Determinants of the Accessibility of Elderly Adults to Primary Health Care Services in Cameroon

Introduction: The size of the elderly population continues to increase rapidly in developing countries. Unfortunately, these countries are often least prepared to meet the health challenges of rapidly ageing population. The old are characterized by chronic non-communicable disease burden and disability, thus requiring opportunities for regular health care. Yet these older persons are believed to lack access to even basic healthcare services. The objective of this study was to identify the determinants of access of the elderly to healthcare services in Cameroon. Methods: We carried out a cross sectional study on 316 elderly persons using a cluster sampling method in two Health Districts chosen conveniently to represent the rural and urban contexts of Cameroon. Factors associated with access to primary health care services were evaluated using Chi squared test and logistic regression. Significance level was set at 5%. Results: Amongst the participants, 45.9%, reported to have gone for medical care within the past year. Almost half of the study population could not remember when they had their last blood sugar test (54.4%) and blood pressure test (43.0%). As concerns HIV testing, 67.5% had ever done an HIV test in their entire life. Furthermore, 26.1% of women and 20.0% of men have at least once done a breast cancer and prostate cancer screening respectively, with the rates being significantly higher for the urban setting (42.3% vs 32.9%, p<0.001). Lastly, accessibility to primary health care services was significantly associated with employment category and availability of a person to accompany the elderly to the hospital. Conclusion: This study showed that more than half of elderly lacked access to basic primary healthcare services. Employment category and availability of person to accompany elderly to the hospital were associated with access to healthcare services, while the setting (urban/rural) was associated with access to prostate and breast cancer screening. There is thus a need to improve access to primary healthcare services for elderly in Cameroon and the aforementioned factors should be considered when designing strategies to improve their accessibility. Larger scaled studies are needed to underscore other factors associated with access that could not be identified by this study.