Implementation of community-based health checks and peer-to-peer support to promote functional ability for older people living in rural Zimbabwe

实施基于社区的健康检查和同伴支持，以提高津巴布韦农村老年人的功能能力

• 批准号: MR/Y019520/1
• 负责人: Celia Gregson
• 金额: $ 135.56万
• 依托单位: University of Bristol
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2024
• 资助国家: 英国
• 起止时间: 2024 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FY019520%2F1
• 关键词: Implementation; community; based; health; checks

Thanks to advances in health and sanitation, around the world people are living longer than ever before, with the greatest improvement in life expectancy happening in sub-Saharan Africa. In these added years of life, older people understandably want health and wellbeing, that is 'healthy ageing'. However, currently many African countries, with challenged healthcare services and limited resources, are struggling to provide for their rapidly ageing populations, meaning older people are more likely to be living with disability and dependence.The World Health Organization (WHO) describes healthy ageing as an older person's ability to walk, see and hear, and function mentally within the place they live. As countries develop health services to meet the growing needs of ageing populations, there is an opportunity now to proactively plan innovative ways of providing holistic healthcare to help people age well. In sub-Saharan Africa most older people retire to their rural homes (called Kumusha in Zimbabwe). Here we will develop a 'Healthy Ageing Check-up', run by nurses and therapy technicians in local rural communities, where older people can be assessed and offered practical management to maintain health as they age. We will work with a range of stakeholders, healthcare experts and older people themselves, to develop a health check-up for people aged 65 years and older, that we will test in Zimbabwe. The check-up will assess for example, walking, balance, nutrition, memory, mood, eyesight, and hearing. We expect most older people will have problems in several areas. When we find a problem we will offer advice, practical solutions, local peer support meetings and, if needed, facilitate specialist referral. We will continue to work closely with local communities throughout the research to understand perspectives, seek advice, feedback progress and importantly, develop effective peer support groups, each led by a lay community champion, trained in particular aspects of healthy ageing by our team. Peer support groups will bring together older people with similar conditions to enable group-based self-management and activities (e.g., group exercises, group work on diet, cooking and nutrition, memory exercises).We will test how well the roll-out of these health checks and the solutions work, for example how often we identify a health problem, how often we can offer a solution and, when we follow them up again after 4 months, how frequently the older person has taken up the recommendations. In theory, access to public healthcare is free for older people in Zimbabwe, although in practice this is not always the case. So, as well as calculating how much it costs to provide the health check-ups and care, we will see if people experience extra 'out-of-pocket' costs because of the health checks, and if so, the reasons for this. Throughout, we will gather detailed feedback from patients, families, and healthcare workers, about the health check-up programme, so that we can refine and improve the process. Finally, communicating with the WHO, we will develop a 'Healthy Ageing Intervention Toolkit' to guide the structured, comprehensive, person-centred assessment and management of older people in community settings, suitable for scale-up to other countries across sub-Saharan Africa.Zimbabwe is an ideal place to do this research, which we have agreed with WHO Africa, as the findings will reflect the situation in similar neighbouring countries in the region, where healthcare services face similar challenges. Plus, our research team have long-standing working relationships with the Ministry of Health, so that our research findings can directly inform healthcare solutions. Over the four years, we will grow a highly skilled and experienced global health and ageing research team to ensure positive impacts on older people's health for many years to come, and build capability to conduct further important research in this area.

得益于健康和卫生的进步，世界各地的寿命比以往任何时候都长，撒哈拉以南非洲的预期寿命最大改善。在这些增加的岁月中，老年人可以理解地想要健康和福祉，即“健康的衰老”。但是，目前，许多具有挑战性医疗服务和有限资源的非洲国家正在努力提供快速老龄化的人口，这意味着老年人更有可能患有残疾和依赖性。世界卫生组织（WHO）将健康的衰老描述为老年人走路，在他们所处的地方进行精神上的人走路，查看和聆听的能力。随着各国发展卫生服务以满足人口老龄化的需求，现在有机会主动计划创新的方式来提供整体医疗保健，以帮助人们良好的老龄化。在撒哈拉以南非洲，大多数老年人都退休到农村房屋（津巴布韦的库穆沙）。在这里，我们将开发由当地农村社区的护士和治疗技术人员经营的“健康老龄化检查”，可以评估老年人并提供实践管理，以随着年龄的增长而保持健康。我们将与一系列利益相关者，医疗保健专家和老年人自己合作，为65岁以上的人开发健康检查，我们将在津巴布韦进行测试。检查将评估例如步行，平衡，营养，记忆，情绪，视力和听力。我们希望大多数老年人在多个领域都会有问题。当我们发现问题时，我们将提供建议，实用解决方案，当地同伴支持会议，并在需要时提供促进专家的推荐。在整个研究中，我们将继续与当地社区紧密合作，以了解观点，寻求建议，反馈进展以及重要的是，建立有效的同伴支持小组，每个人都由一个外行社区冠军领导，并受到我们团队健康衰老的特定方面的培训。同伴支持小组将召集具有类似条件的老年人，以实现基于团体的自我管理和活动（例如，小组练习，饮食，烹饪和营养，记忆练习的小组锻炼，烹饪和营养）。我们将测试这些健康检查和解决方案的推广和解决方案的效果，例如，我们的健康频率是我们的频率，我们经常提供解决方案，我们经常在4个月后加入他们的频率，并在4个月后加入年龄段，以后，又有多个人的建议。从理论上讲，津巴布韦的老年人可以免费获得公共医疗保健，尽管实际上并非总是如此。因此，除了计算提供健康检查和护理费用的费用外，我们还将看到人们是否由于健康检查而经历了额外的“自付费”费用，如果是这样，则是这样的原因。在整个过程中，我们将收集有关健康检查计划的患者，家庭和医护人员的详细反馈，以便我们可以完善和改进过程。最后，我们将与谁开发“健康的老化干预工具包”，以指导在社区环境中对老年人进行结构化，全面，以人为中心的评估和管理，适合于撒哈拉以南非洲地区的其他国家 /地区进行扩展。Zimbabwe是进行这项研究的理想场所，我们已经同意非洲的人，因为我们已经在与之相似的情况下，在各个国家中都在挑战，在各个国家中，在各个国家中都在范围内进行了挑战，该地区的状况是相似的。另外，我们的研究团队与卫生部建立了长期的工作关系，因此我们的研究结果可以直接为医疗保健解决方案提供信息。在四年中，我们将发展一个高技能和经验丰富的全球健康和老龄化研究团队，以确保未来多年对老年人健康的积极影响，并建立在该领域进行进一步重要研究的能力。