Access to Healthcare Services in Informal Settlement: Perspective of the Elderly in Kibera Slum Nairobi-Kenya

Abstract

Background: The world’s older population is increasing at an alarming rate. This comes up with several health problems and the preparedness of health facilities in handling the elderly is under investigated in Kibera urban informal settlement, Kenya. Aim: This study examined perceptions of the elderly on quality of care and fundamental factors to utilization of health services. Subjects and Methods: This was a descriptive cross-sectional study targeting the elderly, to identify factors influencing access to healthcare. Mixed Methods entailing qualitative and quantitative parameters and a multistage sampling approach were used. Quantitative data was analyzed using statistical package for social since. Manifest content analysis was used for qualitative data. Results: Access to healthcare is low 40.4% (161/399). Access was high among very satisfied {unadjusted OR 0.012, 95% CI (0.001-0.157), and satisfied {unadjusted OR 0.012, 95% CI (0.001- 0.157) respondents. Facility (χ2=19.763, df=3 p<0.001), health worker preference (χ2=6.819, df=2 p=0.033) and family support (χ2=21.539, df=4 p<0.001) influenced access. Respondents who preferred treatment by any health worker and those for same sex were less likely {unadjusted OR 2.701, 95% CI (1.022-7.136), p values =0.045 and OR 5.322, 95% CI (1.613-17.555), P value= 0.006} to be associated with access. Access increased with satisfaction of service received. Those very satisfied {unadjusted OR 0.008, 95% CI (0.001-0.091), p value<0.001 and satisfied (OR 0.005, 95% CI (0.001-0.026), P value<0.001) were highly associated with access. Conclusion: Access to healthcare among the elderly in informal settlement is low. Availability and acceptability are major challenges. This calls for perception change among policy and health workers to elderly clients and qualitative research to ascertain the under lying reasons for low acceptability. Keywords: Access, Healthcare, Elderly people