INTRODUCTION:
access to primary healthcare (phc) for older adults is a key component of health equity. in south african township settings, older persons face barriers such as long waiting times, limited mobility, financial constraints, and variable health system responsiveness. previous studies have highlighted the importance of patient-centred access and health system responsiveness¹,²,³. this study aims to explore these barriers and identify potential strategies to enhance access to phc services for older adults in a free state township clinic.

METHODS:
a qualitative case study design will be employed at a weekday-only phc clinic. purposive sampling will recruit 12–15 older adults (aged 65+) and 5 healthcare workers, including the clinic manager. data will be collected through semi-structured interviews, audio-recorded, transcribed verbatim, and analysed thematically using nvivo and microsoft excel. the study is guided by levesque et al.’s framework for access to healthcare, examining approachability, acceptability, availability, affordability, and appropriateness of services¹,⁴. ethical approval will be obtained from the university of the free state health research ethics committee prior to data collection, and all participants will provide written informed consent. Expected outcomes / significance: this study will identify both the barriers and challenges older adults face in accessing phc services, as well as potential strategies and interventions to improve access, including flexible clinic hours, community outreach, patient education, and stakeholder engagement. findings are expected to inform evidence-based recommendations for improving health system responsiveness, patient engagement, and equitable access to phc services for older persons in underserved communities. the study will guide policymakers, healthcare providers, and community stakeholders in developing practical and sustainable approaches to enhance older adults’ access to primary healthcare⁵.