Abstract
BackgroundOlder persons report poor health status and greater need for healthcare. However, there is limited research on older persons’ healthcare disparities in Uganda. Therefore, this paper aimed at investigating factors associated with older persons’ healthcare access in Uganda, using a nationally representative sample.MethodsWe conducted secondary analysis of data from a sample of 1602 older persons who reported being sick in the last 30 days preceding the Uganda National Household Survey. We used frequency distributions for descriptive data analysis and chi-square tests to identify initial associations. We fit generalized linear models (GLM) with the poisson family and the log link function, to obtain incidence risk ratios (RR) of accessing healthcare in the last 30 days, by older persons in Uganda.ResultsMore than three quarters (76%) of the older persons accessed healthcare in the last 30 days. Access to healthcare in the last 30 days was reduced for older persons from poor households (RR = 0.91, 95% CI: 0.83-0.99); with some walking difficulty (RR = 0.90, 95% CI: 0.83-0.97); or with a lot of walking difficulty (RR = 0.84, 95% CI: 0.75-0.95). Conversely, accessing healthcare in the last 30 days for older persons increased for those who earned wages (RR = 1.08, 95% CI: 1.00-1.15) and missed work due to illness for 1–7 days (RR = 1.19, 95% CI: 1.10-1.30); and 8–14 days (RR = 1.19, 95% CI: 1.07-1.31). In addition, those who reported non-communicable diseases (NCDs) such as heart disease, hypertension or diabetes (RR = 1.09, 95% CI: 1.01-1.16); were more likely to access healthcare during the last 30 days.ConclusionIn the Ugandan context, health need factors (self-reported NCDs, severity of illness and mobility limitations) and enabling factors (household wealth status and earning wages in particular) were the most important determinants of accessing healthcare in the last 30 days among older persons.Electronic supplementary materialThe online version of this article (doi:10.1186/s12939-015-0157-z) contains supplementary material, which is available to authorized users.
Highlights
Population ageing is a global demographic event of the 21st century [1]
There is no “standard numerical criterion for defining old age” [1], though age 60 and older, is used by both the United Nations (UN), the African Union [6,7] and the Ministry of Gender, Labour and Social Development (MoGLSD) in Uganda [5,8]. This 60+ age cutoff is inappropriate in many African contexts given the lower life expectancy [1]
Older persons who were age 70–79 (RR = 0.90, 95% CI: 0.83-0.98) and age 80+ (RR = 0.80, 95% CI: 0.69-0.93), had reduced access to healthcare, in comparison to those age 50–59
Summary
Population ageing is a global demographic event of the 21st century [1]. Worldwide, the proportion of older persons (age 60 and older) is 11% and shall increase to 20% by 2050. There is no “standard numerical criterion for defining old age” [1], though age 60 and older, is used by both the United Nations (UN), the African Union [6,7] and the Ministry of Gender, Labour and Social Development (MoGLSD) in Uganda [5,8]. This 60+ age cutoff is inappropriate in many African contexts given the lower life expectancy [1]. This paper aimed at investigating factors associated with older persons’ healthcare access in Uganda, using a nationally representative sample
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