Page 138 - GHES-2-2

Global Health Econ Sustain Improving health of older adults in rural Uganda

one percent of older adults in all age groups perform five or viable, and could be implemented by experienced VHW
six of the contributive functions listed in Table 5. staff. Instead of adopting the traditional research model
The periodic GHAs, linked to the biannual health involving single-variable interventions with treatment and
census, identify older adults who have not yet undergone control groups and measuring longitudinal outcomes, we
screening. In the future, these assessments will incorporate opted for a design that sought to establish the feasibility of
other important issues such as caregiver burden, the need our original intention within the highly variable settings
for social support beyond family, and evidence of elder of rural villages. The limited availability of quantitative
abuse. Since VHWs have access to the GHA–CFS, they can outcome data is partly due to this chosen model and also
facilitate targeted activities based on this data. Information due to the challenges faced in data acquisition, input, and
for each elder is promptly incorporated in the VHW’s analysis posed by VHWs’ low educational levels and the
family binder, located adjacent to the Family Health Sheet. lack of research funding for longitudinal data.
In addition, the VHWs maintain another field book, the Functional independence is widely accepted in
POCR, which lists all village elders and the screenings and geriatrics as the hallmark of successful aging. The benefits of
benefits they have received. interventions aimed at improving vision, hearing, mobility,
and mood, and reducing pain and social isolation—all
4. Discussion factors contributing to functional status—were deemed
The Kisoro Elders Project was conceived with the aim of to be well-established. However, this study did not aim
maximizing the benefits for older adults in the villages to quantify the extent to which individual improvements
served by VHWs in the Kisoro District. This goal of in quality of life contributed to overall improvements in
achieving maximum benefit hinged on interventions that functional status.
could immediately produce positive effects, were financially One of the main goals of the GHA was to demonstrate
that despite functional dependencies, older adults living in
Table 4. Elders dependent on 2 or more Katz activities of
daily living scale by age the villages play crucial roles as contributing members of
their families and communities, deserving of health and
Age range n (%) social support. There exists not only a moral argument
60 – 64 47 (4) for supporting them, but also an economic one. The
65 – 69 21 (3) substantial levels of contribution by older adults across all
70 – 74 20 (3) age categories underscores this theme.
75 – 79 29 (8) The affordability of the project is contingent on the
80 – 84 50 (12) prior infrastructure of DGH Uganda. A representative
85 – 89 24 (13) annual budget, with equipment costs averaged over
5 years, is presented in Appendix. However, numerous
≥90 52 (26) budget items are lower cost than they would be if the
Total 243 DGH program were not in place. For example, the clinical

Table 5. Percentage of elders performing contributive functions categorized by age, gender, and living alone
Age/Sex/ n Helping Helping Taking care of Giving Settling Attending
Demographics with food with farm house/child advice conflict gathering
60 – 64 1,138 95 88 97 95 94 95
65 – 69 689 93 85 98 95 94 96
70 – 74 568 93 77 98 96 94 93
75 – 79 370 88 65 95 92 89 88
80 – 84 406 85 58 94 89 89 76
85 – 89 182 80 43 91 80 80 74
≥9+ 198 64 34 78 66 64 43
Female 2,373 92 76 95 91 90 87
Male 1,178 85 73 96 94 93 91
Solitary elder 443 90 77 96 95 94 91
Total/average 3,551 90 75 96 92 91 88

Volume 2 Issue 2 (2024) 7 https://doi.org/10.36922/ghes.3000