Ageing and life-course

Perth framework for age-friendly community-based primary health care

Overarching principles

As an overarching principle, health care services must aim to provide the highest attainable standards of health, conducive to promoting active ageing and health over the life course and to maintaining life in dignity. Towards this end, health care services must meet the following essential criteria: Availability; accessibility; comprehensiveness; quality; efficiency; non-discrimination; and age-responsiveness. All medical services and attention should cover both physical and mental health, including the provision of equal and timely access to basic promotive, preventive, curative and rehabilitative health services and health education, regular screening programmes, appropriate treatment of illnesses and disabilities, preferably at the community level, as well as the provision of essential drugs. Further, health care services should be coordinated with the provision of social support services, including, when necessary, the provision of basic essentials such as food, shelter and safety.

Health care users of all ages, of which older persons are a growing target group, should be enabled to make informed choices regarding services available to them. The principle of non-discrimination should be upheld to ensure equal distribution and treatment, as well as the prevention of abuse, taking into account the economic, social, psychological and physical vulnerability of older persons.

The special health needs of women, particularly older women, must be taken into account in the promotion of age-friendly attitudes and provision of health care services. As older women generally account for the majority of the growing older population, community-based primary health care must ensure that attitudes, services and relevant policies integrate both age and gender concerns. Further, there is growing evidence that the health needs of ageing men are often neglected and need to be addressed by health care providers through special outreach programmes.

Age-friendly community-based primary health care must be responsive to cultural diversity, and sensitive to the concerns of all health care users, including older persons. The integration of cultural concerns and sensitivity into community health care provision will enhance the responsiveness of services and minimize barriers to service accessibility, thus empowering older persons, their families and community networks.

At the macro policy level, age-friendly community-based primary health care will help promote an integrated approach to public health and health care. The General Principles on Age-Friendly Community-based Primary Health Care must therefore be fully integrated into relevant health and social policies at the national and local levels at all stages of policy making and implementation. For this process to be effective, cooperation and coordination between government departments, other relevant organizations and civil society as well as between the national and local levels must be improved. It is essential that investment in community-based primary health care, including health care of older persons and age-friendly community-based primary health care, be recognized as having long-term benefits and be supported by national governments, with adequate budget allocation and training support to professionals and informal caregivers. Ultimately, age-friendly community-based primary health care should result in attitudinal change, education, training and the whole range of integrated health services and social support to be comprehensive, accessible, responsive and cost-effective.