Abstract
BackgroundAs ageing emerges as the next public health threat in Africa, there is a paucity of information on how prepared its health systems are to provide geriatric friendly care services. In this study, we explored the readiness of Uganda’s public health system to offer geriatric friendly care services in Southern Central Uganda.MethodsFour districts with the highest proportion of old persons in Southern Central Uganda were purposively selected, and a cross-section of 18 randomly selected health facilities (HFs) were visited and assessed for availability of critical items deemed important for provision of geriatric friendly services; as derived from World Health Organization’s Age-friendly primary health care centres toolkit. Data was collected using an adapted health facility geriatric assessment tool, entered into Epi-data software and analysed using STATA version 14. Kruskal-Wallis and Dunn’s post hoc tests were conducted to determine any associations between readiness, health facility level, and district.ResultsThe overall readiness index was 16.92 (SD ±4.19) (range 10.8–26.6). This differed across districts; Lwengo 17.91 (SD ±3.15), Rakai 17.63 (SD ±4.55), Bukomansimbi 16.51 (SD ±7.18), Kalungu 13.74 (SD ±2.56) and facility levels; Hospitals 26.62, Health centers four (HCIV) 20.05 and Health centers three (HCIII) 14.80. Low readiness was due to poor scores concerning; leadership (0%), financing (0%), human resources (1.7%) and health management information systems (HMIS) (11.8%) WHO building blocks. Higher-level HFs were statistically significantly friendlier than lower-level HFs (p = 0.015). The difference in readiness between HCIIIs and HCIVs was 2.39 (p = 0.025).ConclusionThere is a low readiness for public health facilities to provide geriatric friendly care services in Uganda. This is due to gaps in all of the health system building blocks. There is a need for health system reforms in Uganda to adequately cater for service provision for older adults if the 2020 global healthy ageing goal is to be met.
Highlights
As ageing emerges as the public health threat in Africa, there is a paucity of information on how prepared its health systems are to provide geriatric friendly care services
According to the 2016 Uganda demographic health survey, childhood mortality rates declined from 87 deaths per 1000 live births in 1988 to 22 deaths per 1000 live births in 2016, maternal mortality rates per 100,000 live births declined from 524 mothers between 1994 and 2001 to 368 mothers between 2009 and 2016, over 87% of Ugandans know how to prevent themselves from acquiring Human Immunodeficiency Virus (HIV), and malaria prevalence is declining [9]
Of the 18 Health Facility (HF), 50% (n = 9) of them were from Rakai district, 22% (n = 4) from Lwengo district, three HFs (17%) from Kalungu district, and two HFs (11%) were selected from Bukomansimbi district
Summary
As ageing emerges as the public health threat in Africa, there is a paucity of information on how prepared its health systems are to provide geriatric friendly care services. There is a lack of information and research on the organisation and preparedness of public health systems in low-income countries, like Uganda, to offer geriatric friendly care services [7]. Such information is critical for policy decision making and Ssensamba et al BMC Geriatrics (2019) 19:256 financial allocative efficiency in the health sector, more so, if Africa is to meet the 2020 global healthy ageing goal [5]. This is expected to rise to above 5% of the national population by 2020 [12]
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