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Older people’s perceptions of health and wellbeing in rapidly ageing low- and middle-income countries

ALBONE, Rachel
2019

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This report presents the findings of an analysis of data collected by HelpAge International and its network members using HelpAge’s Health Outcomes Tool. The tool is designed to collect data to better understand health and care in older age, and to measure the impact of HelpAge’s health and care programmes. It was developed in response to the challenges posed by the lack of data on older people’s health and care, particularly in low- and middle-income countries, and the resulting lack of understanding about how best to provide age, gender and disability sensitive services for older women and men. The tool was used between 2014 and 2017 in nine low- and middle-income countries across Africa, Asia and Latin America,1 and gathered data from over 3,000 older people. The findings are presented here in the context of the current debate and evidence on older people’s right to health.

This report explores three different areas in relation to ageing and health: older people’s access to health services; availability of care and support; and the impact both health, and care and support services have on older people’s health status, functional ability and wellbeing.

 

 

 

Missing millions: How older people with disabilities are excluded from humanitarian response

SHEPPARD, Phillip
POLACK, Sarah
McGIVERN, Madeleine
July 2018

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The aim of this study was to explore the experiences of older people with disabilities across a range of humanitarian settings, considering:

  • whether older people with disabilities have additional needs and challenges accessing humanitarian assistance and protection
  • what factors facilitate or limit access by older people with disabilities to humanitarian assistance and protection
  • to what extent is humanitarian response inclusive of older people with disabilities

A systematic literature review of published studies was conducted. Key online humanitarian guidelines were explored to review how far they explicitly address older people with disabilities. Data from six population-based disability surveys comparing the living situation of older people with and without disabilities were analysed. These included databases from two crises-affected populations in Haiti (post-earthquake) and Palestine. Data from four non-humanitarian settings was also reviewed to explore more broadly the situation for older people with disabilities – India, Guatemala, Cameroon and Nepal. Interviews were held with older people with disabilities, members of their families and local key informants in two conflict-affected populations in Ndutu and Mtendeli refugee camps in Western Tanzania, and Donetsk and Luhansk regions of Eastern Ukraine to find out about their experiences. Staff of five international agencies working in humanitarian response were also interviewed. 

 

Findings highlight particular issues facing older people with disabilities in humanitarian crises: more risk escaping from danger;  barriers to accessing social protection and work; barriers to accessing health and rehabilitation services; barriers to accessing food and other essentials; unsuitable housing and poor living conditions;  insecurity and discrimination; threats to dignity and independence; social isolation and loneliness; risks to mental health; and missing from humanitarian response.

 

A table brings together the findings from the different components of the research to show the needs, risks, barriers and enablers for older people with disabilities identified in the research. Recommendations are provided to humanitarian donors, policy makers and practitioners

Humanitarian inclusion standards for older people and people with disabilities

ADCAP
TILL, Celia
et al
February 2018

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The Humanitarian inclusion standards for older people and people with disabilities provide guidance across all areas and at all stages of emergency response to ensure older people and people with disabilities are not left out.

The standards consist of nine key inclusion standards, including identification, safe and equitable access, knowledge and participation, and learning. Alongside these, there are seven sector-specific inclusion standards, which include protection, shelter, health, and water, sanitation and hygiene.

Each standard comes with key actions, guidance, tools and resources, and case studies illustrating how older people and people with disabilities have been included in humanitarian responses.

The sector-specific standards provide guidance in three key areas: data and information management, addressing barriers to inclusion, and participation of older people and people with disabilities.

By implementing the key action points provided, organisations will build up a greater evidence base, deliver more inclusive programmes, and be able to better demonstrate impact on the lives of those most at risk during humanitarian crises.

The standards can be used as guidance during programme development, implementation and monitoring, and as a resource for training and advocacy.

A situational analysis of disability and aging in Myanmar

ZEITZER, Ilene
2018

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The interaction of aging and disability is explored in the context of Myanmar. Blindness and deafness data are taken from the census. Carer givers and the family are discussed. Goverment and civil society responses are also discussed.

