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 Botswana and their pattern of health care utilisation. DESIGN A descriptive study where all persons 60 years and older were invited 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 which 337 were included. MAIN OUTCOME MEASURES The general medical examination also included eye status, vision and hearing tests, nutritional status, blood pressure and registering of physical disabilities. Laboratory tests included haemoglobin, blood glucose, HIV antibodies and serum lipids. The questionnaire contained questions regarding family and civil status, self assessed general health, health problems experienced during the previous month, and health care utilisation. Questions also pertained to smoking, taking snuff, and alcohol consumption. RESULTS A majority (75%) of the elderly experienced good or only somewhat reduced 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 concentration of serum lipids is lower than the one found in the elderly population of Norway. Nutritional status indicated a relatively high prevalence (7%) of malnutrition. The majority of men were still married (87%), while most women were widowed (71%). Women reported more health problems than men, and they also reported more worries regarding their own life situation. There is a tendency for the elderly to seek assistance from the established clinics and other health facilities for their health problems. Worries are either kept to themselves or advice is sought from relatives. Traditional healers 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 Botswana aimed at the elderly. Some of the diseases and conditions found in this study could easily be identified and treated in the present health system through a health care programme.