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Service delivery reforms for Asian ageing societies: a cross-country study between Japan, South Korea, China, Thailand, Indonesia, and the Philippines
- Authors:
- NODA Shinichiro, et al
- Journal article citation:
- International Journal of Integrated Care, 21(2), 2021, p.1. Online only
- Publisher:
- International Foundation for Integrated Care
Introduction: Japan’s health policies to address the most advanced-aged society have been the target of focus in Asia, but no studies have investigated this issue using tools for cross-country comparisons. Theory and methods: A cross-country study design was used to compare healthcare reform policies with a framework in Japan, Korea, Thailand, China, Indonesia, and the Philippines. Data were collected via document reviews and key informant interviews. Results: Three distinctions were identified. First, all countries except for the Philippines have policy decisions regarding reforms for the existing service delivery systems for healthcare, long-term care and welfare. Second, the most extensive service delivery reform is currently being implemented in Japan, whose system is shifting to primary health care. Third, the direction of the transformation of service delivery system is different between Thailand and China despite a similar level of ageing society. China has made progress on facility-based care integration between health and social care, whereas Thailand is focusing on home-based care. Conclusions and discussion: Doctor and hospital-based healthcare delivery system requires more drastic reform for an aged society. This fact implies that strengthening primary health care is not only useful for current health issues but also an investment for the aged society near future in low- and middle-income countries. (Edited publisher abstract)
Establishing the well-being of the rural-urban elderly population: a case study of Indonesia
- Authors:
- MOHD Saidatulakmal, et al
- Journal article citation:
- Hong Kong Journal of Social Work, 44(2), Winter 2010, pp.105-120.
- Publisher:
- World Scientific Publishing Company
- Place of publication:
- Singapore
Indonesia is experiencing an aging population due to longer life expectancy and a decline in fertility. This paper examines the influence of various demographic factors (age, marital status, social class and perceived health) and economic conditions as well as living and familial arrangements on the well-being of the elderly. Data was collected from 302 elderly people covering the rural and urban areas of Jakarta, Yogyakarta and Bali using a survey-interview method. The participants were: 157 elderly with a mean age of 70 in the urban areas; and 145 elderly with a mean age of 74 in the rural areas. A causal model of well-being was employed to analyse the data obtained. The model of well-being was then tested using path analysis to test the causal relationships among the variables. In general, the well-being of the elderly in the urban and rural areas did not show much difference. The causal model of well-being of elderly in the rural areas indicated direct relationships between well-being and age, living arrangement and social status. The causal model of well-being of elderly in the urban areas were more complex, showing direct relationships between well-being and age, familial arrangement, social status and perceived health.
A framework for understanding old-age vulnerabilities
- Authors:
- SCHRÖDER-BUTTERFILL Elizabeth, MARIANTI Ruly
- Journal article citation:
- Ageing and Society, 26(1), January 2006, pp.9-35.
- Publisher:
- Cambridge University Press
This article reviews how the concept of vulnerability had been developed in various disciplines. It goes on to develop a framework which captures those aspects of a vulnerability approach which are most relevant to the study of ageing. The article then examines these domains with reference to the research literature on ageing and old age: what might be meant by outcomes, exposure, threats and coping capacities with reference to older people. The article finally 're-assembles' the concept through two examples, one based on work on vulnerability to homelessness in old age in Britain, and the other on vulnerability to a lack of care in old age, which draws on the authors work in Indonesia.
Old-age vulnerability, ill-health and care support in urban areas of Indonesia
- Author:
- VAN EEUWIJK Peter
- Journal article citation:
- Ageing and Society, 26(1), January 2006, pp.61-80.
- Publisher:
- Cambridge University Press
This paper reports a study of the care and support received by chronically ill older people in urban areas of North Sulawesi, Indonesia. The results found that the majority rely on close family members, most often a wife or a daughter (or both), to provide treatment, care and support. The main care activities are support with ‘activities of daily living’ and therapies for specific illnesses. Care-givers experience manifold burdens when providing care for frail older people, and tend to reduce their support as the severity and duration of their relative's illness increases. It is shown that an older person's vulnerability to inadequate care provision, or its withdrawal, is associated with marital status and gender (unmarried women and widows being most at risk), poverty, weak support networks, and having care-givers who are themselves vulnerable.
Migration, social structure and old-age support networks: a comparison of three Indonesian communities
- Author:
- KREAGER Philip
- Journal article citation:
- Ageing and Society, 26(1), January 2006, pp.37-60.
- Publisher:
- Cambridge University Press
Contemporary trends in population ageing and urbanisation in the developing world imply that the extensive out-migration of young people from rural areas coincides with, and is likely to exacerbate, a rise in the older share of the rural population. This paper examines the impact of migration on vulnerability at older ages by drawing on the results of anthropological and demographic field studies in three Indonesian communities. The methodology for identifying vulnerable older people has a progressively sharper focus, beginning first with important differences between the communities, then examining variations by socio-economic strata, and finally the variability of older people's family networks. Comparative analysis indicates considerable heterogeneity in past and present migration patterns, both within and between villages. The migrants' contributions are a normal and important component of older people's support, often in combination with those of local family members. Higher status families are commonly able to reinforce their position by making better use of migration opportunities than the less advantaged. Although family networks in the poorer strata may effect some redistribution of the children's incomes, their social networks are smaller and insufficient to overcome their marked disadvantages. Vulnerability thus arises where several factors, including migration histories, result in unusually small networks, and when the migrations are within rural areas.