Morbidity and health care utilisation among elderly people in Mmankgodi village, Botswana

Objective-To evaluate the health status among the elderly in a village in B otswana and their pattern of health care utilisation. Design-A descriptive study where all persons 60 years and older were invite d to participate, including a medical examination, laboratory testing and a questionnaire aiming at gathering sociodemographic data. Setting-Mmankgodi village of Botswana. Subjects-419 persons were identified as elderly in the village, out of whic h 337 were included. Main outcome measures-The general medical examination also included eye sta tus, vision and hearing tests, nutritional status, blood pressure and regis tering of physical disabilities. Laboratory tests included haemoglobin, blo od glucose, HIV antibodies and serum lipids. The questionnaire contained qu estions regarding family and civil status, self assessed general health, he alth problems experienced during the precious month, and health care utilis ation. Questions also pertained to smoking, taking snuff, and alcohol consu mption. Results-A majority (75%) of the elderly experienced good or only somewhat r educed 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 conce ntration of serum lipids is lower than the one found in the elderly populat ion of Norway. Nutritional status indicated a relatively high prevalence (7 %) of malnutrition. The majority of men were still married (87%), while mos t women were widowed (71%). Women reported more health problems than men, a nd they also reported more worries regarding their own life situation. Ther e is a tendency for the elderly to seek assistance from the established cli nics and other health facilities for their health problems. Worries are eit her kept to themselves or advice is sought from. relatives. Traditional hea lers were not often consulted for health problems or worries. Conclusions-Major health problems were identified among the elderly in this geographical area of Botswana. There is presently no health programme in B otswana aimed at the elderly; Some of the diseases and conditions found in this study could easily be identified and treated in the present health sys tem through a health care programme.