Women Caregivers Under the Spanish Autonomy and Dependence System: A New Social Underclass?

2021 ◽  
pp. 0192513X2110675
Author(s):  
José Ángel Martínez-López ◽  
Juan Carlos Solano Lucas ◽  
Lola Frutos Balibrea ◽  
Marcos Bote Díaz

Long-term care in Spain has traditionally been provided by women as consequence of a family welfare system based historically on familism and sexual division of labour. The Autonomy and Dependence Law, passed in 2006, involved the regulation by the State of informal care. However, the economic crisis is maintaining and stressing gender differences in relation to care since a new profile of women is being built: poor caregivers, as a specific group responsible for the provision of care, becoming an ‘internal market’ linked to the application of the so called Dependence Law. This study presents an analysis of key secondary sources from the System of Autonomy and Attention to Dependency, the Unemployment System and the most relevant indicators of poverty and social exclusion. In addition, an ad hoc survey and semi-structured interviews were conducted. 55.2% of caregivers are poor women, inactive or unemployed and use the cash-for-care as basic income.

Author(s):  
Charles Fonchingong Che ◽  
Marcellus Mbah

Amidst shrinking budgets for community development in most of sub-Saharan Africa, the social solidarity economy is touted as a model in local development. This article situates solidarity initiatives and capability-focused outcomes that deliver enhanced livelihoods, social security and community development. The conceptual framing of social theory, social capital and social economy informs this case study with focus on the Ndong Awing Cultural and Development Association, North-West region, Cameroon. The analysis of semi-structured interviews and secondary sources suggests that solidarity networks such as njangis, cooperatives, quarter development unions and diaspora networks promote village-centric development. These overlapping networks generate scarce financial and human resources–essential packages for livelihoods and welfare. Emerging state policy is yet to calibrate these mechanisms of ground-up, mutual development drives. Galvanising these solidarity assets require meaningful co-productionand revamped state−community relations. This article offers a paradigm shift in how village groups mobilise income, capital and financing of village projects, nurtured through human development and agency.


2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Lucia Leporatti ◽  
Marcello Montefiori

Abstract The increasing life expectancy poses challenges on the future sustainability of long-term care services that today strongly depend on informal care provided within the family by working age children. Ongoing social changes are likely to weaken the informal provision of care. The paper derives optimal policies to help the policy-maker to choose innovative and sustainable solutions to support home care, taking into account the severity of health condition and the different opportunity costs of carers. Drawing inspiration from real world policies, the suitable policy combines lump-sum transfers, paid permissions from work and in-kind provisions. In some circumstances, benefits can favour higher rather than lower income individuals. In the context of information asymmetry, the implementation of the second-best outcome requires the level of care of the most subsidized households’ to be forced towards certain targets to avoid adverse selection.


2021 ◽  
pp. 104973232110041
Author(s):  
Candidus C. Nwakasi ◽  
Kate de Medeiros ◽  
Foluke S. Bosun-Arije

Some Nigerians, in their effort to make sense of dementia symptoms, use descriptions that may stigmatize people with dementia and their families. This qualitative descriptive study focused on the everyday understanding of dementia and the impact of stigma on the caregiving experiences of informal female Nigerian dementia caregivers. Semi-structured interviews were conducted with a purposive sample of 12 adult informal female caregivers in Nigeria and analyzed for themes. Afterward, results were presented to focus groups of 21 adult Nigerians residing in the United States for more contextual insight on the findings. The three major themes were misconceptions about dementia symptoms, caregiving protects against stigmatization, and stigma affects caregiving support. Overall, we argue that knowledge deficit, poor awareness, and traditional spiritual beliefs combine to drive dementia-related stigmatization in Nigeria. Strategies such as culturally appropriate dementia awareness campaigns and formal long-term care policies are urgently needed to help strengthen informal dementia caregiving in Nigeria.


