Evaluating the Compliance of Saveh Primary Healthcare Centers with World Health Organization's Age-Friendly Standards
Authors: Etemadi Manal , Karimy Mahmood , Koukamari Parisa Hosseini , Khoshnazar Zahedeh 
Published: June 2023

Background: Since primary healthcare is a significant link in promoting and maintaining the health of the elderly, evaluating age-friendliness of service provision system is of great importance in ensuring the health of the elderly. The purpose of this study is to evaluate the state of primary healthcare centers’ compliance with the standards of age-friendliness in Saveh city.
Methods: This was a cross-sectional and descriptive study conducted on May and June 2022, in Saveh city, Markazi Province in Iran. The statistical population of the research included 33 primary healthcare centers selected by the census method and based on World Health Organization’s checklist regarding age-friendly primary healthcare centers (2008); they were examined by observation. After translating the checklist, its face validity, content validity, and reliability were reviewed and approved by 13 experts in the fields of health policy, health education and promotion, the elderly's health, occupational health engineering, and healthcare. Data analysis was done using descriptive statistical tests, one-way analysis of variance, Kolmogorov-Smirnov test, Tukey's post hoc test, and SPSS 16 software.
Results: Regarding the psychometric analysis of checklist, based on the experts' opinions, the content validity ratio and content validity index were calculated and except for 8 items, all items scored higher than 0.54 and 0.79. In order to check the reliability, the research tool was provided to 2 observers. By calculating the Kappa coefficient, the agreement between the 2 observers was above 0.6, which indicates the validity of the checklist. This study showed that comprehensive health centers and their affiliated units had a 57.6% access to public transportation and 72.7% access to stairs at the front entrance. The entry was 100% free from obstacles, access to parking was 42.4%, access to public telephones, 18.2%, to a reception counter near the entrance restrooms, 42.4%, to waiting room, 78.8%, to a dining area, 42.4%, to stairs, 9.1%, to corridor, 87.9%, compliance with guiding signs, 66/7%, visibility of the signs, 72.7%, and personnel identification was 42.4%. Also, based on the analysis of variance, a statistically significant difference was obtained between the type of centers (urban and rural) and friendliness towards the elderly (p < 0.05).
Conclusion: Primary healthcare centers of Saveh city did not have an acceptable compliance with the standards of age-friendly centers. The main issues are the number of stairs and the lack of alternatives (ramps and elevators) for people with mobility problems, the lack of facilities such as public telephones, and the inadequacy of guiding signs and personnel identification to identify employees. The government should strengthen and improve primary healthcare centers for the elderly and facilitate geographical access to these centers, considering the important role of these centers in the health of the elderly.