Free healthcare scheme and the health status of older persons: A cross-sectional study in selected districts in Tanzania

Abstract

This article examines the influence of free healthcare services on the health status of older persons in Tanzania. The Tanzania Free Healthcare Scheme of 1994 aimed to relieve older persons from medical expenses at public healthcare facilities. Despite the aim, older persons still experience challenges such as inadequate geriatricians, illegal payments, and bureaucracy in accessing healthcare. This study used a cross-sectional survey design involving older persons who were randomly selected from Nachingwea and Kilwa districts in Lindi Region, in Tanzania. The data was collected using household surveys, key informant interviews, focus group discussion, and documentary review. The SPSS software was used to analyse the quantitative data, while content analysis was used to analyse the qualitative data. The findings show that 60.5% of the participants (n = 369) have poor self-rated health. The prevalence of non-communicable diseases is high, particularly hypertension (65.38%; n = 369). Due to such non-communicable diseases, 88% (43 out of 49) total deaths in 2023 were of older persons. Medication (ꭓ2 = 8.2542, p <0.005) and diagnosis services (ꭓ2 = 6.8891, p < 0.005) are significantly associated with poor health status of older persons. The findings conclude that the overall health status of older persons who utilize free healthcare is poor. The study recommends that the health policy should enhance access to free healthcare services to older persons; including preventive education, early detection, screening, and the availability of medication for the control of non-communicable diseases to reduce mortality among the elderly