scholarly journals Long-term Care for Older People in South Africa: The Enduring Legacies of Apartheid and HIV/AIDS

2018 ◽  
Vol 48 (1) ◽  
pp. 147-167 ◽  
Author(s):  
PETER LLOYD-SHERLOCK
Keyword(s):  
Older People ◽  
Long Term Care ◽  
Term Care ◽  
Middle Income ◽  
Racial Categories ◽  
Middle Income Countries ◽  
High Profile ◽  
State Oversight ◽  
Societal Challenge

AbstractThis paper sets out a general framework for analysing long-term care (LTC) systems for older people in different countries and then applies this framework to a specific national setting. The paper considers the extent to which South Africa's emerging LTC system conforms to broader patterns observed across low- and middle-income countries and how far it has been shaped by more local effects. It finds that patterns of demand for LTC vary across different racial categories. Despite having lower rates of ageing that the white population, Africans account for the majority of LTC demand. Residential services cater primarily for older whites and there is a widespread perception that LTC for Africans should be a family responsibility. Across the sector there is evidence of gaps in service availability, limited state oversight and uneven service quality. In 2016 this led to a high-profile political scandal which may prompt more effective state responses to this growing societal challenge.

scholarly journals An emergency strategy framework for managing COVID-19 in long-term care facilities in Brazil

2021 ◽  
Vol 15 ◽  
Author(s):  
Peter Lloyd-Sherlock ◽  
João Bastos Freire ◽  
Meirelayne Duarte ◽  
Monica Frank ◽  
Karla Giacomin ◽  
...  
Keyword(s):  
Long Term Care ◽  
Policy Framework ◽  
Intersectoral Collaboration ◽  
Term Care ◽  
Middle Income ◽  
Local Implementation ◽  
Middle Income Countries ◽  
Care Facilities ◽  
The Impact

This paper presents a novel policy framework to support government responses to COVID-19 in long-term care facilities (LTCFs) in low and middle-income countries. It focuses on issues that are of specific relevance to Brazilian policy-settings, including examples of its local implementation. The CIAT Framework combines and summarizes broad elements for an emergency strategy to address the potential effects of COVID-19. The 4 steps of the Framework entail policies to coordinate, identify, assess, and target support. Those policies can be applied immediately to mitigate the impact of the COVID-19 pandemic in LTCFs. It is, however, essential to situate these responses within a more comprehensive and permanent strategy. Intersectoral collaboration must evolve into a fully institutionalized system.

scholarly journals ASSESSING THE EFFECTS OF LONG-TERM CARE INSURANCE ON EQUITY AND EFFICIENCY: A CASE STUDY OF QINGDAO CITY IN CHINA

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S300-S300
Author(s):  
Wei Yang ◽  
Shuang Chang
Keyword(s):  
Long Term Care ◽  
Financial Burden ◽  
Care Providers ◽  
Term Care ◽  
Middle Income ◽  
Middle Income Countries ◽  
Equity And Efficiency ◽  
Qingdao City ◽  
Insurance Model

Abstract The demand for equitable and efficient long-term care (LTC) has risen rapidly, and finding a suitable mechanism to finance LTC has become a pressing policy concern for many countries. A number of high income countries have chosen to use a social LTC insurance to fund the LTC system, but empirical assessments on such an insurance in low-and middle-income countries are limited. Using China as an example, this paper empirically assesses the performance of newly-piloted LTCNI by evaluating its impact on equity and efficiency in financing. We draw data from 47 in-depth interviews conducted with local government, care providers and family members of the LTCNI participants in Qingdao in 2016. We found that there remain sizable disparities in financial burden among LTCNI participants, despite of its emphasis on ensuring access to care based on people’s needs; care providers are incentivised to provide care at the least cost even this care is deemed as insufficient or inadequate due to fixed payment for their services. Our paper offers critical insights into the potential and challenges in applying LTC insurance model to a LMIC, where critical lessons can be drawn for public LTC insurance in other LMICs.

Barriers to linking research and policy: the case of long-term care in low and middle income countries

2015 ◽  
Vol 12 (2) ◽  
pp. 62-67 ◽  
Author(s):  
Peter Lloyd-Sherlock
Keyword(s):  
Long Term Care ◽  
Problem Definition ◽  
Negative Consequences ◽  
Term Care ◽  
Middle Income ◽  
Policy Makers ◽  
Middle Income Countries ◽  
Research And Policy ◽  
Low And Middle Income

Abstract This paper sets out a number of issues related to the translation of research into evidence and policy for long-term care (LTC) in low and middle income countries (LMICs). First, it assesses the role research can play in problem definition, including establishing the scale of long-term care demand in LMICs and identifying potential negative consequences of policy inaction. Second, it assesses the role that research can play in identifying and evaluating solutions to the problem, in the form of suitable policies and interventions. Lastly, it assesses mutual accessibility between researchers and policy-makers, paying particular attention to institutional and organisational structures. Applying this framework, the paper demonstrates that the capacity for research to influence long-term care policy is very limited. The paper calls for the establishment of an adequately resourced global institutional hub to support research in this area and to promote knowledge-sharing between academics and policy-makers.