2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Natalia Arias-Casais ◽  
Eduardo Garralda ◽  
Miguel Antonio Sánchez-Cárdenas ◽  
John Y. Rhee ◽  
Carlos Centeno

Abstract Background Palliative care (PC) development cannot only be assessed from a specialized provision perspective. Recently, PC integration into other health systems has been identified as a component of specialized development. Yet, there is a lack of indicators to assess PC integration for pediatrics, long-term care facilities, primary care, volunteering and cardiology. Aim To identify and design indicators capable of exploring national-level integration of PC into the areas mentioned above. Methods A process composed of a desk literature review, consultation and semi-structured interviews with EAPC task force members and a rating process was performed to create a list of indicators for the assessment of PC integration into pediatrics, long-term care facilities, primary care, cardiology, and volunteering. The new indicators were mapped onto the four domains of the WHO Public Health Strategy. Results The literature review identified experts with whom 11 semi-structured interviews were conducted. A total of 34 new indicators were identified for national-level monitoring of palliative care integration. Ten were for pediatrics, five for primary care, six for long-term care facilities, seven for volunteering, and six for cardiology. All indicators mapped onto the WHO domains of policy and education while only pediatrics had an indicator that mapped onto the domain of services. No indicators mapped onto the domain of use of medicines. Conclusion Meaningful contributions are being made in Europe towards the integration of PC into the explored fields. These efforts should be assessed in future regional mapping studies using indicators to deliver a more complete picture of PC development.


2017 ◽  
Vol 55 (1) ◽  
pp. 33-48 ◽  
Author(s):  
Ann Leaf ◽  
George Odhiambo

Purpose The purpose of this paper is to report on a study examining the perceptions of secondary principals, deputies and teachers, of deputy principal (DP) instructional leadership (IL), as well as deputies’ professional learning (PL) needs. Framed within an interpretivist approach, the specific objectives of this study were: to explore the extent to which DPs are perceived as leaders of learning, to examine the actual responsibilities of these DPs and to explore the PL that support DP roles. Design/methodology/approach The researchers used multiple perspective case studies which included semi-structured interviews and key school document analysis. A thematic content analysis facilitated qualitative descriptions and insights from the perspectives of the principals, DPs and teachers of four high-performing secondary schools in Sydney, Australia. Findings The data revealed that deputies performed a huge range of tasks; all the principals were distributing leadership to their deputies to build leadership capacity and supported their PL in a variety of ways. Across three of the case study schools, most deputies were frequently performing as instructional leaders, improving their school’s performance through distributing leadership, team building and goal setting. Deputy PL was largely dependent on principal mentoring and self-initiated but was often ad hoc. Findings add more validity to the importance of principals building the educational leadership of their deputies. Research limitations/implications This study relied upon responses from four case study schools. Further insight into the key issues discussed may require a longitudinal data that describe perceptions from a substantial number of schools in Australia over time. However, studying only four schools allowed for an in-depth investigation. Practical implications The findings from this study have practical implications for system leaders with responsibilities of framing the deputies’ role as emergent educational leaders rather than as administrators and the need for coherent, integrated, consequential and systematic approaches to DP professional development. Further research is required on the effect of deputy IL on school performance. Originality/value There is a dearth of research-based evidence exploring the range of responsibilities of deputies and perceptions of staff about deputies’ IL role and their PL needs. This is the first published New South Wales, Australian DP study and adds to the growing evidence around perceptions of DPs as instructional leaders by providing an Australian perspective on the phenomenon. The paper raises important concerns about the complexity of the DP’s role on the one hand, and on the other hand, the PL that is perceived to be most appropriate for dealing with this complexity.


2021 ◽  
Vol 16 (3) ◽  
Author(s):  
Mercy Akrofi Ansah ◽  
Mercy Adzo Klugah

The relevance of language for quality healthcare delivery cannot be overemphasised. Within the framework of communication accommodation theory, this paper discusses language barriers in expatriate doctor–patient communication in three state-owned hospitals in Ghana, and the strategies employed by the medical personnel to bridge communication gaps. The study design is qualitative and the data were obtained through semi-structured interviews with 16 expatriate doctors, three nurses and three patients. Furthermore, observation of five patient–doctor interactions was undertaken and notes taken. Both datasets were then analysed using the qualitative conventional content analysis approach. The findings revealed that the expatriate doctors employed convergence strategies such as ad hoc interpreters, gestures, picture charts and electronic dictionaries to deal with language barriers. The study is expected to stimulate further research into innovative ways of dealing with language barriers in expatriate doctor–patient interactions.


Viruses ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 1410
Author(s):  
Ana Paula Lopes de Melo ◽  
Tereza Lyra ◽  
Thália Velho Barreto de Araújo ◽  
Maria do Socorro Veloso de Albuquerque ◽  
Sandra Valongueiro ◽  
...  

