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They ‘don't cure old age’: older Ugandans’ delays to health-care access

Published online by Cambridge University Press:  15 June 2017

Department of Health Sciences, University of Missouri, Columbia, USA.
Department of Global Health & Development, London School of Hygiene & Tropical Medicine, UK. Medical Research Council/Uganda Virus Research Institute, Entebbe, Uganda.
School of Public Health, University of Sydney, Australia.
Department of Health Sciences, University of Missouri, Columbia, USA. Medical Research Council/Uganda Virus Research Institute, Entebbe, Uganda.
Address for correspondence: Enid Schatz, 535 Clark Hall, Columbia, MO 65211,


Uganda's population is ageing, which comes with increased and varied burdens of disease and health-care needs. At the same time, gerontological care in Uganda remains neglected. This paper examines the factors that cause older Ugandans to delay health-care access. We conduct a thematic analysis of data drawn from nine focus groups held with rural Ugandans aged 60-plus. Our analysis highlights the factors that delay older persons’ access to health care and how these align with the Three-Delay Model, which was originally developed to assess and improve obstetric care in low-resource settings. Our participants report delays in deciding to seek care related to mobility and financial limitations, disease aetiology, severity and stigma (Delay I); reaching care because of poor roads and limited transportation options (Delay II); and receiving appropriate care because of ageism among health-care workers, and poorly staffed and under-supplied facilities (Delay III). We find these delays to care are interrelated and impacted by factors at the individual, community and health-system levels. We conclude by arguing for multi-pronged interventions that will address these delays, improve access to care and ultimately enhance older Ugandans’ health and wellbeing.

Copyright © Cambridge University Press 2017 

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