Ogunyemi Adedoyin O, Balogun Mobolanle R, Ojo Adedayo E, Welch Sarah B, Onasanya Oluwatosin O, Yesufu Victoria O, Omotayo Abisola O, Hirschhorn Lisa R
Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria.
Department of Internal Medicine, University of Abuja Teaching Hospital, Abuja, Nigeria.
PLOS Glob Public Health. 2023 Aug 8;3(8):e0001411. doi: 10.1371/journal.pgph.0001411. eCollection 2023.
There is a growing focus on interventions at the health system level to promote healthy aging and provide age-friendly health services (AFHS) in low- and middle-income countries where populations are aging. This study aimed to determine the provider and facility readiness for AFHS. We developed and implemented surveys to collect PHC facility capacity and readiness to deliver AFHS and a KAP survey for facility healthcare workers based on guidelines from the WHO age-friendly tool kit and questionnaires from other studies. Direct observation and structured interviews of facility heads were conducted in a stratified random sample of 15 out of the 57 comprehensive PHC facilities in Lagos, Nigeria. One hundred and twenty providers were conveniently sampled for the KAP survey. Statistical analysis was conducted using STATA version 15 (StataCorp, College Station, Texas, USA). For facility readiness, only 13.3% of PHCs sometimes offered hearing assessment and none of the PHCs offered colorectal cancer assessment. Few (20.0%) facilities offered home services and only 1 (0.7%) had dedicated funding for care of older people. Ramps were at the entrance in 60.0% of facilities and almost half (43.3%) of the PHCs had wheelchair accessible entrances to the public toilets. The majority of HCWs (81.7%) had heard about healthy aging but only 5.0% about AFHS, only 10.8% reported formal training. Around a third knew about specific conditions which affect people as they age, including; depression (37.5%), urinary incontinence (35.0%), and falls/immobility (33.3%). Over half of the providers (54.2%) screened for malnutrition in older patients, 25.8% screened for suspected elder abuse and much less (19.2%) for delirium. This study found some areas of strength but also gaps in facility readiness as well as knowledge and training needed to support AFHS care. We recommend identifying interventions to improve the availability and delivery of care for older adults.
在人口老龄化的低收入和中等收入国家，越来越关注卫生系统层面的干预措施，以促进健康老龄化并提供关爱老年人的卫生服务（AFHS）。本研究旨在确定提供方和机构对AFHS的准备情况。我们根据世界卫生组织关爱老年人工具包的指南以及其他研究的问卷，开发并实施了调查，以收集初级卫生保健（PHC）机构提供AFHS的能力和准备情况，以及针对机构医护人员的知识、态度和实践（KAP）调查。在尼日利亚拉各斯57家综合PHC机构中，对15家进行分层随机抽样，对机构负责人进行直接观察和结构化访谈。对120名提供方进行方便抽样以进行KAP调查。使用STATA 15版本（美国德克萨斯州大学站的StataCorp公司）进行统计分析。就机构准备情况而言，只有13.3%的PHC有时提供听力评估，没有PHC提供结直肠癌评估。很少有机构（20.0%）提供上门服务，只有1家（0.7%）有专门用于老年人护理的资金。60.0%的机构入口处有坡道，近一半（43.3%）的PHC公共厕所入口可供轮椅通行。大多数医护人员（81.7%）听说过健康老龄化，但只有5.0%听说过AFHS，只有10.8%报告接受过正规培训。约三分之一的人了解随着年龄增长影响人们的特定疾病，包括：抑郁症（37.5%）、尿失禁（35.0%）和跌倒/行动不便（33.3%）。超过一半的提供方（54.2%）对老年患者进行营养不良筛查，25.8%对疑似虐待老年人情况进行筛查，而对谵妄进行筛查的比例要低得多（19.2%）。本研究发现了一些优势领域，但在机构准备情况以及支持AFHS护理所需的知识和培训方面也存在差距。我们建议确定干预措施，以改善老年人护理的可及性和提供情况。