A briefing paper is also available.

Global AgeWatch Insights. The right to health for older people, the right to be counted

ALBONE, Rachel
et al
2018

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This report considers the progress being made to achieve older people's right to health amid the global drive towards universal health coverage. It explores how older people are currently accessing health services and what changes need to be made to improve on this. It considers the role of data in driving and informing changes to health systems and the services they deliver. Data must be collected with and about older people to ensure adequate evidence for service design and delivery that is targeted and appropriate. This report explores the adequacy of current data systems and collection mechanisms and how, alongside health systems, they must be adapted in an ageing world. 

 

This report is supported by 12 country profiles (for Argentina, Colombia, El Salvador, Kenya, Lebanon, Moldova, Myanmar, Pakistan, Serbia, Tanzania, Vietnam and Zimbabwe; see Appendix 1). These provide national information on trends in the physical and mental health status of older people, and population-level information on access to UHC. The profiles are supplemented by data mapping, showing the national data available on older people’s health in the 12 profile countries, and revealing the data gaps. The data mapping results are available at www.GlobalAgeWatch.org.

Minimum standards for age and disability inclusion in humanitarian action : pilot version

AGE AND DISABILITY CONSORTIUM
2015

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This pilot version of the Minimum Standards for Age and Disability Inclusion in Humanitarian Action has “been developed for use by all practitioners involved in humanitarian response, including staff and volunteers of local, national, and international humanitarian agencies, with the expectation that the inclusion of people with disabilities and older people is feasible at every stage of the response and in every sector and context. The Standards are intended to inform the design, implementation, monitoring and evaluation of humanitarian programmes; to strengthen accountability to people with disabilities and older people; and to support advocacy, capacity-building and preparedness measures on age and disability across the humanitarian system

 

The Standards are drawn from a wide-ranging review of existing guidance and standards developed by humanitarian actors over recent years. This includes material from organisations with a special focus on disability and/or older age, together with key documents, including the Sphere Handbook, the Sphere Companion Standards and the Core Humanitarian Standard on Quality and Accountability (CHS). The Minimum Standards for Age and Disability Inclusion do not create entirely new demands on humanitarian actors; rather, they clarify and reinforce what is already required if broader standards of impartial humanitarian programming and the principles of the Humanitarian Charter are to be upheld”

“We can also change” Piloting participatory research with persons with disabilities and older people in Bangladesh

BURNS, Danny
OSWALD, Katy
November 2014

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Sightsavers, HelpAge International, ADD International and Alzheimer’s Disease International worked together with the Institute of Development Studies (IDS) to bring the perspectives of those who live in poverty or who are highly marginalised into post-2015 policy making. The aim of the research was to understand better the experiences of social, political and economic exclusion of persons with disabilities and older people in Bangladesh from their own perspectives. Two groups (community and NGO) of peer researchers collected 70 stories from poor and/or excluded persons with disabilities and older people from each of the two sites: Bhashantek, an urban slum in Dhaka; and Cox’s Bazar, a rural area in southeast Bangladesh. From the stories collected and analysed in workshops, the peer researchers identified 13 priority areas that affect persons with disabilities and older people: accidents and disasters; livelihoods; access to education; medical treatment; family support; exclusion and mistreatment; superstition; access to services; mobility; marriage; land; rape and sexual abuse; the role of grassroots community-based organisations. Recommendations from the researchers are made in each area. The peer research programme was evaluated and guidelines for its use are provided.

