions implemented to improve access, and related theoretical frameworks. Methods: This scoping review will follow the theoretical framework proposed by Arksey and O’Malley. The five databases that will be searched are CINAHL, PubMed, LILACS, Embase, and Cochrane Libraries. Studies will be selected according to a set of inclusion/exclusion criteria. Data will then be mapped, extracted, and presented graphically along with a narrative report. Conclusions: The scoping review is a first step to synthesise and disseminate the literature on older people’s access to PHC. This will provide information for researchers to reorient their studies, and intel for decision-makers, enabling them to enact policies that meet older people’s needs.
Highlights
Ageing population The ageing population trend is challenging the whole world
The World Health Organization (WHO) has anticipated that the number of people aged above 60 years will reach 20% of the total population in 2025, versus 11% in 2007, with 75% of them living in developing countries (WHO, 2011)
The preliminary search conducted by the corresponding author (SD) on six databases (Cochrane libraries, CINAHL, Medline, Pubmed, Google Scholar, and Embase), revealed few studies had examined the factors that determine older people’s access to health care in low and middle-income countries
Summary
Ageing population The ageing population trend is challenging the whole world. The United Nations [UN] stated that one in 11 people was aged over 65 years in 2019, whereas it is expected to reach one person in six aged above 65 by 2025 (UN, 2019). The preliminary search conducted by the corresponding author (SD) on six databases (Cochrane libraries, CINAHL, Medline, Pubmed, Google Scholar, and Embase), revealed few studies had examined the factors that determine older people’s access to health care in low and middle-income countries. These examined factors include characteristics of the PHC services, the perception, experience, and satisfaction of older persons regarding quality and efficacy (Lubenow et al, 2016). Stage 1: Identifying the research question This first aim of this review is to map and summarise the nature, features, and breadth of the available evidence related to older people’s access to primary health care in LMICs, and to identify gaps in the existing literature. Extracted data will be filled in an Excel sheet (version 16.48) according to the below themes (Figure 1): 1. Author(s)
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