EXAMINING SUPPORT SYSTEMS TOWARDS IMPROVEMENT OF LIVELIHOODS OF THE ELDERLY IN KIRA MUNICIPALITY

• Introduction

This study will examine support systems towards improvement of livelihoods of elderly in Kira Municipality, Wakiso District. The chapter presents the background of the study, problem statement, the purpose of the study, objectives of the study, Research questions, thescope of the study, significance of the study, limitations, delimitations and definition of key terms.

• Background of the study

Sometimes romanticised as that stage of our life you can dedicate to your hobbies, retirement is often thought of with mixed feelings. Why? Because it is associated with old age, chronical health conditions and social isolation. Way too often, young people get caught in the myriad of commitments, worries and hectic schedules of their own lives that they forget about what the elderly, be them parents or distant relatives. Just making a phone call once in a while does not cover it. The elderly’s life quality depends on so many factors and there is so much we can do to improve it:

1.1.1    Company and aide

No matter how trivial the conversation, it keeps them thinking and talking which is better than living in deafening silence. Plus, they will feel more self-confident when not being along all the time. If you don’t live in the near-by area, or cannot visit them very often, think about a home health aide to assist them on a day by day basis, especially when regular tasks like washing themselves, toileting and cooking become difficult to manage on their own.

1.1.2.   Make them feel useful

This is a simple one. They have lived their entire lives in society. They are used to being active and now they find themselves in a situation where other people do everything for them. Yes, maybe you can do the job better or quicker. But still let them help you out. It will make them feel useful and they will ultimately be happier with themselves.

1.1.3.   Mental activity

Keep them mentally active; talk to them and get them involved in mentally stimulating activities. If their brain is kept active they will stay healthier. Get them books to read and puzzles to solve. Crosswords, jigsaws, Sudoku and other such puzzles,this will help them keep their minds active while they do not have someone to talk to. These activities allow them to immerse themselves into something else rather than think about their health issues.

1.1.4.    Sense of community

Get them involved in social activities. Look for social gatherings for retirees in your local area. Even if it is only once a week, it gives them something to look forward to and be a part of,this alone is enough to dramatically improve the quality of their life.

1.1.5.   Physical activity

This is one that applies to people of all ages; we all need to stay physically active. Even if it is something as simple as walking up and down the living room a few times, it gets the blood flowing and keeps them active in some way. Don’t underestimate the power of keeping physically active on the quality of your life. If they tend to spend their day in an armchair, looking out the window, maybe you could invent some daily chores for them such as buying the milk or the bread, getting the newspaper. It might be a good idea to think of getting them a pet. Taking the dog out for a walk, for instance, can be exactly what they need to stay active physically and feel they have a purpose in life.

These are just a few of the small things that can improve the quality of the life of an elderly person. They are all simple ideas but together they amount to a far superior life for them.

Table I: Population by parishes in Kira municipality.

The aging persons are an important component of every country’s demographic strata, deserving social protection like other age sets.  In developing counties, few elderly people have been formally employed, so very few pensioners are covered by private or state savings schemes. This has been supported by the fact that a great majority of people are subsistence farmers, dependent for their survival on family labor and favorable growing weather(World Bank, 2006).

Until recently Ugandans in rural and semi-urban areas lived in mutually supporting family units that included elderly relatives. However, modernization is spreading rapidly from large cities out to small towns, bringing different values and pressures. The greater receptivity, mobility and ambition of the younger generation means they are faster to adapt to changed circumstances, while the elderly, most of whom are illiterate, are likely to miss out on benefits brought by development.

Majority of older persons in Uganda are rural-based and are among the vulnerable groups in the society, following rapid urbanization, rural-urban migration and the HIV/AIDS scourge. Consequently, the elderly persons are slowly being isolated in desperation, thus a vulnerable lot, more so for low income families.

The seemingly inevitable growth in the demand for support systems towards improving livelihoods of the elderly and accompanying cost implications have spurred strong interest among government, civil society and development partners. The rationale for such systems is a mixture of prevention, displacement, and deinstitutionalization; with alternative services proving to be additive rather than substitutive. Much research is needed to provide the basis for examining the variety of proposed alternatives to allow comparison and above all, a feasible solution.

