Home-Based Primary Care: Advancing Aging in Place in Nigeria by 2026

Abstract

Nigeria is undergoing a demographic transition characterized by a rapidly growing older population, while healthcare systems historically oriented toward maternal and child health remain insufficiently equipped to address the complex needs of older adults. Although aging in place has emerged as a sustainable model of eldercare, Nigeria’s reliance on family-centered caregiving often imposes substantial financial, emotional, and physical burdens on caregivers in the absence of structured support. This study investigates the feasibility, outcomes, and challenges of Home-Based Primary Care (HBPC) in Nigeria and evaluates its potential to advance aging in place by 2026, with particular attention to health outcomes, caregiver burden, hospital utilization, healthcare expenditure, cultural acceptance, and policy implications. A mixed-methods design was employed from January 2024 to December 2025. Quantitative surveys involved 500 adults aged 60 years and above from urban communities in Lagos and Abuja and rural communities in Oyo and Benue, while qualitative interviews were conducted with 50 older adults, caregivers, and healthcare providers. A pilot HBPC program provided routine medical check-ups, medication delivery, physiotherapy, and psychosocial support. Quantitative data were analyzed using descriptive statistics, chi-square tests, and logistic regression, whereas qualitative data were examined through thematic analysis using NVivo. The findings show that 68% of participants reported improved chronic disease management, while hospital readmissions decreased by 32%. Functional independence scores increased by 15 points in urban areas and 10 points in rural areas, while psychological well-being and social relationship indicators improved by 21% and 18%, respectively. Caregiver strain decreased by 40%, and household healthcare expenditure declined by 27%. Qualitative findings further revealed strong cultural acceptance of HBPC, trust in community health workers, and reduced caregiver burden, although workforce shortages, funding constraints, and supply-chain inefficiencies remained significant barriers. The study concludes that HBPC represents a viable approach to advancing aging in place in Nigeria by improving health outcomes, reducing caregiver burden and healthcare costs, and supporting the dignity and independence of older adults. The findings contribute to geriatric and primary healthcare policy by demonstrating the potential value of integrating structured home-based services into Nigeria’s health system and highlight the need for strategic investment, workforce development, and institutional support, including through the National Senior Citizens Centre, to facilitate broader implementation.