Breaking barriers: challenges faced by the older adults in accessing primary healthcare in a developing country

Given the growing older adults, ensuring their access to primary and basic healthcare services is crucial. Older adults face significant challenges in accessing care, making the develop and implementation of targeted programs vital. This study aims to explore accessibility barriers of the older adults to primary care in urban health centers of an area of Iran. This study employed a qualitative content analysis approach using five focus group discussions with both service providers and selected older adults from the primary health care registration system. Data were analyzed using inductive data-driven coding and conventional content analysis. Four categories and ten sub-categories emerged: accessibility, availability, affordability, and system management and policy. Key barriers included: (1) geographic and physical inaccessibility, particularly for those with mobility issues; (2) service limitations such as insufficient specialist care, lack of home visits, and mismatch between services and older adults’ needs; (3) high out-of-pocket costs, even for insured individuals; and (4) mismanagement in coordination and planning, workforce burnout, poor interdepartmental coordination, and inadequate specialized training. Older adults also expressed limited awareness of services and mistrust in public systems. Healthcare providers highlighted system-level issues, such as weak information systems and a lack of supportive infrastructure. The perspectives of both groups revealed deep alignment in perceived barriers. Addressing the multi-level barriers faced by older adults in accessing primary care requires coordinated reforms in service delivery, financing, human resources, and infrastructure. Key interventions include investment in public transportation, expansion of home-based healthcare services, and adjusting healthcare center operating hours and staffing schedules to better accommodate the needs of older individuals. Additionally, providing daily mental health services with experienced professionals, rather than only occasional availability could, enhance care quality. These targeted strategies are essential for responding to the unique and complex needs of the elderly population and ensuring equitable access to primary healthcare in resource-constrained settings.