Exploring challenges experienced by older persons in accessing health services in Malawi

Background: Malawi, like other developing countries, is not prepared to adequately address the health needs of older persons. Objectives: This article explores challenges older persons experience in accessing health care. Method: This article is based on data from two large. Conducted in Blantyre, Phalombe, Dowa and Rumphi Districts, the EquitAble study examined self-reported barriers. The GeoHealthAccess study examined geographical barriers, conducted in Blantyre and Phalombe. A sub-sample of 338 (17%) older persons of the 1991 respondents in the EquitAble study is used in this article. Respondents were asked to identify factors that made it difficult for them to access health care. Sixty-six in-depth interviews and two focus group discussions with older persons were conducted to obtain in-depth information about barriers to accessing health care. Results: Barriers experienced by older persons in accessing health care included being unable to pay to for services at fee paying health facilities; failure to pay for transportation; long distances to health centres; mountainous terrains; having severe rheumatism; living alone; poor attitudes of health workers; and shortage of staff, medicines and equipment. Conclusion: To address these challenges, there is need to have adequate health workers with knowledge of diseases and conditions experienced by older persons and the introduction of outreach health services targeting them. Contribution: Poverty at individual level and health system factors are major barriers to accessing health care by older persons. There is a need for the development and implementation of strategies to better improve access for older persons.