Prevention for better health among older persons: are primary healthcare clinics in Jamaica meeting the challenge?

Objectives: The study sought to determine the level and type of preventive care offered to older persons (persons 50 years and over) in the primary healthcare system and to identify the barriers to prevention-related activities.

Methods: The study was carried out in three phases utilizing quantitative and qualitative methods. Quantitative data were collected over a six-week period from 738 older patients accessing health centre curative services and from 86 health centre staff Focus group discussions were used to obtain information from non-users of health centres.

Results: The findings showed that while clinical practice was good, there were relatively inadequate levels of prevention care practices and there were barriers to prevention-related activities for older persons in the primary healthcare system. Only 5.1%, 24.5% and 9.6% of older persons reported being advised about smoking, physical activity and alcohol consumption respectively by health centre staff A higher proportion (56.5%) reported being advised about diet. Older persons did not appear to understand the role of prevention in maintaining health status. Barriers identified include inadequate numbers of staff overcrowded clinics, rapid staffturnover; high costs of investigations and medications, and poor staff perception of older persons 'abilities to care for themselves.

Conclusion: Health promotion and secondary prevention for older persons in the primary healthcare clinics need strengthening. Training and facilitation of health workers in age-related age-specific prevention activities are recommended. The provision of appropriate resources for prevention activities among older persons in primary healthcare settings should be addressed.