Date of Award

12-9-2024

Degree Type

Thesis

Degree Name

Master of Health Policy and Management

First Advisor

Dr. Bilal Ahmed Usmani

Second Advisor

Dr. Muhammad Asim

Third Advisor

Dr. Sonia Sameen

Department

Community Health Sciences

Abstract

Background: The older adult population is growing globally and is expected to reach 2 billion by the year 2050. Of these, 80% of older adults are expected to reside in low and middle-income countries (LMICs). In Pakistan, the number of older adults is projected to reach 1.8 million by 2050, which will be 12% of the total country’s population. According to the World Health Organization (WHO) 80% of older adults aged 70 years and above are physically inactive. Physical activity (PA) is influenced by a variety of social determinants of health, which include socioeconomic status, cultural norms, and environmental factors. It is protective for ageing that can improve quality of life and reduce the burden of disease including musculoskeletal disorders and non-communicable diseases (NCDs). Most studies on older adults focus on hospital settings and lack exploration of factors influencing PA within community settings, where diverse socioeconomic and cultural backgrounds play a role.
Objective: The study aims to explore the facilitators and barriers regarding PA at individual, interpersonal, community, and policy levels among older adults living in community settings in the urban areas of Karachi.
Methods: A qualitative exploratory study was conducted from July to September 2024 in Karachi's District Central and District East. Using purposive sampling, 24 older adults (12 each district; 45% female, 55% male) aged 60 and above, with no physical limitations, were interviewed at their residences. Data were analyzed inductively through open coding, following Braun and Clark’s thematic analysis, resulting in four major themes.
Results: The study identified four themes at each level of the Socioecological model (SEM) including health, motivation, knowledge, and attitude at the individual level; social connections and support networks were identified at the interpersonal level; environment, and social attitudes at the community level; and the need for accessible spaces and government initiatives at the policy level. Key findings are Knowledge about PA, perceived health benefits, family support, community-based centers and walking paths in the community acted as key facilitators. Sociocultural norms, societal views about the older adults, and environmental barriers including lack of parks, safety concerns, uneven surfaces, and the unavailability of walking paths were reported by most of the participants.
Conclusion: Our findings demonstrate a complex interrelationship of facilitators and barriers to PA among older adults aged 60 and above. There is a need for a policy on age-friendly urban planning that ensures the safe and accessible creation of space for PA. Furthermore, addressing sociocultural barriers, especially women's participation, and culture-appropriate initiatives can help in improving PA levels.

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1

Last Page

65

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