Formal Social Protection for Older People in Developing Countries: Three Different Approaches

2002 ◽  
Vol 31 (4) ◽  
pp. 695-713 ◽  
Author(s):  
PETER LLOYD-SHERLOCK
Keyword(s):  
Developing Countries ◽  
Older People ◽  
Social Protection ◽  
Income Support ◽  
Term Care ◽  
Middle Income ◽  
Means Testing ◽  
Middle Income Countries ◽  
Provision Of Care

The paper examines social protection for older people in three middle-income countries: Argentina, Thailand and South Africa. It focuses on income support, health services and the provision of care, as well as considering the effects of these policies on social exclusion. The paper locates each country's different social protection programmes within a broader welfare regime model. It finds an interesting variety of approaches to pension and health provision, which range from generous universalism to minimal means-testing. However, it finds much less innovation in areas such as long-term care and intermediary services. The paper challenges generalisations about old age social protection in developing countries, and argues that the different experiences of these three countries could provide useful lessons for social protection in many parts of the world.

scholarly journals Evaluating the quality of long-term care services in the city of La Plata, Argentina

2019 ◽  
Vol 41 (1) ◽  
pp. 208-230
Author(s):  
Peter Lloyd-Sherlock ◽  
Bridget Penhale ◽  
Nelida Redondo
Keyword(s):  
Older People ◽  
Long Term Care ◽  
State Regulation ◽  
Care Needs ◽  
Term Care ◽  
Middle Income ◽  
La Plata ◽  
Regulatory Processes ◽  
Care Systems

AbstractThis paper reports on an innovative survey of long-term care facilities for older people in the Argentine city of La Plata. It applies a range of qualitative methodologies, including a clandestine audit conducted by older people living in the community. The paper pays particular attention to the types and availability of services, perceived quality and the rigour of regulatory processes. It finds that there has been a rapid growth in the availability of formal services, but that there are many gaps in provision, especially for older people with complex care needs. There are strong indications that service quality is uneven and, in some cases, this amounts to the contravention of basic human rights. State regulation is hampered by institutional fragmentation and weak governance. A wider set of expert interviews and the limited available published information indicate that these findings are unlikely to be exceptional, and that similar issues affect rapidly emerging long-term care systems in many low- and middle-income countries.

scholarly journals Exploring a Common Data Element for International Research in Long-Term Care Homes: A Measure for Evaluating Nursing Supervisor Effectiveness

2020 ◽  
Vol 6 ◽  
pp. 233372142097981
Author(s):  
Katherine S. McGilton ◽  
Annica Backman ◽  
Veronqiue Boscart ◽  
Charlene Chu ◽  
Montserrat Gea Sánchez ◽  
...  
Keyword(s):  
International Research ◽  
Long Term Care ◽  
Data Element ◽  
Supervisory Support ◽  
Common Data Element ◽  
Term Care ◽  
Middle Income ◽  
Middle Income Countries ◽  
Potential Applications

The aim of this study is to recommend a common data element (CDE) to measure supervisory effectiveness of staff working in LTC homes that can be used in international research. Supervisory effectiveness can serve as a CDE in an effort to establish an international, person-centered LTC research infrastructure in accordance with the aims of the WE-THRIVE group (Worldwide Elements to Harmonize Research in Long Term Care Living Environments). A literature review was completed and then a panel of experts independently reviewed and prioritized appropriateness of the measures with mindfulness of their potential applications to international LTC settings. The selection of a recommended CDE measure was guided by the WE-THRIVE group’s focus on capacity rather than deficits, the expected availability of internationally comparable data and the goal to provide a short, ecologically viable measurement, specifically for low- and middle-income countries. Two measures were considered as the CDE for supervisory effectiveness, Benjamin Rose Relationship Scale and the Supervisory Support Scale; however, given that the latter measure has been translated in Spanish and Chinese and has been tested with nursing assistants in both of these countries with good psychometric properties, our group recommends it as the CDE going forward.

scholarly journals Projecting the Need for and Cost of Long-Term Care for Older Persons

2021 ◽  
Author(s):  
Wendy Holmes
Keyword(s):  
Older Persons ◽  
Long Term Care ◽  
Term Care ◽  
Middle Income ◽  
Policy Makers ◽  
Working Paper ◽  
Middle Income Countries ◽  
Modeling Studies ◽  
Key Issues

With the numbers of older persons in the Asia and Pacific region increasing rapidly, there is a growing urgency to develop and strengthen long-term care (LTC) support systems and services. This working paper aims to enhance the understanding, particularly of policy makers and those planning modeling studies, of using statistical models to project the need, demand, and cost of LTC services. The paper first outlines modeling and its importance. Second, it describes key concepts related to LTC need, demand, and measurement. Then, it identifies key issues to consider when designing and using models. A review of recent modeling studies is also summarized, drawing out lessons relevant to low- and middle- income countries.

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