Challenges Facing the Elderly in Accessing Health Services

A Case Study of Akheri Ward in Arumeru District, Arusha, Tanzania

Authors

DOI:

https://doi.org/10.56741/jscd.v2i03.1345


Keywords:

Barriers, Elderly, Geriatric Services, Healthcare Access, Rural Tanzania

Abstract

Globally, the ageing population is growing fast. Older adults face complex health needs and struggle to access appropriate care, especially in low- and middle-income countries. In Tanzania, rural elderly individuals face multiple barriers to healthcare. These include long distances to facilities, financial hardship, and a shortage of geriatric services. This study examined the challenges faced by elderly people in accessing healthcare in Akheri Ward, Arumeru District. The study employed a mixed-methods cross-sectional design involving 78 participants. The sample included elderly residents, community members, healthcare workers, and local leaders. Quantitative data came from structured questionnaires. Qualitative information was gathered through interviews, focus group discussions, and document reviews. Results showed that distance to facilities, poor transport options, and dependence on public health centers limited access. Socioeconomic barriers, including a lack of insurance, high medical costs, and low income, exacerbated the problem. Quality of care was mostly rated average. Long waits, limited explanations from providers, and a lack of geriatric specialists were common concerns. Ageism and weakening family support added further challenges. The study recommends decentralizing services, expanding mobile clinics, training more geriatric staff, improving financial protection, and reducing discrimination. These steps can help ensure that elderly people in rural Tanzania receive fair, respectful, and effective healthcare.

Author Biography

Anande Kweka, Tengeru Institute of Community Development

is a lecturer in the Department of Community Development Studies at the Tengeru Institute of Community Development, Arusha, Tanzania. His academic and professional work focuses on community empowerment, sustainable rural development, and participatory approaches in education. He has been actively involved in research and training programs that strengthen local governance, promote gender equality, and enhance community resilience through inclusive development practices. (email: anandeswai@yahoo.com).

References

R. M. Gyasi and D. R. Phillips, “Aging and the rising burden of noncommunicable diseases in sub-Saharan Africa and other low-and middle-income countries: a call for holistic action,” The Gerontologist, vol. 60, no. 5, pp. 806–811, 2020. Available: https://doi.org/10.1093/geront/gnz102 DOI: https://doi.org/10.1093/geront/gnz102

I. Aboderin, African Union Policy Framework and Plan of Action on Ageing. Ethiopia: African Union, 2022. Available: https://coilink.org/20.500.12592/551883

A. Donabedian, “Evaluating the quality of medical care,” The Milbank Quarterly, vol. 83, no. 4, pp. 691–729, 2005. Available: https://doi.org/10.2307/3348969 DOI: https://doi.org/10.1111/j.1468-0009.2005.00397.x

E. H. Erikson, Childhood and Society, 2nd ed. New York, NY: W. W. Norton & Company, 1963.

J. T. Hertz, D. B. Madut, G. William, V. P. Maro, J. A. Crump, and M. P. Rubach, “Perceptions of stroke and associated health-care-seeking behavior in Northern Tanzania: a community-based study,” Neuroepidemiology, vol. 53, no. 1–2, pp. 41–47, 2019. Available: https://doi.org/10.1159/000499069 DOI: https://doi.org/10.1159/000499069

E. Geubbels, S. Amri, F. Levira, J. Schellenberg, H. Masanja, and R. Nathan, “Health & demographic surveillance system profile: the Ifakara rural and urban health and demographic surveillance system (Ifakara HDSS),” Int. J. Epidemiol., vol. 44, no. 3, pp. 848–861, 2015. Available: https://doi.org/10.1093/ije/dyv068 DOI: https://doi.org/10.1093/ije/dyv068

G. Frumence, T. Nyamhanga, and A. Anaeli, “Facilitators and barriers to health care access among the elderly in Tanzania: A health system perspective from managers and service providers,” J. Aging Res. Healthc., vol. 1, no. 3, pp. 1–10, 2017. Available: https://doi.org/10.14302/issn.2474-7785.jarh-16-1354 DOI: https://doi.org/10.14302/issn.2474-7785.jarh-16-1354

A. C. Liwa, L. R. Smart, A. Frumkin, et al., “Traditional herbal medicine use among hypertensive patients in sub-Saharan Africa: A systematic review,” Curr. Hypertens. Rep., vol. 16, p. 437, 2014. Available: https://doi.org/10.1007/s11906-014-0437-9 DOI: https://doi.org/10.1007/s11906-014-0437-9

D. Zoorob, Y. Hasbini, K. Chen, V. Wangia-Anderson, H. Moussa, B. Miller, and D. Brobst, “Ageism in healthcare technology: the older patients’ aspirations for improved online accessibility,” JAMIA Open, vol. 5, no. 3, Oct. 2022. Available: https://doi.org/10.1093/jamiaopen/ooac061 DOI: https://doi.org/10.1093/jamiaopen/ooac061

