Barriers and facilitators to the delivery of age-friendly health services in Primary Health Care centres in southwest, Nigeria: A qualitative study.


Journal

PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081

Informations de publication

Date de publication:
2024
Historique:
received: 30 06 2023
accepted: 07 02 2024
medline: 19 3 2024
pubmed: 19 3 2024
entrez: 19 3 2024
Statut: epublish

Résumé

With the rapid growth of Nigeria's older population, it has become important to establish age-friendly healthcare systems that support care for older people. This study aimed to explore the barriers and facilitators to the delivery of age-friendly health services from the perspectives of primary healthcare managers in Lagos State, Nigeria. We conducted 13 key informant interviews including medical officers of health, principal officers of the (Primary Health Care) PHC Board and board members at the state level. Using a grounded theory approach, qualitative data analysis was initially done by rapid thematic analysis followed by constant comparative analysis using Dedoose software to create a codebook. Three teams of two coders each blind-coded the interviews, resolved coding discrepancies, and reviewed excerpts by code to extract themes. The main barriers to the delivery of age-friendly services included the lack of recognition of older adults as a priority population group; absence of PHC policies targeted to serve older adults specifically; limited training in care of older adults; lack of dedicated funding for care services for older adults and data disaggregated by age to drive decision-making. Key facilitators included an acknowledged mission of the PHCs to provide services for all ages; opportunities for the enhancement of older adult care; availability of a new building template that supports facility design which is more age-friendly; access to basic health care funds; and a positive attitude towards capacity building for existing workforce. While we identified a number of challenges, these offer opportunities to strengthen and prioritize services for older adults in PHCs and build on existing facilitators. Work is needed to identify and test interventions to overcome these challenges and improve the responsiveness of the PHC system to older adults through the delivery of age-friendly health services in PHCs in Lagos, Nigeria.

Sections du résumé

BACKGROUND BACKGROUND
With the rapid growth of Nigeria's older population, it has become important to establish age-friendly healthcare systems that support care for older people. This study aimed to explore the barriers and facilitators to the delivery of age-friendly health services from the perspectives of primary healthcare managers in Lagos State, Nigeria.
METHOD METHODS
We conducted 13 key informant interviews including medical officers of health, principal officers of the (Primary Health Care) PHC Board and board members at the state level. Using a grounded theory approach, qualitative data analysis was initially done by rapid thematic analysis followed by constant comparative analysis using Dedoose software to create a codebook. Three teams of two coders each blind-coded the interviews, resolved coding discrepancies, and reviewed excerpts by code to extract themes.
RESULTS RESULTS
The main barriers to the delivery of age-friendly services included the lack of recognition of older adults as a priority population group; absence of PHC policies targeted to serve older adults specifically; limited training in care of older adults; lack of dedicated funding for care services for older adults and data disaggregated by age to drive decision-making. Key facilitators included an acknowledged mission of the PHCs to provide services for all ages; opportunities for the enhancement of older adult care; availability of a new building template that supports facility design which is more age-friendly; access to basic health care funds; and a positive attitude towards capacity building for existing workforce.
CONCLUSION CONCLUSIONS
While we identified a number of challenges, these offer opportunities to strengthen and prioritize services for older adults in PHCs and build on existing facilitators. Work is needed to identify and test interventions to overcome these challenges and improve the responsiveness of the PHC system to older adults through the delivery of age-friendly health services in PHCs in Lagos, Nigeria.

Identifiants

pubmed: 38502650
doi: 10.1371/journal.pone.0288574
pii: PONE-D-23-19632
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0288574

Informations de copyright

Copyright: © 2024 Ogunyemi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

Auteurs

Adedoyin O Ogunyemi (AO)

Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria.

Mobolanle R Balogun (MR)

Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria.

Adedayo E Ojo (AE)

Department of Internal Medicine, University of Abuja Teaching Hospital, Abuja, Nigeria.
Department of Epidemiology and Global Health, University Medical Centre, Utrecht University, Utrecht, The Netherlands.

Sarah B Welch (SB)

Buehler Center for Health Policy and Economics, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America.
Robert J Havey Institute for Global Health, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America.

Oluwatosin O Onasanya (OO)

Lagos State Ministry of Health, Nigeria.

Victoria O Yesufu (VO)

Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria.

Abisola T Omotayo (AT)

Lagos State Sports Commission, Nigeria.

Lisa R Hirschhorn (LR)

Robert J Havey Institute for Global Health, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America.
Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America.

Classifications MeSH