Browsing by Author "Maselko, Joanna"

Developing nations in Asia are posed to experience a significant increase in the population of older adults living in their respective societies. Over the coming decades, India, the second most populous country in the entire world, is poised to experience a significant increase in its elder population. India's population of adults 60 years of age or older is projected to increase from 8% to 19% of the countries total population by the year 2050. Figures predict that by mid-century, 323 million people in India will be aged 60 years or older, more than the total current U.S. population. As the demographic structure of India is making a dramatic shift, concerns regarding the health and wellbeing of the growing Indian elder population are emerging, as is the growing concern for social policy. In addition, Sri Lanka is the fastest aging nation in South Asia. Multiple factors, including an increase in the number of people considered to be the "oldest old" (80+ years of age), a decrease in the number of working age adults, and increases in disability amongst the elderly, could necessitate an increased need for institutionalization of elderly Sri Lankans into long-term care facilities.

This project aims to study aging in south Asia from two different perspectives. An analysis of existing data from Southern India was done to examine the attitudes and beliefs of Indian elders towards aging and support systems for the elderly. Mental health of Indian elders was assessed and logistic regression analysis was conducted to examine possible correlations between attitudes and beliefs of the elderly and elder mental health. In addition, a qualitative descriptive study of Sri Lankan elder homes was carried out in the southern district of Galle, Sri Lanka. A convenience sampling method was used to identify six elder homes located in the area, and visits were made to each of the homes. During the visits, elder home mangers were interviewed in order to gain general information on the functioning and history of the elder homes, as well as general information on the residents living at the facilities.

Results from the Kerala Aging Survey revealed that psychological distress was present for over one third of elders in Kerala. Rates of psychological distress were higher for women, the poor, and those with advanced age. Elder women appear to be especially vulnerable to psychological distress in old age. Elders believe that children are responsible for supporting parents in their old age; lack of satisfaction with support received from children was associated with the presence of psychological distress amongst elders. For the qualitative study on Sri Lankan elders homes, it was found that both familial and community support are significant factors in the long-term care of elderly Sri Lankans. Though many elder home residents had been diagnosed with a chronic NCD or disability, lack of familial support was consistently identified as the driving force necessitating the elderly to reside at the long-term care facilities. With little or no financial assistance from the government, the facilities themselves all relied heavily on donations from the community to function on a daily basis.

Background: The role of grandparents has changed in response to social, economic and demographic factors, which may operate both in favour of or against the relationship between grandparents and their grandchildren. The potential positive impact of the grandparent-grandchild relationship on the development of adolescent grandchildren has been increasingly recognized, although relatively few studies have directly related this relationship to measures of child well-being. This study aims to examine the association between grandparent-grandchild interactions and socio-emotional and cognitive outcomes among adolescent grandchildren in Sri Lanka. Methods: This cross-sectional study was conducted within schools, temples, homes and community buildings in Galle District. An interviewer-assisted survey was used to collect data about the adolescent participants’ demographics, family and household information, grandparent relationships, empathy, and socio-emotional development. A cognitive test was used to assess the adolescents’ cognitive development. Univariate, bivariate and multivariate analyses were used to examine the association between the grandparent-grandchild relationship and adolescent outcomes. Results: Our results indicate that grandparent-grandchild relationships are significantly associated with adolescent socio-emotional and cognitive development. Conclusions: This study underlines the importance of the grandparent-grandchild relationship.

Background: Mental health, specifically depression, is a burden of disease in Pakistan. Religion and depression have not been studied in Pakistan currently, specially within a subset of a rural population. Methods: A secondary-data analysis was conducted using logistic regression for a non-parametrically distributed data set. The setting was in rural Pakistan, near Rawalpindi, and the sample size data was collected from the SHARE (South Asian Hub for Advocacy, Research, and Education). The measures used were the phq9 scaled for depression, prayer number, mother’s education, mother’s age, and if the mothers work. Results: This study demonstrated that there was no association between prayer and depression in this cohort. The mean prayer number between depressed and non-depressed women was 1.22 and 1.42, respectively, and a Wilcoxan rank sum test indicated that this was not significant. Conclusions: The primary finding indicates that increased frequency of prayer is not associated with a decreased rate of depression. This may be due to prayer number not being a significant enough measure. The implications of these findings stress the need for more depression intervention in rural Pakistan.

Background: Pakistan has a large and increasing burden of maternal depression which has important repercussions for both maternal and child health. This was an exploratory study with the aims to assess the differences in the prevalence proportion of maternal depression between migrant and non-migrant households and to further explore how family structure, perceived social support, and marital satisfaction affect the relationship between male migration and maternal depression.

Methods: The sample used for this study originates from a follow up study in 2013 to the Thinking Health Programme (THP) originally implemented in rural Rawalpindi in 2007. 860 women were included in the final sample and multivariate regression modeling was used to assess the relationship between male outmigration and maternal depression with the covariates perceived social support, marital support, and joint family status.

Results: Initially, there was no significant association between male outmigration and maternal depression. Once stratified by socioeconomic status, there was an association among the poor women (p=0.002) (OR = 1.63; 95% CI:1.19, 2.22), but not the non-poor women (p=0.696) (PR = 1.10; 95% CI:0.68, 1.79). Models further adjusting for perceived social support, marital support, and joint family status did not yield any significant differences.

Conclusions: Male outmigration is a predictor of maternal depression among poor families in rural Pakistan even after adjustments for social and marital support.