Community-oriented primary care to improve health in older adults of rural Uganda: A feasibility study

The developing world is aging rapidly within economies that lack the resources and personnel to deliver adequate health and social services to older adults. This study examines the feasibility of utilizing village health workers (VHWs) to deliver low-cost interventions aimed at improving health and quality of life for older adults living in rural villages. VHWs, initially trained to deliver preventive, clinical, and educational services to younger adults and children, were retrained to conduct screening and interventions addressing issues related to vision, hearing, mobility, pain, depression, and energy poverty in older adults. After a 5-year period, 3,615 adults aged 60 years and above received the following interventions: 2,282 pairs of reading glasses, 690 cerumen removals, 92 listening devices, 671 canes, ongoing paracetamol for 3,450 recipients, depression support for 69 individuals, and 1,746 solar lights. Older adults reported improvements in their ability to read, sew, prepare food, sort crops, and perform personal care; enhanced hearing; improved mobility on rocky terrain without falling; reduced pain during farming and daily activities; improved mood and reduced social isolation; and high levels of satisfaction and a further reduction in social isolation with the use of solar lights. Although the study is limited by the largely qualitative nature of the outcome data, it demonstrates the feasibility of utilizing VHWs to deliver interventions that positively affect the health and quality of life of older adults at a low cost. For developing economies facing rapidly growing populations of older adults, this study provides a model for community-based geriatric support that can be adapted to local needs, economic conditions, and available personnel capabilities.