1.2.      Statement of the Problem

The existence of a large population of elderly people, specifically women is becoming a major issue for attention by governments, international organizations and NGOs (CBS, 2000). The proportion of the age group 65 years and older is expected to increase by 93% between 2000 and 2020 in sub-Saharan Africa (Adam Chak, 1989).

Despite the projected growth, the elderly remain neglected in both consultative and decision making processes, both of which are vital in the development of a given nation. Apt and Grieco (1994) argue that the increase in the ageing population has a host of economic and social implications for policy and planning, a fact that African governments cannot ignore.

The older people are disproportionately among the poorest and most marginalized. There is therefore an urgent need for governments and international community to set a higher priority on the realization of older person’s human rights such as the right to life, security of the individual and property. This can be done through examining support systems towards improvement of livelihoods of the elderly in the country.

1.3.      Purpose of the research study

The research aims at examining support systems towards improvement of Livelihoods of the elderly in Kira Municipality, Wakiso district.

1.4.      Broad Objective of the Study 

The broad objective of this study is to identify and analyze the support systems towards improving livelihoods of the elderly in Kira Municipality.

1.5.      Specific Objectives of the Study

• To establish the impact of various age related livelihood experiences on the elderly in Kira Municipality.
• To identify and analyze the responsive behavior among the elderly in Kira Municipality in coping with livelihood challenges faced.
• To ascertain feasible support systems towards improving livelihoods of the elderly in Kira Municipality

1.6.      Research Questions

The study will be guided by the following research questions:

1. What is the age related livelihood challenges facing elderly women living in Kira Municipality?
2. What responsive behavior and strategies have been adopted by the elderly women in coping with the livelihood challenges faced?
3. What are the most feasible strategies that can be used to improve livelihoods of the elderly in Developing Countries?

1.7.      Scope of the Study

Kira Town Council is located within Kira municipality, Wakiso District in central Uganda in Buganda Region.  The Town Council is bounded by Kampala to the West and Nangabo Sub County to the North.  From the East Kira bounds Mukono from the Namanve stream that drains South wards into Lake Victoria while to the North, the Nakiyanja and Nangobe streams that flows into Lwajjali River forms the boundary, to the North is the Ntole swamp that flows to the South Western direction boarding Nangabo Sub-County.  While to the West, Kawooya and Kinawataka swamps form the boundary between Kampala and Kira.  A section of the Eastern boarder is formed by the boundaries of the mailo blocks in Kyaddondo, Nyanjaradde, Nakalerere and Kinawataka streams.

The study seeks to examine the age related livelihood challenges facing elderly women, the responsive behavior and strategies that have been adopted by the elderly women in coping with the livelihood challenges faced and most feasible strategies that can be used to improve livelihoods of the elderly in Kira Municipality, Wakiso district. It will take 5 days in the field and 1 week’s preparation of the report.

1.8.      Significance of the study

According to the research, the following will be the significance of the research study;

It can help in providing a valuable point of reference for researchers carrying out similar studies and also provide available body of literature for conducting research on support systems for improving the livelihood of the elderly.

It can benefit the Kyambogo University libraries with data for reference in any study of the same topic and area.

With its findings, if submitted to the Government and relevant ministries, it can be used for planning and identifying priority areas for service delivery.

1.9.      Limitations of the study

The researcher will suffer from communication barriers due to variety of languages being used in Kira Municipality of which some are not known by the researcher. However, the researcher will get help from some people who will interpret the information for the researcher thus making her work easier.

Financial limitation since the study is a student based research where the researcher has inadequate finances for purchasing materials for research, logistics and transport for moving in the field, payment for secretarial services among others which will lead to delay in the process of research. However, the researcher will be funded will be funded by parent to help in financing the services required.

Some of the respondents will take time to respond or give data to the researcher which will lead to the delay of the research process. This will be mitigated by making appropriate appointment that suit the free time of the respondents.

1.10.    Delimitations of the study

The researcher will do the following to enable her successfully complete the study;

The researcher will walk on foot during data collection since some areas are close to the other for example Bulindo and kiwologoma.

The researcher will ask for financial help from her parents.

The researcher will borrow money from her friends. The money will be used for transport, typesetting, printing and binding the research report.

The problem of language barrier will be solved by the researcher in a way that she will move with an interpreter who will help her speak Luganda to respondents who do not understand English.

