“The Ugly Face of Old Age”: Elders’ Unmet Expectations for Care and Support in Rural Ethiopia

2020 ◽  
pp. 009141502091190
Author(s):  
Abraham Zelalem ◽  
Messay Gebremariam Kotecho ◽  
Margaret E. Adamek
Keyword(s):  
Developing Nations ◽  
Filial Obligation ◽  
Community Based ◽  
Rural Ethiopia ◽  
Unmet Expectations ◽  
Care And Support ◽  
Adequate Care ◽  
Wish To Die ◽  
Cooperative Models ◽  
Depth Interviews

As migration, urbanization, and aging accelerate in developing nations, traditional family supports for elders are diminishing. With these trends in mind, hermeneutic phenomenology was used to examine the experiences of 10 rural Ethiopian elders of age 70 and older. Narrative data from in-depth interviews revealed three prominent themes: the “good old days,” drained happiness, worry and pessimism. Elders felt devalued by their children, grandchildren, and youth in general. Compared to how they treated their own parents, elders believed that their children’s sense of filial obligation was weak and unreliable. Interactions were described as undermining, embarrassing, and abusive. Elders were pessimistic about the prospect of reliable caregivers, even expressing a wish to die before they become dependent on others for care. Despite such challenges, participants viewed aging as a privilege. New cooperative models of community-based care are needed to ensure that elders in developing nations can expect adequate care throughout their lives.

scholarly journals AGING IN RURAL ETHIOPIA: IMPACT ON FILIAL RESPONSIBILITY AND INTERGENERATIONAL SOLIDARITY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S153-S153 ◽  
Author(s):  
Margaret E Adamek ◽  
Messay Gebremariam ◽  
Abraham Zelalem
Keyword(s):  
Phenomenological Approach ◽  
Developing Nations ◽  
Intergenerational Solidarity ◽  
Filial Responsibility ◽  
Daily Lives ◽  
Rural Ethiopia ◽  
Adequate Care ◽  
Wish To Die ◽  
Support Mechanisms ◽  
Caregiving Roles

Abstract As migration and urbanization continue to progress in developing nations, the filial support and traditional support mechanisms that serve as buffers against the plight of older people are diminishing. Agrarian families find themselves in a rapidly changing world that severely limits their ability to assume caregiving roles for elders. With these trends in mind, a phenomenological approach was used to explore the lived experiences of 10 rural elders in Ethiopia. Prominent themes in the elders’ narratives was the nostalgia of filial responsibility and intergenerational solidarity in the “good old days” and a strong sense of devaluation. Elders expressed feeling devalued by their children, grandchildren, and youth in general. As one elder shared, “These days, there is no respect for an older person. We are treated like a broken utensil thrown away which is considered as useless anymore.” Compared to how they treated their own parents, elders believed that their children’s sense of moral obligation was weak and unreliable. Interactions with children and grandchildren were described as abusive, undermining, and embarrassing, triggering deep sorrow. Elders were pessimistic about the prospect of reliable caregivers, even expressing a wish to die before they become dependent on others for care. Despite the challenges they face in their daily lives, all participants viewed aging as a privilege that should be celebrated. As traditional family support structures in developing nations continue to deteriorate, new models of community-based care are needed to ensure that elders can expect adequate care throughout their lives.

Fulfilling the Responsibility to Protect

2020 ◽  
Vol 9 (1) ◽  
pp. 29-54
Author(s):  
Getachew Alebachew Mekonnen
Keyword(s):  
Significant Contribution ◽  
Psychosocial Support ◽  
Data Gathering ◽  
Responsibility To Protect ◽  
Vulnerable Groups ◽  
Community Based ◽  
Community Based Organizations ◽  
Care And Support ◽  
Depth Interviews ◽  
Physical And Sexual Abuse

Iddirs are traditional community-based organizations (CBOs) primarily established to facilitate burial ceremonies and comforting the bereaved. This study emphasized the additional roles and functions of Iddirs on supporting vulnerable groups of the community. The research has employed a qualitative research method, and it employs in-depth interviews, FGD and document analysis as data gathering instruments. Participants of the study were beneficiaries of Iddir (orphans and their caregivers), Iddir members and Iddir committees. The findings of this study showed that Iddir has significant contribution to improve the life of orphans and their caregivers. The types of care and support provided by Iddir include financial, material, medical, emotional, and psychosocial support. The study also shows that orphans in the area are vulnerable to a range of problems: food insecurity, lack of clothes and footwear, inadequate access to school and school materials, poor health, and physical and sexual abuse, in terms of their severity.