The congenital Zika syndrome (CZS) epidemic in Brazil turned the spotlight on many other factors beyond illness, such as poverty, gender, and inequalities in health care. Women were the emblematic subjects in this study, not only because Zika virus is a vertical transmission disease, but also because women—in Brazil and elsewhere—typically represent the primary carers of children. This is a qualitative analytic study using semi-structured interviews with 23 female family carers of children with CZS in Brazil. Through the concept of biographical disruption, we analysed some of the social impacts experienced by women involved in caring for affected children. We identified that the arrival of a child with disabilities resulted in biographical disruption similar to that experienced by people with chronic illnesses. Social support networks were configured through an alliance between women from different generations, revealing solidarity networks, but also highlighting the absence of the state in tackling these social vulnerabilities. Tracing the pathways of these biographical narratives enables us to understand how women have acted to defend the value of their disabled children in a society structured on the model of body normativity and inequality. These results may provide clues to a more inclusive society, which confronts systems of gender oppression and the sexual division of labour focused on women.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S554-S554
Author(s):  
Candace C Harrington ◽  
Candace C Harrington

Abstract Previous interventional studies have failed to show long-term improvements in caregiver stress, health indices, burden, or delay in long-term care placement. The Virtual Dementia Tour® (VDT) provides a vicarious first-person perspective of symptoms related to dementia. This interpretative phenomenological study revealed family dementia caregivers’ perceptions of the VDT® and its impact on their perception of a person living with dementia. In-depth open semi-structured interviews were conducted with ten VDT® participants following a community event. Participants’ statements described a life-changing process with eye-opening epiphanies about the lived experience of dementia and served as a “call to action” to change their approach to caring. Innovative advances in family caregiving research are critical to support this valuable geriatric workforce. This original study provided new knowledge about the value of the VDT® to inform interventions that harness the unrecognized power of vicarious experiences like the VDT® for family dementia caregivers to improve long-term outcomes.


2021 ◽  
Vol 26 (48) ◽  
Author(s):  
Françoise Renard ◽  
Aline Scohy ◽  
Johan Van der Heyden ◽  
Ilse Peeters ◽  
Sara Dequeker ◽  
...  

Background COVID-19-related mortality in Belgium has drawn attention for two reasons: its high level, and a good completeness in reporting of deaths. An ad hoc surveillance was established to register COVID-19 death numbers in hospitals, long-term care facilities (LTCF) and the community. Belgium adopted broad inclusion criteria for the COVID-19 death notifications, also including possible cases, resulting in a robust correlation between COVID-19 and all-cause mortality. Aim To document and assess the COVID-19 mortality surveillance in Belgium. Methods We described the content and data flows of the registration and we assessed the situation as of 21 June 2020, 103 days after the first death attributable to COVID-19 in Belgium. We calculated the participation rate, the notification delay, the percentage of error detected, and the results of additional investigations. Results The participation rate was 100% for hospitals and 83% for nursing homes. Of all deaths, 85% were recorded within 2 calendar days: 11% within the same day, 41% after 1 day and 33% after 2 days, with a quicker notification in hospitals than in LTCF. Corrections of detected errors reduced the death toll by 5%. Conclusion Belgium implemented a rather complete surveillance of COVID-19 mortality, on account of a rapid investment of the hospitals and LTCF. LTCF could build on past experience of previous surveys and surveillance activities. The adoption of an extended definition of ‘COVID-19-related deaths’ in a context of limited testing capacity has provided timely information about the severity of the epidemic.


2019 ◽  
Vol 8 (8) ◽  
pp. 462-466 ◽  
Author(s):  
Naoki Ikegami

Long-term care (LTC) must be carefully delineated when expenditures are compared across countries because how LTC services are defined and delivered differ in each country. LTC’s objectives are to compensate for functional decline and mitigate the care burden of the family. Governments have tended to focus on the poor but Germany opted to make LTC universally available in 1995/1996. The applicant’s level of dependence is assessed by the medical team of the social insurance plan. Japan basically followed this model but, unlike Germany where those eligible may opt for cash benefits, they are limited to services. Benefits are set more generously in Japan because, prior to its implementation in 2000, health insurance had covered long-stays in hospitals and there had been major expansions of social services. These service levels had to be maintained and be made universally available for all those meeting the eligibility criteria. As a result, efforts to contain costs after the implementation of the LTC Insurance have had only marginal effects. This indicates it would be more efficient and equitable to introduce public LTC Insurance at an early stage before benefits have expanded as a result of ad hoc policy decisions.


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