Public health policy and practice
Morbidity and health care utilisation among elderly people in
Mmankgodi village, Botswana
Fredrik Clausena, Edwin Sandberga, Benedicte Ingstadb, Per Hjortdahla
a Sections of General
Practice, b and Medical Anthropology, Department of General Practice and Community
Medicine, University of Oslo, Oslo, Norway
Correspondence to: Dr F Clausen, PB 313, 2001 Lillestrom, Norway
Accepted for publication 31 May 1999
OBJECTIVE
To evaluate the health
status among the elderly in a village in Botswana and their pattern of
health care utilisation.
DESIGNA descriptive study
where all persons 60 years and older were invited to participate,
including a medical examination, laboratory testing and a questionnaire
aiming at gathering sociodemographic data.
SETTINGMmankgodi
village of Botswana.
SUBJECTS419 persons
were identified as elderly in the village, out of which 337 were included.
MAIN OUTCOME
MEASURESThe general medical examination also
included eye status, vision and hearing tests, nutritional status,
blood pressure and registering of physical disabilities. Laboratory
tests included haemoglobin, blood glucose, HIV antibodies and serum
lipids. The questionnaire contained questions regarding family and
civil status, self assessed general health, health problems experienced
during the previous month, and health care utilisation. Questions also pertained to smoking, taking snuff, and alcohol consumption.
RESULTSA majority
(75%) of the elderly experienced good or only somewhat reduced health,
while one quarter suffered more serious health problems. The most
frequent health problems were related to the musculoskeletal system.
Eye diseases, including cataract and blindness, were also common. The
concentration of serum lipids is lower than the one found in the
elderly population of Norway. Nutritional status indicated a relatively
high prevalence (7%) of malnutrition. The majority of men were still
married (87%), while most women were widowed (71%). Women reported
more health problems than men, and they also reported more worries
regarding their own life situation. There is a tendency for the elderly to seek assistance from the established clinics and other health facilities for their health problems. Worries are either kept to
themselves or advice is sought from relatives. Traditional healers were
not often consulted for health problems or worries.
CONCLUSIONSMajor
health problems were identified among the elderly in this geographical
area of Botswana. There is presently no health programme in Botswana
aimed at the elderly. Some of the diseases and conditions found in this
study could easily be identified and treated in the present health
system through a health care programme.
Keywords: elderly people; developing countries; morbidity; utilisation of health care
© 2000 by Journal of Epidemiology and Community Health
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