Dr. K. Arulanandem

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HEALTH CARE NEEDS AND SERVICES AVAILABLE FOR ELDERS IN THE BATTICALOA DISTRICT

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“HEALTH CARE NEEDS AND SERVICES AVAILABLE FOR ELDERS IN THE BATTICALOA DISTRICT” ARULANANDEM K

HEALTH CARE NEEDS AND SERVICES AVAILABLE FOR ELDERS IN THE BATTICALOA DISTRICT :

HEALTH CARE NEEDS AND SERVICES AVAILABLE FOR ELDERS IN THE BATTICALOA DISTRICT Arulanandem K, Jayawickramarajah PT Ramanayake RPJC, Hettige S, Kisokanth G

CONTENTS:

CONTENTS Introduction Background Justification Objectives Materials and Methods Results and Discussion Conclusions Recommendations 3

INTRODUCTION:

INTRODUCTION The accelerated ageing of the population brings about new challenges to the health care and to the social welfare systems of Sri Lanka ( Karunathilake , 2012). Prolonged illness, disability or simply the challenges of ageing can significantly alter the lifestyle of elderly individuals ( Mathur 2007 and Bains et al., 2010). The provision of long-term health care is another most serious issue associated with the ageing of the population. 4

Ageing trends in Sri Lanka :

Ageing trends in Sri Lanka 5 9.2% 12.2% 16.7% 20.7% 24.8% 7.9% 28.5% 27.2% 30.6% Source: Indralal De Silva, 2012 In Sri Lanka, 60 years old or more as a senior citizen (Gazette, 2005) In Sri Lanka the percentage of population over 60 years increased from 4.2% in 1971 to 9.2% in 2000 and is expected to reach 28.5% by 2050 (Atapattu and Goonaratna, 2012 & Karunathilake, 2012).

Health and Social Services for Elders:

Health and Social Services for Elders The health system in Sri Lanka is enriched by the operational coexistence of Allopathic, Ayurvedic, and several other systems of medicine, which consists of both the state and private sectors. The Ministry of Social Services has taken several measures to face the challenges posed by rapidly ageing population. The successive governments of Sri Lanka have accorded high priority to health, and social services for elders (WHO, 2012). A better coordination of care across health and social services, as well as across different levels of health care becomes as crucial.

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The care of the elderly as a special group has not attracted enough attention in most special care systems (WHO, 2006).

Objective:

Objective To address the health care needs of elders and assessing the availability of health, social services in Batticaloa district.

Study Setting- Batticaloa District:

Study Setting- Batticaloa District Located in Eastern Sri Lanka Land area : 2,854 Km 2 Population : 596,317 (Statistical Handbook of Batticaloa , 2009) 9 MATERIALS AND METHODS

METHODS AND MATERIALS:

METHODS AND MATERIALS Case Definition - An Elder: An individual of age 60 years and above. Design - A cross sectional descriptive study. Sample size - A sample of 845 elders in Batticaloa district.

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11 Sample size Sample size 845 was calculated using Lwanga and Lemeshow (1991) guide for minimum sample size. where, Z- Z score (1.96 for 95% of Confidence level) P-Anticipated population proportion Ɛ-Relative Precision Based on a study by Mendis and Illesinghe (1989) on health and social aspects of elders. 35% of elders’ population as anticipated population 10% of relative precision were considered.

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Sampling - Simple random sampling method. Study Instruments - Interviewer administrated questionnaire Check list Analysis - Descriptive statistical analysis SPSS-15 Ethical clearance - from Ethic Review Committee, Faculty of Health Care Sciences, Eastern University, Sri Lanka.

Results :

Results

Identified Medical problems among elders :

Identified Medical problems among elders 14

Impairments among elders :

Impairments among elders 15 No significant association between gender and impairments p> 0.05

Common problems associated with old age :

Common problems associated with old age 16

Falls among elders:

Falls among elders 17 Falls among elders within last one year 20% (n=169/845) Accident falls 92.9% No significant association between gender and falls p> 0.05 Fainting 7.1%

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18 Health Care Institutions in Batticaloa Allopathic Non-Allopathic Preventive RDHS 14 MOH Division Curative Teaching Hospital (1) Base Hospital (4) Divisional Hospital (16) Primary medical unit (14) GPs (66) Private Nursing Home (5) Teaching Hospital (1) Base Hospital (1) Divisional Hospital (1) Pancha Homa Hospital (2) Central Dispensary (13) Health Services available in Batticaloa district

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19 Social Services available in Batticaloa District Service available Responses Percent Social subsidiaries ( Samurthy ) Yes No 90% 10% Level of satisfaction on subsidiaries Satisfied Unsatisfied 46% 54% Special Elderly ID Card Holding Yes No Benefitted Yes No Satisfied Yes No 69% 31% 50% 50% 44% 56% Membership in elder committee Yes No 36% 64% Awareness of Social services Yes No 37% 63%

CONCLUSIONS :

CONCLUSIONS Identified medical and other aged related problems need long term care coordinating health and social services. Even though Social Ministry had launched many programmes , most of the elders were unaware and not benefitted much. Clear gaps were identified in both health and social services for elders in the context of accessibility and availability. Initiating a pragmatic caring system through multi sectoral partnerships of governmental, private-sector and voluntary organizations in the district is much anticipated .

REFERENCES :

Atapattu, P. & Goonaratna,C. (2012) Medicine in the elderly. Vol.2; 1-17. Colomobo:Ananda Press. Bains, P., Singh, A. & Singh, T. (2010) Status of Home Based Care Provision to Bedridden Elderly in Chandigarh. Journal of The Indian Academy of Geriatrics 6 :1; 9-13. De Silva, I. (2007) The Age Structure Transition and the Demographic Dividend: An Opportunity for Rapid Economic Take-off in Sri Lanka Sri Lanka Journal of Advanced Social Studies 2 :1. Karunathilake, I.M. (2012) Health Changes in Sri Lanka: Benefits of Primary Health Care and Public Health. Asia-Pacific Journal of Public Health 24 :4; 663– 671. Lwanga,S.K. & Lemeshow,S. (1991) Sample Size Determination in Health Studies. A Practical Manual Geneva:WHO pp – 2, 27 & 28. Mathur, A. (2007) Geriatric Caregiver Training. Journal of The Indian Academy of Geriatrics 3 :2; 47. Mendis, N & Illesinghe, D. (1989). Health and social aspects of the elderly. A preliminary community survey. Ceylon Medical Journal . 34(2): 95-98. World Health Organization (2006) A strategy for active, healthy ageing and old age care in the Eastern Mediterranean Region 2006–2015 Cairo:World Health Organization Regional Office for the Eastern Mediterranean. <http://applications.emro.who.int/dsaf/dsa542.pdf. (17/06/2013). World Health Organization (2012) Global Action Plan for the Prevention and Control of NCDs 2013-2020 <http://www.who.int/nmh/events/ ncd_action_plan/en/> (28/09/2013). REFERENCES

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