Guidance on including older people in emergency shelter programmes

HELPAGE INTERNATIONAL
INTERNATIONAL FEDERATION OF RED CROSS AND RED CRESCENT SOCIETIES (IFRC)
2011

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Given the lack of attention to older people in shelter programmes, these guidelines provide the following five key action points for including older people in shelter programmes: understand the needs and capacities of older people; ensure that older people participate and are represented; target vulnerable older people; incorporate age-friendly in both household and community shelters; and promote coordination, cooperation and sharing. Clear information is provided for each action point action supported by case studies, and the recommendations provide a framework for the different phases of a shelter programme (temporary, transitional and permanent). This resource is useful for people interested in including older people in emergency shelter programmes

Making a living last longer : insights into older people's livelihood strategies

ERB, Susan
2011

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This research report explores the challenges faced by older people in securing a sustainable livelihood in four countries. The research found that older people face significant barriers in achieving livelihood security due to lack of regular, predictable and sufficient cash income such as non-contributory pensions. Gender, destitution, and emergency preparedness emerged as cross-cutting issues that affect older people’s livelihood challenges regardless of location. The research also found that older people have only limited access to microfinance institutions (MFIs) and banks, and therefore to credit and savings facilities. It concludes by highlighting key guiding principles for governments, community-based organisations, NGOs, MFIs and others working to support older people to achieve greater livelihood security

Guidance on including older people in emergency shelter programmes : a summary

HELPAGE INTERNATIONAL (HAI)
INTERNATIONAL FEDERATION OF RED CROSS AND RED CRESENT SOCIETIES (IFRC)
2011

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This summary provides a brief introduction and recommends the following five key action points for including older people in shelter programmes: understand the needs and capacities of older people; ensure that older people participate and are represented; target vulnerable older people; incorporate age-friendly in both household and community shelters; and promote coordination, cooperation and sharing. This resource is useful for people interested in including older people in emergency shelter programmes

What do older people need in emergencies?|The experience in the Philippines after typhoon Ketsana

FORMILLEZA, Sammie P
2011

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This report presents a study on the experiences of older people in 5 rural and urban communities of the Philippines following Typhoon Ketsana. The research methods included key informant interviews (KII), focus group discussions (FGD) and a review of secondary materials. The results provide a summary of older people’s needs and problems on the following issues: basic food needs, shelter (including evacuation), water supply, health, clothing, household articles, bedding and livelihood activities. It is recommended that it is critical to work with the older people and their community organisations in identifying ways and means to address their concerns during disaster and recovery situations

Caught up in conflict : older people in humanitarian crises in Kyrgyzstan

MIKKONEN-JEANNERET, Eppu
RAYAPOVA, Roza
SCHLAEFFER, Alois
June 2010

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This report presents the results of phone call survey led by HelpAge International with older people affected by the conflict situation in Osh in 2010. "The interviews revealed that two thirds of the respondents were coping badly with the situation, about 60 per cent stated that they found it difficult to get food. While 70 per cent said that they had to take medicine regularly, only about one third had some medication left. It came out that older people in humanitarian crisis often face life-threatening problems. However, there were also positive examples of how older people cope with these threats. They often are, against all odds, still caring for other people and help out each other, regardless of ethnics or religion"

Assessment report : the vulnerability of older people in post-conflict Osh, Kyrgyzstan

MACDONALD, David
2010

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"This report discusses the findings of a survey which was organized by HelpAge International with the intention of evaluating both the social situation and the requirements of vulnerable older people in a post conflict environment. The survey was undertaken in Osh, Kyrgyzstan, following the violent events of June 2010 in south of the country. It was conducted by Luch Lotosa, a local NGO, and the results were evaluated by HelpAge staff. The purpose of the survey and this resulting report was to assess the nature of the specific challenges of vulnerable older people in Osh today in order to inspire action on their behalf on the part of HelpAge’s emergency team as well as all other organizations working in the area. The results of the survey suggest a myriad of problems including those of emotional, social and subsistence nature. However, the greatest challenges older people in Osh appear to be facing are economic. According to this survey, the economic constraints people are facing are significant enough to have a major detrimental impact on the ability of many of the most vulnerable to feed and clothe both themselves and their dependents. The scale of the problems reported in the survey appears rather large; however, it is the prognosis for the future which holds the most concern"

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