{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T15:18:17Z","timestamp":1788535097419,"version":"build-2803163510"},"reference-count":41,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T00:00:00Z","timestamp":1771545600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosglobalpublichealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Glob Public Health"],"abstract":"<jats:p>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\u00a0socio-ecological\u00a0model. 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\u20136 participants. They were conducted using a semi-structured guide, moderated in local languages, and\u00a0analyzed\u00a0thematically using the\u00a0socio-ecological\u00a0model 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\u00a0socializing\u00a0opportunities 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.<\/jats:p>","DOI":"10.1371\/journal.pgph.0005916","type":"journal-article","created":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T18:29:41Z","timestamp":1771612181000},"page":"e0005916","update-policy":"https:\/\/doi.org\/10.1371\/journal.pgph.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["We know what we need: Older adults\u2019 and stakeholders\u2019 perspectives on ageing, health, and wellbeing in Pakistan"],"prefix":"10.1371","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1589-2470","authenticated-orcid":true,"given":"Sonia","family":"Sameen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7910-4683","authenticated-orcid":true,"given":"Javeria","family":"Mansoor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryam Pyar Ali","family":"Lakhdir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Asim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rose","family":"Munyoki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolyn","family":"Greig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justine","family":"Davies","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bilal Ahmed","family":"Usmani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,2,20]]},"reference":[{"key":"pgph.0005916.ref001","doi-asserted-by":"crossref","first-page":"1121761","DOI":"10.3389\/fpubh.2023.1121761","article-title":"Active aging needs from the perspectives of older adults and geriatric experts: a qualitative study","volume":"11","author":"S Ayoubi-Mahani","year":"2023","journal-title":"Front Public Health"},{"key":"pgph.0005916.ref002","author":"World Health Organization"},{"key":"pgph.0005916.ref003","author":"United Nations","year":"2024"},{"issue":"4","key":"pgph.0005916.ref004","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1016\/j.gerinurse.2021.04.025","article-title":"Community-dwelling older adults who are low-income and disabled weathering financial challenges","volume":"42","author":"LJ Samuel","year":"2021","journal-title":"Geriatr Nurs"},{"key":"pgph.0005916.ref005"},{"key":"pgph.0005916.ref006","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1177\/00333549141291S206","article-title":"The social determinants of health: it\u2019s time to consider the causes of the causes","author":"P Braveman","year":"2014","journal-title":"Public Health Rep"},{"key":"pgph.0005916.ref007","author":"Pakistan-International Fund for Agricultural Development"},{"issue":"1","key":"pgph.0005916.ref008","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1186\/s12877-019-1376-8","article-title":"Exploring the experiences of the older adults who are brought to live in shelter homes in Karachi, Pakistan: a qualitative study","volume":"20","author":"LA Cassum","year":"2020","journal-title":"BMC Geriatr"},{"key":"pgph.0005916.ref009","author":"The Borgen project"},{"key":"pgph.0005916.ref010","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1007\/978-3-030-51406-8_3","article-title":"Socio-demographic risk factors related to material deprivation among older persons in Europe: A comparative analysis based on SHARE data.","volume-title":"Social exclusion in later life: Interdisciplinary and policy perspectives","author":"M Sumil-Laanemaa","year":"2021"},{"issue":"1","key":"pgph.0005916.ref011","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1186\/s12877-023-04196-3","article-title":"Social isolation and loneliness among older adults living in rural areas during the COVID-19 pandemic: a scoping review","volume":"23","author":"J Pickering","year":"2023","journal-title":"BMC Geriatr"},{"issue":"6","key":"pgph.0005916.ref012","first-page":"192","article-title":"Are the elderly in Pakistan getting their due share in health services? 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