Abstract

Background: A community based case study on the situation of elderly people who are above 60 years of age living in rural areas, mainly with respect to their financial capability to withstand healthcare needs has been undertaken in this work.

Method: Primary cross sectional data from the elderly people belonging to Sumi tribe living in rural areas of Nagaland, located at the North Eastern region of India generated during 2017 has been used in this present study. A statistical descriptive financial status and security for healthcare financing from household use perspective has been emphasized in our study.

Findings: This present case study on the tribal elderly people living in rural areas of Nagaland in India observed a serious concern for healthcare financing arising from inadequate regular income and savings accentuated by the absence of efficient provision of geriatric healthcare services. Majority of the elderly people in rural Nagaland who are dependent on agriculture and old age pensions for income are faced with a situation of declining income and in general among those negatively affected are the very old ones above 80 years, elderly women and widowed elderly.

Application/Improvements: Declining of income and savings among the rural elderly has an adverse negative impact on healthcare in particular and wellbeing in general. Steps to improve the economic status of the rural elderly through improvement in providing sufficient and efficient income distribution is advisable and at the same time healthcare can be greatly improved if easily accessible, affordable and geriatric friendly healthcare services can be made possible at the primary and community healthcare centers.

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Abstract

Background: A case study on the nature and determinants of work participation among rural elderly people has been undertaken in this work. The paper analyses the economic life with respect to work participation among elderly people belonging to Sumi community living in rural areas of the state Nagaland in India.

Methods: Cross sectional primary data on rural elderly above 60 years of age has been used in the study. And in order to study the nature and determinants of work participation of the elderly we have applied both descriptive statistical analysis and multinomial logistic regression analysis to present our findings.

Findings: Majority of elderly in the study area were still found to be engaged in economic activities both as full time and part time workers respectively. Among those elderly people working, majority of the respondents were found to be in informal economic activity such as agriculture and allied activities. Factors such as age of the elderly, sex, income and health were found to be statistically significant determinants of elderly work participation.

Application/Improvement: Based on our findings, it has been observed that one of the main concerns for the prolonged work participation among elderly is due to the effect of economic necessity. As lack of economic security among rural elderly pushes them to remain working and that factor such as health enables elderly to earn livelihood which possibly can secure them against poverty, policies should be directed towards positively improving the wellbeing of the elderly people not only on economic stability but also towards healthy ageing.

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Abstract

Background and Objective: Quality of public healthcare service is one of the major issues in the rural areas of India. Though integrated healthcare is provided by the government, the utilization of the same has been low due to various reasons and one could be the quality of service itself. Therefore, it is important that quality is assessed to constantly improve upon the health care services. This will help in more health care utilization by the rural people, which will help meeting the targets of the Sustainable Development Goals (SDGs) in health care domain.

Data and Methodology: The data have been collected from the field in the summer of 2015. We have used Principal Component Analysis (PCA) to examine the structure of the relationship among variables representing the perceived quality dimensions of the rural public health care. The assessment is based on Likert scale of 1 to 5; where 1= strongly disagree, 2=disagree, 3=neither agree nor disagree, 4=agree and 5=strongly agree on access, usage, reliability and satisfaction factors. We also assessed the quality difference between Primary Health Centres (PHCs) and Community Health Centres (CHCs) by using t-test.

Results and Applications: Easy accessibility is a problem with the public health care service in the rural areas of Assam. Usage of the public health care service is poor even though reliability and satisfaction of the service are adequate. PHCs are found to be better than CHCs except in the reliability aspect. This could be due to the fact that accessibility of PHCs is better than the CHCs. The findings of the study suggest that the rural public health care needs to be improved and they should not act only as referral units. In order to improve the usage of the publicly provided health care service, awareness on health care utilization needs to be created which would also improve the health status of the people and also reduce the out of pocket spending on health care. However, for this to happen, improvement in the service provided is necessary.

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