Elder Vulnerability in Receiving Home Care Services: Evidence from Bangladesh

By Pradhan, Mohammad Abdul Hannan; Mathbor, Golam M. | Social Development Issues, May 1, 2017 | Go to article overview

Elder Vulnerability in Receiving Home Care Services: Evidence from Bangladesh


Pradhan, Mohammad Abdul Hannan, Mathbor, Golam M., Social Development Issues


Background of the Study

Dubey, Bhasin, Gupta, and Sharma (2011) pointed out that elderly people are trapped between weakening traditional values and an absence of adequate social security. Significant changes have been taking place in the structure of aging population in developing countries. It is estimated that nearly two-thirds of the total elderly population, defined as those who are sixty years and older, are living in developing countries. The elderly population of Bangladesh, a developing country, is experiencing substantial population growth (Uddin, Islam, & Kabir, 2012). The growth rate of the elderly is higher than the growth rate of the total population. Elderly people represented 5.2 and 5.7 percent of the population in 1961 and 1991, respectively. This rate increased to 6.1 and 7.6 percent in 2001 and 2014, respectively. The current number of elderly people in Bangladesh is more than the total population of Cuba, and more than twice the populations of countries such as Lebanon, Singapore, and Denmark. It is projected that about 11 percent of the current population will become elderly by 2025 (U.S. Census Bureau, 2015). A country is considered to be an elder-populated country if its elderly population is 11 percent or more. By 2050, the total elderly will number more than 50 million, accounting for 20 percent of the population.

These changes in population characteristics have a serious effect on the overall socioeconomic development of the country. In most cases, elderly people are not able to earn their own incomes. Consequently, they must depend on others for their livelihood. With the increase in the elderly population, the demand for home care, either informal or formal, is likely to increase. This demand for home care cannot be met without an adequate supply of informal or formal care providers. In Bangladesh, informal care provisions for the elderly are traditionally made by adult children and spouses. During the last few decades, the availability of home care services has rapidly declined owing to the breakdown of the traditional joint family along with rapid modernization and urbanization (Hossain, 2013; Hossain, Akhtar, & Uddin, 2006; Tostensen, 2004).There is also an absence of a formal care system. Most elderly people lack adequate financial resources owing to either poor pension coverage or inadequate benefit payments by the formal social security systems (Gillion, Turner, & Latulippe, 2000). As a result, the majority of the elderly are dependent on their family members for home care (Bongaarts & Zimmer, 2002). Cain (1991) found that 62 and 50 percent of the elderly lived with a married son in 1976 and 1986, respectively, in the rural areas of Bangladesh.

It is hypothesized that the elderly in Bangladesh do not receive home care from their children or spouse. The question arises as to who will provide care for the elderly? What is the role of friends, relatives, and neighbors in providing home care for the elderly? This study examines the home care that is received by the elderly and identifies where there are further needs. We purposely conducted this study in Sylhet because the area is undergoing rapid urbanization, with the youth moving from the area for work opportunities abroad and leaving their parents at home.

Research Strategy, Data, and Empirical Model

This study employed the household survey method and a structured questionnaire survey technique to collect data from desired respondents sixty years of age or older. Quantitative information such as socioeconomic characteristics, child characteristics, informal and formal care received, and future expectations of home care was collected.

The Sylhet district was purposively selected, including respondents from both urban and rural areas. Sylhet Sadar was considered an urban area, and Upazilla, Balagonj, and Kanaighat, were randomly selected as rural areas. Face-to-face interviews were conducted from November to December 2015 in two villages (Muhammadpur and Shankorpur) of Balagonj and three villages (Prurbogram, Jingabari, and Bhatirpoud) of Kanaighat in the Sylhet district. …

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