Health and wellbeing of indigenous older adults living in the tea gardens of Bangladesh

Farah Naz Rahman, Hafiz T A Khan, Md Jahangir Hossain, Anthony Obinna Iwuagwu, Farah Naz Rahman, Hafiz T A Khan, Md Jahangir Hossain, Anthony Obinna Iwuagwu

Abstract

Background: There are currently 1.5 million indigenous people in Bangladesh, constituting 1.8% of the total population and representing one of the country's most deprived communities. This study explores the health status and quality of life along with their determinants among indigenous older people in Bangladesh in order to fill the knowledge and evidence gap on this topic.

Methods: A mixed-methods approach was deployed in October 2019 in the Sylhet division of Bangladesh which involved a cross-sectional survey among 400 indigenous older adults (200 males, 200 females) from 8 tea gardens using a pre-tested semi-structured questionnaire. Ten in-depth interviews were also conducted with providers of the tea garden health facilities. Descriptive analysis, multiple logistic and multi-nominal linear regression were performed to explore associated factors around health and quality of life.

Results: Of the total respondents, the majority (79.5%) had chronic diseases, with visual difficulty being predominant (74%) among the conditions. Almost all (94%) of the respondents experienced delays in receiving treatment and poverty was identified by most (85%) as the primary cause of those delays. Extreme age, being male, living alone and low family income were significantly associated with suffering from chronic conditions. Furthermore, having a chronic condition and extreme age were found to be significantly associated with a low quality of life. Health service providers identified lack of logistical support in the health facilities, the economic crisis and lack of awareness as the major causes of poor health status and poor health seeking behaviour of the indigenous older adults.

Conclusion: Indigenous older men in extreme old age are more vulnerable to adverse health conditions and poor quality of life. Health literacy and health seeking behaviour is poor among indigenous older adults generally and there is a huge gap in the health services and social supports available to them.

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1. Distribution of age, education and…
Fig 1. Distribution of age, education and marital status of indigenous older adults by gender.
Fig 2. Distribution of chronic conditions of…
Fig 2. Distribution of chronic conditions of indigenous older adults with their level of severity.
Fig 3. Distribution of multi-morbidity among indigenous…
Fig 3. Distribution of multi-morbidity among indigenous older adults across gender.
Fig 4. Limitation on daily activities among…
Fig 4. Limitation on daily activities among indigenous older adults with severity.
Fig 5. Facilities from where indigenous older…
Fig 5. Facilities from where indigenous older adults received treatment.

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