Aging populations in low-resource countries face a critical gap: how to deliver comprehensive geriatric care when healthcare systems lack specialized infrastructure and training. This challenge becomes more urgent as demographic transitions accelerate globally, making scalable elder care models essential for health systems worldwide.
Clinical implementers of WHO's Integrated Care for Older People (ICOPE) model in Nepal identified key systemic obstacles through a targeted survey of 11 healthcare providers. Infrastructure deficits, workforce shortages, and limited national policy support emerged as primary barriers. The four-step ICOPE protocol—screening, assessment, care planning, and monitoring—faced particular challenges from absent referral systems and lack of electronic health record integration. Despite these constraints, implementers reported the model remained clinically feasible with appropriate digital health tools.
This assessment reveals critical insights for global aging policy. ICOPE represents WHO's flagship approach to comprehensive geriatric care, emphasizing early intervention and community-based support. The Nepal experience suggests that even resource-constrained settings can adopt evidence-based elder care frameworks when supported by motivated clinical teams and international technical assistance. However, success requires addressing fundamental health system gaps—trained geriatric workforce, digital infrastructure, and policy prioritization of aging health. The finding that local adaptation and digital tools could enhance feasibility indicates potential pathways for scaling integrated geriatric care across similar low-resource contexts, where aging populations increasingly strain existing healthcare capacity.