Background: The population of older people in Malawi is rising and this is a problem globally. Evidence confirms that older people due to diseases associated with old age or the ageing process are prone to functional capacity decline, disability and participation restriction. As such, within the frameworks of multidisciplinary elderly care, physiotherapy is vital. However, access to physiotherapy services in Malawi remains a challenge as services are rarely available at primary level. Kalibu Elderly Clinic (KEC) was established in 2014 to augment government’s effort towards improving healthcare access for older Malawians. Being a clinic of its kind in Malawi and sub-Saharan Africa, KEC provides free physiotherapy services to older people, alongside medical, pharmacy and nursing care.

Aim: A study was designed to assess physiotherapy care practices at KEC for comparison with standards stipulated in existing literature so as to identify best practices and explore opportunities for adaptation and application at a larger scale.

Methods: A mixed-methods study design incorporating quantitative and qualitative approaches was employed. Data was collected at the clinic and the clinic’s outreach sites through observations, review of records and taped interviews on clients and personnel. Questions sought information on clinic’s operations, service circumference, clients’ characteristics, trends in patient outcomes and impact of the facility in improving access to physiotherapy services. Descriptive statistics were run for quantitative data. Qualitative data was processed by Thematic Analysis.

Results: KEC operates as a multi-disciplinary facility providing health, nutritional and social care to over ten thousand older Malawians. Services are delivered in forms of institutionalized care and outreach. Outreach targets older people with varying limitations, and runs with assistance of specially-trained locals who identify clients. Cardiorespiratory and musculoskeletal problems are the most prevailing presenting complaints, respectively constituting 44.7% and 21.6 in institutionalized care and 42.6% and 50% in outreach. Physiotherapy is an integral component of care and comprises such interventions as exercise therapy, fall-prevention programs, functional re-education and assistive-device prescription. Largely, clients reported improvement in access to healthcare following establishment of the facility, citing affordable distance, complete care and adequate supply of medicines as advantages.

Conclusions: Practices at KEC appear to be answering the international community’s call-to-action on sustainable development goals, particularly goals number 2, 3 and 10. Incorporating social and nutritional support in primary health care (PHC) conforms to the multi-dimensional definition of health and the biopsychosocial model where health is viewed beyond mere absence of disease. This also resonates with WHO’s current framework on ageing, healthy ageing, which emphasizes tackling inequalities and ensuring ageing in place. Practices at KEC present an effective model of low-cost implementation in health using available evidence. Building designated elderly clinics, incorporating physiotherapy, running joint clinic-based and outreach programs and training locals in elderly care are all important lessons that governments can implement broadly. Particularly, Malawi’s recent incorporation of Health Surveillance Assistants within PHC offers an opportunity where they can be trained to identify elderly needs for further intervention.