We know what we need: Older adults’ and stakeholders’ perspectives on ageing, health, and wellbeing in Pakistan

The rapid increase in the older adult population worldwide, especially in low- and middle-income countries (LMICs) like Pakistan, raises critical challenges for healthcare, social support, and policy planning. Older adults in LMICs, especially in culturally diverse regions like Sindh, Pakistan, often face limited access to healthcare, economic insecurity, and social isolation. These challenges highlight the need to understand ageing in this context and explore potential solutions at multiple levels of the socio-ecological model. This qualitative descriptive study used focus group discussions (FGDs) to gather information from 24 older adults and 24 stakeholders in urban Karachi, and 26 older adults and 26 stakeholders in rural Thatta. Each FGD consisted of 4–6 participants. They were conducted using a semi-structured guide, moderated in local languages, and analyzed thematically using the socio-ecological model as a guiding framework. At the individual level, mental health concerns like loneliness, depression, and stress were prevalent, with participants emphasizing the importance of family and community support. Technological barriers were noted, particularly in urban areas where older adults expressed a desire to learn to use smartphones and social media. At the sociocultural level, participants highlighted a lack of respect, social integration, and the need for senior care homes. They noted that family support was crucial but also expressed the need for socializing opportunities and greater societal recognition. At the structural level, difficulties accessing healthcare and managing medications were major concerns. Additionally, there was a lack of awareness about existing social security programs which could be expanded to support older adults. The study emphasizes the complexity of ageing-related issues in LMICs and the importance of addressing personal, sociocultural, and structural barriers. These study findings may contribute to discussions around improving support systems for older adults in similar contexts and fostering a more inclusive approach to ageing in resource-deprived settings, like Pakistan.