scholarly journals Providing safe maternity care under challenging conditions in rural Ethiopia: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Elin Mordal ◽  
Ingrid Hanssen ◽  
Andargachew Kassa Biratu ◽  
Solfrid Vatne
Keyword(s):  
Rural Areas ◽  
Maternity Care ◽  
Rural Ethiopia ◽  
Research Priority ◽  
Care And Support ◽  
Primary Hospital ◽  
Qualitative Descriptive ◽  
Expectant Mothers ◽  
Depth Interviews

Abstract Background Women’s health and the reduction in the global maternal mortality rate is a research priority worldwide. The aim of this study was to investigate the structural conditions that influence the maternity care provided for women in rural Ethiopia. Methods A qualitative descriptive study was conducted, composed of 28 individual in-depth interviews with midwives and women who had given birth during the past 8 months, and observations of maternity care at health centres and a primary hospital. A thematic analysis was conducted. Results The midwives do their utmost to save the lives of mothers and prioritise saving lives over providing compassionate care. Inadequate resources, such as equipment, medicine and water, affect the quality of care they provide for the birthing women. This creates a conflict between the midwives’ ideals and what conditions allow them to do. Families and the women’s network play important roles in providing care and support to the women who give birth in health facilities. Conclusions Structural conditions make it difficult for Ethiopian midwives in rural areas to provide optimal maternity care. In addition to the availability of professional midwifery care, the expectant mothers’ families and networks also tend to provide important support and care. Further studies on how to improve the quality of maternity care from the women’s perspective are needed.

Understanding Why Older People Develop a Wish to Die

Crisis ◽  
2011 ◽  
Vol 32 (4) ◽  
pp. 204-216 ◽  
Author(s):  
M. L. Rurup ◽  
H. R. W. Pasman ◽  
J. Goedhart ◽  
D. J. H. Deeg ◽  
A. J. F. M. Kerkhof ◽  
...  
Keyword(s):  
Older People ◽  
Cohort Studies ◽  
Conceptual Framework ◽  
Life Events ◽  
Traumatic Life Events ◽  
Quantitative Studies ◽  
Wish To Die ◽  
Open Coding ◽  
Death Wishes ◽  
Depth Interviews

Background: Quantitative studies in several European countries showed that 10–20% of older people have or have had a wish to die. Aims: To improve our understanding of why some older people develop a wish to die. Methods: In-depth interviews with people with a wish to die (n = 31) were carried out. Through open coding and inductive analysis, we developed a conceptual framework to describe the development of death wishes. Respondents were selected from two cohort studies. Results: The wish to die had either been triggered suddenly after traumatic life events or had developed gradually after a life full of adversity, as a consequence of aging or illness, or after recurring depression. The respondents were in a situation they considered unacceptable, yet they felt they had no control to change their situation and thus progressively “gave up” trying. Recurring themes included being widowed, feeling lonely, being a victim, being dependent, and wanting to be useful. Developing thoughts about death as a positive thing or a release from problems seemed to them like a way to reclaim control. Conclusions: People who wish to die originally develop thoughts about death as a positive solution to life events or to an adverse situation, and eventually reach a balance of the wish to live and to die.

scholarly journals Mothers’ Experiences and Perceptions of Facility-based Delivery Care in Rural Ethiopia

2021 ◽  
Vol 14 ◽  
pp. 117863292110176
Author(s):  
Elin Mordal ◽  
Ingrid Hanssen ◽  
Andargachew Kassa ◽  
Solfrid Vatne
Keyword(s):  
Family Involvement ◽  
Healthcare Facility ◽  
Healthcare Services ◽  
Skilled Birth Attendants ◽  
Adequate Treatment ◽  
Rural Ethiopia ◽  
Birth Attendants ◽  
Southern District ◽  
Depth Interviews ◽  
Respectful Care