D. Ngusa, “Mobility challenges faced by rural women and the implementation of the national transport policy in Busega District, Tanzania,” Tanzania J. Popul. Stud. Dev., vol. 30, no. 2, pp. 1–26, 2023. Available: https://doi.org/10.56279/tjpsd.v30i2.217 DOI: https://doi.org/10.56279/tjpsd.v30i2.217

C. Kachimanga, H. R. Zaniku, T. H. Divala, J. C. Ket, J. S. Mukherjee, D. Palazuelos, … and T. V. D. Akker, “Evaluating the adoption of mHealth technologies by community health workers to improve the use of maternal health services in Sub-Saharan Africa: systematic review,” JMIR mHealth uHealth, vol. 12, p. e55819, 2024. Available: https://doi.org/10.2196/55819 DOI: https://doi.org/10.2196/55819

S. Nuhu, C. J. Mpambije, and K. Ngussa, “Challenges in health service delivery under public-private partnership in Tanzania: stakeholders’ views from Dar es Salaam region,” BMC Health Serv. Res., vol. 20, no. 1, p. 765, 2020. Available: https://doi.org/10.1186/s12913-020-05638-z DOI: https://doi.org/10.1186/s12913-020-05638-z

P. Binyaruka and J. Borghi, “An equity analysis on the household costs of accessing and utilising maternal and child health care services in Tanzania,” Health Econ. Rev., vol.. 12, p. 36, 2022. Available: https://doi.org/10.1186/s13561-022-00387-7 DOI: https://doi.org/10.1186/s13561-022-00387-7

M. Tungu, P. J. Amani, A. K. Hurtig, A. D. Kiwara, M. Mwangu, L. Lindholm, and M. San Sebastián, “Does health insurance contribute to improved utilization of health care services for the elderly in rural Tanzania? A cross-sectional study,” Global Health Action, vol. 13, no. 1, p. 1841962, 2020. Available: https://doi.org/10.1080/16549716.2020.1841962 DOI: https://doi.org/10.1080/16549716.2020.1841962

T. Mboghoina and L. Osberg, “Social protection of the elderly in Tanzania. Current status and future possibilities,” Res. Poverty Alleviation (REPOA), vol. 10, no. 5, p. 34, 2010.

C. Oppong, “Familial roles and social transformations: Older men and women in sub-Saharan Africa,” Res. Aging, vol. 28, no. 6, pp. 654–668, 2006. Available: https://doi.org/10.1177/0164027506291744 DOI: https://doi.org/10.1177/0164027506291744

E. M. Nyangena, “An examination of manifestations of ageism among the elderly populations in Kenya,” Editon Consort. J. Econ. Dev. Stud., vol. 4, no. 1, pp. 359–365, 2022. Available: https://doi.org/10.51317/ecjeds.v4i1.405 DOI: https://doi.org/10.51317/ecjeds.v4i1.405

A. Officer, M. L. Schneiders, D. Wu, P. Nash, J. A. Thiyagarajan, and J. R. Beard, “Valuing older people: time for a global campaign to combat ageism,” Bull. World Health Organ., vol. 94, no. 10, p. 710, 2016. Available: https://doi.org/10.2471/BLT.16.184960 DOI: https://doi.org/10.2471/BLT.16.184960

Organization for Economic Co-operation and Development, Health at a Glance 2021: OECD Indicators. Paris: OECD Publishing, 2021.

United Nations Department of Economic and Social Affairs, World Population Prospects 2022. New York, NY: UN DESA, Population Division, 2022.

United Republic of Tanzania, National Ageing Policy. Dar es Salaam: Ministry of Labour, Youth Development and Sports, 2003.

P. J. Amani, A. K. Hurtig, G. Frumence, A. D. Kiwara, I. Goicolea, and M. San Sebastián, “Health insurance and health system (un) responsiveness: a qualitative study with the elderly in rural Tanzania,” BMC Health Serv. Res., vol. 21, no. 1, p. 1140, 2021. Available: https://doi.org/10.1186/s12913-021-07144-2 DOI: https://doi.org/10.1186/s12913-021-07144-2

World Bank, World Development Indicators: Health Systems. Washington, DC: World Bank Group, 2021.

World Health Organization, Decade of Healthy Ageing: Baseline Report. Geneva: WHO, 2021.

World Health Organization, Global Report on Ageism. Geneva: WHO, 2022.

World Health Organization, World Report on Ageing and Health. Geneva: WHO Press, 2022.

T. Yamane, Statistics: An Introductory Analysis, 2nd ed. New York, NY: Harper & Row, 1967.

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Published

2025-11-03

How to Cite

Kweka, A. (2025). Challenges Facing the Elderly in Accessing Health Services: A Case Study of Akheri Ward in Arumeru District, Arusha, Tanzania. Journal of Social and Community Development, 2(03), 207–216. https://doi.org/10.56741/jscd.v2i03.1345

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