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      Provider and facility readiness for age-friendly health services for older adults in primary health care centres in southwest, Nigeria

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          Abstract

          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.

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          Understanding the care and support needs of older people: a scoping review and categorisation using the WHO international classification of functioning, disability and health framework (ICF)

          Background The number of older people with unmet care and support needs is increasing substantially due to the challenges facing the formal and informal care system in the United Kingdom. Addressing these unmet needs is becoming one of the urgent public health priorities. In order to develop effective solutions to address some of these needs, it is important first to understand the care and support needs of older people. Methods A scoping review was conducted, using the Arksey and O’Malley original and enhanced framework, to understand the care and support needs of older people, focusing on those living at home with chronic conditions in the UK. The search was conducted using five electronic data bases, grey literature and reference list checks. The WHO International Classification of Functioning, Disability and Health (ICF) framework was used to analyse and categorise the literature findings. Results Forty studies were included in the final analysis- 32 from academic literature and 8 from grey literature. The review highlighted that older adults faced a range of physical, social and psychological challenges due to living with chronic conditions and required care and support in three main areas: 1) social activities and relationships; 2) psychological health; and 3) activities related to mobility, self-care and domestic life. The review also highlighted that many older people demonstrated a desire to cope with their illness and maintain independence, however, environmental factors interfered with these efforts including: 1) lack of professional advice on self-care strategies; 2) poor communication and coordination of services; and 3) lack of information on services such as care pathways. A gap in the knowledge was also identified about the care and support needs of two groups within the older population: 1) older workers; and 2) older carers. Conclusions The review highlighted that older people living with chronic conditions have unmet care needs related to their physical and psychological health, social life, as well as the environment in which they live and interact. Findings of this review also emphasized the importance of developing care models and support services based around the needs of older people. Electronic supplementary material The online version of this article (10.1186/s12877-019-1189-9) contains supplementary material, which is available to authorized users.
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            Measuring and monitoring success in compressing morbidity.

            J Fries (2003)
            The Compression of Morbidity paradigm, introduced in 1980, maintains that if the average age at first infirmity, disability, or other morbidity is postponed and if this postponement is greater than increases in life expectancy, then cumulative lifetime morbidity will decrease-compressed between a later onset and the time of death. The National Long-Term Care Survey, the National Health Interview Survey, and other data now document declining disability trends beginning in 1982 and accelerating more recently. The decline is about 2% per year, contrasted with a decline in mortality rates of about 1% per year, thereby documenting compression of morbidity in the United States at the population level. Longitudinal studies now link good health risk status with long-term reductions in cumulative lifetime disability; persons with few behavioral health risks have only one-fourth the disability of those who have more risk factors, and the onset of disability is postponed from 7 to 12 years, far more than any increases in longevity in the groups. Randomized, controlled trials of health enhancement programs in elderly populations show reduction in health risks, improved health status, and decreased medical care utilization. Health policy initiatives now being undertaken have promise of increasing and consolidating health gains for the elderly.
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              Country Contextualization of the Mental Health Gap Action Programme Intervention Guide: A Case Study from Nigeria

              As one article in an ongoing series on Global Mental Health Practice, Jibril Abdulmalik and colleagues describe the implementation of the mhGAP-Intervention Guide in Nigeria, which has resulted in a country-specific version. Please see later in the article for the Editors' Summary
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: Project administrationRole: SupervisionRole: ValidationRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: Project administrationRole: SupervisionRole: ValidationRole: Writing – review & editing
                Role: Data curationRole: Formal analysisRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: SupervisionRole: ValidationRole: Writing – review & editing
                Role: Funding acquisitionRole: InvestigationRole: MethodologyRole: Project administrationRole: SoftwareRole: SupervisionRole: ValidationRole: Writing – review & editing
                Role: MethodologyRole: Project administrationRole: ResourcesRole: Writing – review & editing
                Role: InvestigationRole: MethodologyRole: Project administrationRole: ValidationRole: Writing – review & editing
                Role: InvestigationRole: MethodologyRole: Project administrationRole: ValidationRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: Project administrationRole: ResourcesRole: SupervisionRole: ValidationRole: Writing – review & editing
                Role: Editor
                Journal
                PLOS Glob Public Health
                PLOS Glob Public Health
                plos
                PLOS Global Public Health
                Public Library of Science (San Francisco, CA USA )
                2767-3375
                8 August 2023
                2023
                : 3
                : 8
                : e0001411
                Affiliations
                [1 ] Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
                [2 ] Department of Internal Medicine, University of Abuja Teaching Hospital, Abuja, Nigeria
                [3 ] Department of Epidemiology and Global Health, University Medical Centre, Utrecht University, Utrecht, The Netherlands
                [4 ] Buehler Center for Health Policy and Economics, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America
                [5 ] Robert J Havey Institute of Global Health, Feinberg School of Medicine, Northwestern University, Chicago IL, United States of America
                [6 ] Lagos State Ministry of Health, Lagos, Nigeria
                [7 ] Lagos State Sports Commission, Lagos, Nigeria
                [8 ] Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago IL, United States of America
                African Population and Health Research Center, KENYA
                Author notes

                The authors have declared that no competing interests exist.

                ‡ OOO, VOY, and AOO also contributed equally to this work.

                Author information
                https://orcid.org/0000-0002-6131-0446
                https://orcid.org/0000-0001-8147-2111
                https://orcid.org/0000-0002-4064-7832
                Article
                PGPH-D-22-01792
                10.1371/journal.pgph.0001411
                10409274
                37552675
                93cbc02d-9fa4-4db1-a4ff-7594a991a08f
                © 2023 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.

                History
                : 11 November 2022
                : 12 July 2023
                Page count
                Figures: 0, Tables: 6, Pages: 16
                Funding
                Funded by: Robert J. Havey Institute of Global Health
                Award Recipient :
                Funded by: Robert J. Havey Institute of Global Health
                Award Recipient :
                Funded by: Robert J. Havey Institute of Global Health
                Award Recipient :
                Research reported in this publication was supported by Northwestern University’s Robert J Havey Institute of Global Health Catalyzer Fund. LHR, AOO and MRB were the recipients of the award https://www.globalhealth.northwestern.edu/research/awarded-catalyzers.html The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                People and Places
                Population Groupings
                Age Groups
                Adults
                Elderly
                Medicine and Health Sciences
                Health Care
                Health Care Facilities
                Biology and Life Sciences
                Developmental Biology
                Organism Development
                Aging
                Biology and Life Sciences
                Physiology
                Physiological Processes
                Aging
                People and Places
                Geographical Locations
                Africa
                Nigeria
                Social Sciences
                Economics
                Health Economics
                Medicine and Health Sciences
                Health Care
                Health Economics
                Biology and Life Sciences
                Psychology
                Psychological Attitudes
                Social Sciences
                Psychology
                Psychological Attitudes
                Medicine and Health Sciences
                Geriatrics
                Medicine and Health Sciences
                Health Care
                Health Care Policy
                Health Systems Strengthening
                Custom metadata
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