Assessing public health facility readiness to provide geriatric friendly healthcare services in Southern Central Uganda

Abstract

Background: Uganda’s demographic transition is seeing more citizens make it to old age. Although ageing comes with a higher risk of acquiring diseases, little is known about the readiness of Uganda’s public health facilities (PHFs) to offer geriatric friendly care services. It is thus key to assess the state of affairs in Uganda. Objectives: To determine and compare the readiness of PHFs to provide geriatric friendly services and explore provider views on provision of these services in southern central Uganda. Methods: The study employed a mixed methods approach involving health facility (HF) assessments and key informant interviews. Quantitative data was collected using an adapted health facility geriatric assessment tool. Raw data was entered into Epi-data software and analysed using STATA version 14. Kruskal-Wallis and Dunn’s post hoc tests were conducted to elicit any associations. Content analysis was used to analyse qualitative data. Results: The overall mean readiness index was 16.92 (SD ±4.19) (range 10.8 - 26.6) of the expected 100. 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, HCs IV 20.05 and HCs III 14.80. The low readiness to provide geriatric friendly services was due to poor scores in key WHO building blocks like; leadership (0%), financing (0%), human resource (1.7%) and health management information systems (HMIS) (11.8%). Higher level health facilities (HFs) were statistically significantly friendlier than lower level health facilities. The difference in mean readiness across HFs was 2.39 between HCs III and HCs IV (p=0.025). Majority of respondents had never had formal training in geriatrics and their HFs did not have special provisions for the elderly. All KIs had positive views towards geriatric care services; recommending that government addresses gaps in WHO building blocks such as absence of a geriatric policy, inadequate geriatric training, inadequate funding and equipment for the elderly Conclusion: Readiness of HFs to provide geriatric friendly services in southern central Uganda was generally low. This was due to gaps in leadership, financing, service delivery, equipment, human resource and HMIS. However, health workers had positive views towards provision of these service. For Uganda is to meet the 2020 global healthy ageing goal, government should institute the relevant policy and system changes for geriatric care.