In Ethiopia, delivery wards are a part of primary healthcare services. However, although the maternal mortality rate is very high, approximately 50% of mothers use skilled birth attendants. This study focused on how women in a rural southern district of Ethiopia experience maternity care offered at the local delivery wards. In this qualitative, exploratory study, 19 women who had given birth in a healthcare facility were interviewed in 2019. Individual in-depth interviews were supplemented with observations conducted at 2 different delivery wards in the same district in 2020. Two main themes emerged from the thematic content analysis: increased awareness and safety were the primary reasons for giving birth at a healthcare facility, and traditions and norms affected women’s birth experiences in public maternity wards. The main shortcomings were a shortage of medicine, ambulance not arriving in time, and lack of care at night. For some women, being assisted by a male midwife could be challenging, and the inability to afford necessary medicine made adequate treatment inaccessible. Providing continuous information gave the women a certain feeling of control. Strong family involvement indicated that collectivistic expectations were key to rural delivery wards. The healthcare system must be structured to meet women’s needs. Moreover, managers and midwives should ensure that birthing women receive high-quality, safe, timely, and respectful care.

scholarly journals Follow-up services for delirium after COVID-19—where now?

2021 ◽  
Author(s):  
Shibley Rahman ◽  
Kit Byatt
Keyword(s):  
Service Utilisation ◽  
Sustainable Business ◽  
Community Based ◽  
Care And Support ◽  
Early Supported Discharge ◽  
Business Cases ◽  
Older Inpatients ◽  
The Impact

Abstract Delirium is a common presentation in older inpatients with coronavirus disease 2019 (COVID-19), and a risk factor for cognitive decline at discharge. The glaring gaps in the service provision in delirium care, regardless of aetiology, after a hospital admission pre-existed the pandemic, but the pandemic arguably offers an opportunity now to address them. Whilst a delirium episode in itself is not a long-term condition, the context of it may well be, and therefore patients might benefit from personalised care and support planning. There is no reason to believe that the delirium following COVID-19 is fundamentally different from any other delirium. We propose that the needs of older patients who have experienced delirium including from COVID-19 could be addressed through a new model of post-acute delirium care that combines early supported discharge, including discharge-to-assess, with community-based follow-up to assess for persistent delirium and early new long-term cognitive impairment. Such a drive could be structurally integrated with existing memory clinic services. To succeed, such an ambition has to be flexible, adaptable and person-centred. To understand the impact on resource and service utilisation, techniques of quality improvement should be implemented, and appropriate metrics reflecting both process and outcome will be essential to underpin robust and sustainable business cases to support implementation of delirium care as a long-term solution.

scholarly journals Pengembangan Potensi Pusat Kota Serang sebagai Wisata Heritage Perkotaan Berbasis Masyarakat

2020 ◽  
pp. 144
Author(s):  
Arfah Sahabudin ◽  
Rusdin Rusdin ◽  
M. Sapari Dwi Hadian
Keyword(s):  
Qualitative Method ◽  
Heritage Tourism ◽  
Secondary Data ◽  
Decision Makers ◽  
Primary Data ◽  
Community Based ◽  
Tourist Destination ◽  
Library Research ◽  
Strategic Policy ◽  
Depth Interviews

The existence of the potential for heritage tourism in center of Kota Serang is now almost eliminated and forgotten, whereas if it is managed optimally, many benefits can be generated. The purpose of the research is to reveal the potential of heritage tourism in center of Kota Serang to be developed as a tourist destination. The research method used is a qualitative method. Primary data collection through observation techniques and in-depth interviews. Secondary data through library research. Data analysis uses an interactive model, through three activities namely data reduction, data presentation, and drawing conclusions. The results of the study indicate that there is no clear strategic policy and the lack of efforts in achieving optimal utilization of potential inheritance for tourism development. The synergy of all stakeholders and decision makers is needed to run in line with the vision and mission of development. The proposed development model is community-based heritage tourism. Keywords: heritage tourism, urban-community-based tourism, urban tourism

scholarly journals AN ANALYSIS OF ZAKAH FUNDS THROUGH COMMUNITY BASED DEVELOPMENT

2017 ◽  
Vol 22 (2) ◽  
pp. 403
Author(s):  
M. Ihsan Dacholfany ◽  
Nedi Hendri
Keyword(s):  
Group Discussion ◽  
Model Identification ◽  
Survey Method ◽  
Prototype Model ◽  
Planning Program ◽  
Community Based ◽  
The Poor ◽  
Identification Stage ◽  
Depth Interviews ◽  
Reconstruction Model

