Barriers and Facilitators to Health-seeking Behaviors and Self-care Practices of Older Adults in Rural India, A Mixed Method Study

Abstract

Background: Effective self-care is crucial for maintaining health in older adults in resource-constrained communities. This study examined self-care practices, health-seeking behaviors, and associated factors among older adults in rural India. Methods: A mixed-methods study was conducted among 400 adults aged ≥65 years. Participants were selected through multistage random sampling from 5 slum areas. Self-care practices, health-seeking behaviors, demographic information, chronic conditions, self-efficacy, and health literacy were assessed through interviews. The qualitative data were explored through in-depth interviews with 30 participants. Results: Inadequate health literacy 180 (45%) and low self-efficacy 150 (37.5%) were common. While 300 (75%) reported an adequate diet and 350 (87.5%) reported medication adherence, only 80 (20%) monitored diabetes complications. Only 180 (45%) patients underwent cancer screening, and 300 (75%) had ≥2 doctor visits yearly. Age, sex, education, income, comorbidities, self-efficacy, and health literacy were significantly associated with self-care and health-seeking. Along with facilitators such as social support, barriers such as limited healthcare access and lack of preventive orientation emerged. Conclusion: Suboptimal prevention orientation and overreliance on secondary care instead of self-care among elderly people are problematic given the limited use of geriatric services. Grassroots health workers can improve health literacy and self-efficacy through home visits to enable self-care. Healthcare access inequities for vulnerable groups merit policy attention.