Background: Social prescription programs represent a viable solution to linking primary care patients to nonmedical community resources for improving patient well-being. However, their success depends on the integration of patient needs with local resources. This integration could be accelerated by digital tools that use expressive ontology to organize knowledge resources, thus enabling the seamless navigation of diverse community interventions and services tailored to the needs of individual users. This infrastructure bears particular relevance for older adults, who experience a range of social needs that impact their health, including social isolation and loneliness. An essential first step in enabling knowledge mobilization and the successful implementation of social prescription initiatives to meet the social needs of older adults is to incorporate the evidence-based academic literature on what works, with on-the-ground solutions in the community.Objective: This study aims to integrate scientific evidence with on-the-ground knowledge to build a comprehensive list of intervention terms and keywords related to reducing social isolation and loneliness in older adults.Methods: A meta-review was conducted using a search strategy combining terms related to older adult population, social isolation and loneliness, and study types relevant to reviews using 5 databases. Review extraction included intervention characteristics, outcomes (social [eg, loneliness, social isolation, and social support] or mental health [eg, psychological well-being, depression, and anxiety]), and effectiveness (reported as consistent, mixed, or not supported). Terms related to identified intervention types were extracted from the reviewed literature as well as descriptions of corresponding community services in Montréal, Canada, available from web-based regional, municipal, and community data sources.Results: The meta-review identified 11 intervention types addressing social isolation and loneliness in older adults by either increasing social interactions, providing instrumental support, promoting mental and physical well-being, or providing home and community care. Group-based social activities, support groups with educational elements, recreational activities, and training or use of information and communication technologies were the most effective in improving outcomes. Examples of most intervention types were found in community data sources. Terms derived from the literature that were the most commonly congruent with those describing existing community services were related to telehealth, recreational activities, and psychological therapy. However, several discrepancies were observed between review-based terms and those addressing the available services.Conclusions: A range of interventions found to be effective at addressing social isolation and loneliness or their impact on mental health were identified from the literature, and many of these interventions were represented in services available to older residents in Montréal, Canada. However, different terms were occasionally used to describe or categorize similar services across data sources. Establishing an efficient means of identifying and structuring such sources is important to facilitate referrals and help-seeking behaviors of older adults and for strategic planning of resources.

In Bangladesh, the health risks of unplanned urbanization are disproportionately shouldered by the urban poor. At the same time, affordable formal primary care services are scarce, and what exists is almost exclusively provided by non-government organizations (NGOs) working on a project basis. So where do the poor go for health care? A health facility mapping of six urban slum settlements in Dhaka was undertaken to explore the configuration of healthcare services proximate to where the poor reside. Three methods were employed: (1) Social mapping and listing of all Health Service Delivery Points (HSDPs); (2) Creation of a geospatial map including Global Positioning System (GPS) co-ordinates of all HSPDs in the six study areas and (3) Implementation of a facility survey of all HSDPs within six study areas. Descriptive statistics are used to examine the number, type and concentration of service provider types, as well as indicators of their accessibility in terms of location and hours of service. A total of 1041 HSDPs were mapped, of which 80% are privately operated and the rest by NGOs and the public sector. Phamacies and non-formal or traditional doctors make up 75% of the private sector while consultation chambers account for 20%. Most NGO and Urban Primary Health Care Project (UPHCP) static clinics are open 5–6 days/week, but close by 4–5 pm in the afternoon. Evening services are almost exclusively offered by private HSDPs; however, only 37% of private sector health staff possess some kind of formal medical qualification. This spatial analysis of health service supply in poor urban settlements emphasizes the importance of taking the informal private sector into account in efforts to increase effective coverage of quality services. Features of informal private sector service provision that have facilitated market penetration may be relevant in designing formal services that better meet the needs of the urban poor.

It is generally assumed that socioeconomic development interventions for the poor will enhance their material and social capacities to prevent ill health and to seek appropriate and timely care. Using cross-sectional data from surveys undertaken in 1995 and 1999 as part of the BRAC-ICDDR,B Joint Research Project in Matlab, Bangladesh, this paper explores patterns of health-seeking behaviour over time, with the hypothesis that exposure to integrated socioeconomic development activities will enhance gender equity in care-seeking and the use of qualified medical care. While there is tentative evidence of greater gender equity in treatment choice among households benefiting from development interventions, a preference for qualified medical care is not apparent. Findings reveal a striking and generalized rise in self-treatment over the 4-year period that is attributed to the economic repercussions of a major flood in 1998, and greater heath awareness due to the density of community health workers in Matlab. Also noteworthy is the substantial reliance on informal and often unqualified practitioners (over 20%) such as pharmacists and itinerant drug sellers. Factors associated with the type of health care sought were identified using logistic regression. Self-care is associated with female gender, the absence of low cost health services and illnesses of relatively short duration. Medical care, on the other hand, is positively predicted by male gender, geographic location, greater socioeconomic status and serious illness of long duration. The paper concludes by emphasizing the importance of enhancing local capacities to determine whether self-treatment is indicated, to self-treat appropriately, or in cases where health care is sought, to judge provider competence and evaluate whether treatment costs are justified. The provision of pharmaceutical training to the full spectrum of health care providers is also recommended.