Elderly Family Members’ Health Status in Pakistan's Plural Healthcare System: A Qualitative Study of Medical Practitioners’ Perspectives

Vollständiger Abstract

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The health status of elderly family members is shaped by complex biological, psychological, and social factors; however, the role of healthcare practitioner behavior and system-level practices within family-oriented and plural healthcare contexts remains under-explored, particularly in low- and middle-income countries. This study examined how medical practitioners conceptualize determinants of elderly family members’ health outcomes in Pakistan's plural healthcare system. Using a qualitative exploratory design, 22 practitioners, including physicians, homeopathic, and traditional providers, were selected through purposive maximum variation sampling. Data were collected via semi-structured interviews in Urdu and analyzed using thematic analysis informed by Colaizzi's phenomenological approach. Findings indicated that the health outcomes of elderly family members are influenced by multi-morbidity, age-related decline, health literacy, medication adherence, and healthcare system factors. Importantly, practitioners highlighted the central role of family members in caregiving, treatment decision-making, financial support, and communication with healthcare providers, which significantly shaped health outcomes in the elderly. Practitioner-related issues, including communication gaps, inconsistent prescribing, time constraints, and non-standard practices, further influenced interactions between healthcare providers and families. Grounded in the biopsychosocial model, the study emphasizes integrating family-centered approaches into healthcare delivery to improve geriatric care in resource-constrained and plural healthcare settings.