What the elderly experience and expect from primary care services in KwaZulu-Natal, South Africa

BACKGROUND: People aged 60 years and above are predicted to outnumber those aged under 5 years in South Africa for the first time by 2040. This will put increased demands on the health system to address geriatric health needs. However, data on geriatric populations in sub-Saharan Africa are scarce. Health policymakers need to be informed of the expectations of the elderly people regarding health services, especially at primary care level. AIM: The aim of this study was to explore the experiences and expectations of people aged 60 years and above regarding ageing and health services, and the factors that might improve the quality of primary care services for geriatric patients. SETTING: The study was conducted at three public health primary care facilities in KwaZulu-Natal province, South Africa: one in a rural setting, one in a peri-urban and one in an urban setting. METHODS: This qualitative study involved a purposive sample of 28 participants, aged 60 years and above. Four focus group discussions were conducted in either isiZulu or English, depending on the preference of the participants. Data were analysed thematically using an inductive approach. RESULTS: Nineteen of the 28 participants were women. Five key findings emerged from the study: (1) long waiting times – participants were distressed by lengthy waiting times, (2) illness-centred care – participants felt that they were seen as diseases to be treated, (3) lack of caring – health providers were perceived to lack compassion, (4) pill burden – participants experienced adverse effects of prescribed medication and (5) need for priority care – participants wanted a separate queue for the elderly. CONCLUSION: Health systems and health professions educators should consider the need for patient-centred and integrated care for geriatric populations. Further research is required on the unmet needs of geriatric people in the community.