Abstrak Tujuan dari penelitian ini adalah untuk mengetahui model prototipe optimalisasi dana amal yang tepat dalam pemberdayaan masyarakat  miskin perkotaan berdasarkan kearifan lokal di Lampung. Penelitian ini menggunakan metode survei dengan data yang berasal dari hasil Diskusi Kelompok yang terfokus  dan wawancara mendalam dengan pembicara adalah tahap identifikasi model. Kemudian model rekonstruksi menggunakan analisis komparatif. Pengembangan Berbasis Masyarakat ini menggunakan metode yang melibatkan masyarakat dalam pembangunan. Di mana konstruksi dimulai pada tahap ide, perencanaan, kegiatan pengembangan program, penganggaran, pengadaan sumber daya hingga implementasi yang lebih menekankan pada keinginan nyata atau kebutuhan nyata  masyarakat dalam sekelompok orang.  Melalui Relasi Mustahiq yang sangat membantu sebagai sumber daya manusia, Dengan harapan Pengembangan Masyarakat Terpadu diharaplan  menjadi pusat penyaluran program tersebut sehingga programnya lebih terukur, dan terkendali.     Kata kunci: Dana Zakat, Pemberdayaan, Miskin Perkotaan, dan Pengembangan Berbasis Masyarakat   Abstract The aim of this study is to find a prototype model of the proper optimization of charity funds in the empowerment of the poor town based on local wisdom in Lampung. This study used a survey method with the data derived from the results of the Focus Group Discussion (FGD) and in-depth interviews with the speakers is the model identification stage. Then, reconstruction model using comparative analysis. Community Based Development (CBD) is a method  that involves communities in development. Where constructions began on the stage of ideas, planning, program development activities, budgeting, procurement of resources to the implementation of a more emphasis on real desire or the real needs of the community in a group of people. Through Mustahiq Relation Officer (MRO) ashuman resources assistant, Integrated Community Development (ICD) became the center ofthe distribution of the program so that the program is more scalable, and controlled.   Keywords: Zakah Fund, Empowerment, Poor Urban, and Community Based Development (CBD).  

HIV Prevention and Care of Transgender Women in an HIV and STI Clinic in the Paris Metropolitan Area

2020 ◽  
Vol 7 (4) ◽  
pp. 585-597
Author(s):  
Bahar Azadi ◽  
Julia Zélie ◽  
Florence Michard ◽  
Yazdan Yazdanpanah
Keyword(s):  
Sex Workers ◽  
Social Inclusion ◽  
Preventive Measures ◽  
Transgender Women ◽  
High Rate ◽  
Hiv Care ◽  
Medical Adherence ◽  
Policy And Practice ◽  
Community Based ◽  
Depth Interviews

Abstract HIV infection burden is globally high among transgender women (TGW) and particularly in TGW migrant sex workers and TGW subpopulations with structural inequalities like racism and classism. In addition to stigma related to transphobia, migrant TGW face multiple forms of discrimination because of intersection with other experiences of stigma related to migration and working as sex workers in the host society. This study explores the experiences of TGW seeking care in an HIV and STI clinic in Paris, to evaluate medical adherence, namely, the degree to which a patient is regularly followed up in care and adequately takes the treatment, and trans individuals' social inclusion in this health institution. We examined the different forms of HIV-associated stigma among TGW. A qualitative study was conducted using semistructural in-depth interviews with TGW receiving HIV care and HIV preventive measures. A description is given of how a community-based participation policy and practice in this clinic integrate an intersectional approach among TGW. This results in a high rate of medical adherence in TGW migrants and could lead to social integration.

Active and Healthy Aging

2017 ◽  
pp. 369-391
Author(s):  
Emine Özmete
Keyword(s):  
Qualitative Research ◽  
Delivery System ◽  
Healthy Aging ◽  
Healthcare Delivery ◽  
Healthcare Services ◽  
Capital City ◽  
Elderly Persons ◽  
Healthcare Delivery System ◽  
Care And Support ◽  
Depth Interviews

This study aims to investigate the difficulties experienced by elderly persons in accessing healthcare services and their satisfaction with issues as regards the healthcare system. In this study, qualitative research was carried out to assess the difficulties regarding the healthcare delivery system and satisfaction with the healthcare services. This qualitative research was performed through in-depth interviews with 6 men and 4 women aged 65+ years, in Ankara, the capital city of Turkey. It was discovered that elderly persons required the support of others to access a doctor, a health institution or hospital and the care and support of others for the regular intake of their drugs with increasing age. They were satisfied with the current family physician program. The most significant challenges experienced by elderly persons regarding the healthcare delivery system included crowded hospitals, difficulty walking, the unavailability of wheel chairs, and inadequate assistance from support staff.

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