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BMC Geriatrics
Published in: BMC Geriatrics 1/2017

Open Access 01-12-2017 | Research Article

Health needs, access to healthcare, and perceptions of ageing in an urbanizing community in India: a qualitative study

Authors: Nandita Bhan, Pavitra Madhira, Arundati Muralidharan, Bharati Kulkarni, GVS Murthy, Sanjay Basu, Sanjay Kinra

Published in: BMC Geriatrics | Issue 1/2017

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Abstract

Background

India’s elderly population is rising at an unprecedented rate, with a majority living in rural areas. Health challenges associated with ageing, changing social networks and limited public health infrastructure are issues faced by the elderly and caregivers. We examined perceptions of health needs of the elderly across local stakeholders in an urbanizing rural area.

Methods

The qualitative study was conducted among participants in the Andhra Pradesh Children and Parents Study (APCAPS) site in Rangareddy district, Telangana. We collected data using focus group discussions and interviews among communities (n = 6), health providers (n = 9) and administrators (n = 6). We assessed stakeholders’ views on the influence of urbanization on health issues faced and interventions for alleviating these challenges. We used a conceptual-analytical model to derive themes and used an inductive approach to organizing emerging codes as per a priori themes. These were organized as per thematic groups and ranked by different authors in order of importance. Bronfebrenner’s theory was used to understand stakeholder perspectives and suggest interventions within four identified spheres of influence - individual, household, community and services.

Results

Stakeholders reported frailty, lack of transport and dependence on others as factors impacting health access of the elderly. Existing public health systems were perceived as overburdened and insensitive towards the elderly. Urbanization was viewed positively, but road accidents, crime and loneliness were significant concerns. Interventions suggested by stakeholders included health service outreach, lifestyle counseling, community monitoring of healthcare and engagement activities.

Conclusions

We recommend integrating outreach services and lifestyle counseling within programs for care of the elderly. Community institutions can play an important role in the delivery and monitoring of health and social services for the elderly.
Appendix
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Footnotes
1
Families in south Asia have typically comprised cohabiting multiple generations (‘joint’ families) with within household hierarchies and role relations. With socioeconomic transitions, changes in occupational structures, social norms, urbanization and migration, families are transitioning to ‘nuclear’ households comprising two adults and children. The joint family has sometimes been associated with Hindu religion (hence the phrase ‘Hindu joint family’); however, this phenomenon has applied to south Asia and often transcends religious boundaries.
 
2
Gram Sabha is an elected local body created at the village level that has jurisdiction on basic governance and social matters of the village
 
3
104 is a mobile health van that visits the community once every fortnight and can provide basic preventive care services and OPD. This is an initiative of the State government and is being conducted by a non-profit organization based on a Public Private Partnership model. This van makes fortnightly or monthly visits to villages and provides free medication. A doctor who travels in the van does a BP measurement and basic diagnostics as well.
 
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Metadata
Title
Health needs, access to healthcare, and perceptions of ageing in an urbanizing community in India: a qualitative study
Authors
Nandita Bhan
Pavitra Madhira
Arundati Muralidharan
Bharati Kulkarni
GVS Murthy
Sanjay Basu
Sanjay Kinra
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2017
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-017-0544-y

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