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Social networks and their impact on access to health care: insights from older widows living alone in Kottayam, South India
Ageing & Society ( IF 3.718 ) Pub Date : 2021-07-29 , DOI: 10.1017/s0144686x21001100
Mathew Sunil George 1 , Rakhal Gaitonde 2 , Rachel Davey 3 , Vyas Sukumaran 4 , Itismita Mohanty 3 , Penney Upton 3
Affiliation  

The feminisation of ageing observed across the world is a significant challenge in many societies. Women's greater longevity is associated with the increased likelihood of age-related disability and morbidity. Furthermore, gendered disadvantage and poverty can make access to health care increasingly problematic in later years. Among the Indian states, Kerala has the highest number of residents above the age of 60 and many are older widows. Given this context, this paper explores what promotes access to health care for older widows living alone in the south Indian state of Kerala. Thirty-two in-depth interviews, eight focus group discussions and eight units of participant observation were carried out among widows, health-care providers and key informants. Applying a reflexive inductive approach to our analysis, the main barriers to access that emerged were altered family structures and loneliness, whilst enablers included good social networks and access to neighbourhood clinics. Our participants’ social networks were drawn from three levels: family, neighbourhood and the wider community. The ability to form a personal community from their social networks and the quality of relationships within this community strongly predicted the capacity to access health care. Efforts to improve access to health care for older widows requires a response that is rooted in the socio-cultural context of the community. Comprehensive social protection policies that promote initiatives to engender social capital among the older population, decentralised primary health-care services, and the training and sensitisation of health service staff would be key to promote equitable access for older widows.



中文翻译:

社交网络及其对获得医疗保健的影响:来自印度南部科塔亚姆独居老年寡妇的见解

世界各地观察到的老龄化女性化是许多社会面临的重大挑战。女性的更长寿与与年龄相关的残疾和发病率增加的可能性有关。此外,性别劣势和贫困会使晚年获得医疗保健的问题越来越多。在印度各邦中,喀拉拉邦的 60 岁以上居民人数最多,其中许多是老年寡妇。鉴于此背景,本文探讨了是什么促进了印度南部喀拉拉邦独居的老年寡妇获得医疗保健的机会。对寡妇、医疗保健提供者和主要知情人进行了 32 次深入访谈、8 次焦点小组讨论和 8 个参与观察单元。将反身归纳方法应用于我们的分析,出现的主要障碍是家庭结构的改变和孤独,而促成因素包括良好的社交网络和获得社区诊所的机会。我们参与者的社交网络来自三个层面:家庭、邻里和更广泛的社区。从他们的社交网络形成个人社区的能力以及该社区内关系的质量强烈预测了获得医疗保健的能力。改善老年寡妇获得医疗保健服务的努力需要根植于社区的社会文化背景。促进在老年人口中产生社会资本的举措的全面社会保护政策、分散的初级保健服务、

更新日期:2021-07-29
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