1.11.    Definitions of key terms

Older persons are defined by the United Nations as those aged 60 years and above.

Livelihood is defined as a set of activities, involving securing water, food, fodder, medicine, shelter, clothing and the capacity to acquire above necessities working either individually or as a group by using endowments (both human and material) for meeting the requirements of the self and his/her household on a sustainable basis with dignity.

CHAPTER TWO

REVIEW OF RELATED LITERATURE

2.0       Introduction

This chapter presents the literature review on the support systems towards improving livelihoods of the elderly in Kira Municipality The review of literature is presented under the sub topics impact of various age related livelihood experiences on the elderly, the responsive behavior among the elderly in coping with livelihood challenges faced and ascertain feasible support systems towards improving livelihoods of the elderly.

2.1. Background

This study provides a brief overview of demographic trends in developing countries, paying specific attention to relationships between ageing and poverty. It then focuses on particular policy challenges which result from the population ageing process. First, it considers the need to ensure that older people enjoy a satisfactory level of economic well-being, arguing that the high priority given to pension reform in many developing countries has deflected attention away from the economic realities of the poor. This study goes on to examine health care needs and health policy for the aged. It observes that the current wave of health sector reforms rarely take into account the requirements of older people. Three central themes which inform the discussion are that (a) poor older people are a highly heterogeneous group for whom Western notions of old age often do not apply; (b) that the contexts in which they live are varied and highly dynamic, and (c) that the needs of older people are interlinked and should elicit intersectoral policy responses.

The UK, like most developed economies has an ageing population. In 1901 nearly one in seven were aged 50 and over but by 1997 this had doubled to one in three (ONS 1999) a trend that will continue over the next twenty years (Scase 1999:13). Accompanying this shift has been a burgeoning debate on the roles and involvement of older people in society and the economy (Laslett 1996; Phillipson 1998). Many of the themes in this debate, however, are contradictory. For example, self-definitions and cultural constructs associated with older people often emphasise growing old as liberating.

2.2.      Definitions, trends and meanings

There is general dissatisfaction with defining old age in purely chronological terms, but there would appear to be no universally appropriate alternative to this approach. Old age is perceived and understood in a multitude of different ways, often with important cultural variations. These may refer to biological processes and physical appearance, key life events, or social roles Apt, 1997, Knopoff et al., 1991 and Derricourt and Miller, 1992. Since old age can cover a span of over three decades, most cultures distinguish between the “old old” and “young old,” and it is usually more meaningful to think in terms of a gradual change, rather than a sharp cut-off between adulthood and later life (Feathersone and Werwick, 1995). Social attitudes and media imagery rarely reflect this heterogeneity of old age, and the labeling of elders as frail, dependent and vulnerable is the rule in many countries Hazan, 1991 and Gorman, 1999a. Similarly, international policy debates reflect what might be termed a “negative paradigm of old age,” in which older people are seen as uniformly marginal to economic activity and development (Lloyd-Sherlock, 2000a).

This partly accounts for the lack of attention given to population ageing in the international agenda and the inappropriate nature of many policies.

Demographic ageing (defined as an increase in the percentage of a population aged 65 years old or over) is now an established trend in all world regions, with the exception of Africa (Table 1 and Table 2). To date, the process has been much more evident in developed countries. Indeed, projections of population ageing in Asia and Latin America for 2025 predict similar levels to those of Europe back in the 1970s. This does not mean, however, that elderly populations outside the developed world are insignificant: since 1980 more older people have been living in developing than developed regions. In Asia and Latin America, rapid rates of absolute population growth will lead to a threefold increase in over 60 year-olds during 1990–2025, reaching 795 million (Table 3). In much of Africa accelerated life-cycle transitions mean that standard chronological measurements of age understate the true importance of the ageing process (Apt, 1996). Overall population ageing is paralleled by similar increases in the number of very old people (table 1).

Table 2: Estimated percentage of total population aged 65 years or more by world region (%)

2.3.      Responsive behavior among the elderly in coping with livelihood challenges faced.

Health promotion behavior is one of the main criteria for determining health that is recognized as the basic factor in catching numerous diseases. Observing such behaviors by the elderly prevents affliction to various diseases and has potential effect in promoting health and increasing the elderly quality of life. This research was done for the aim of determining effective factors on health promotion behaviors and health status in the elderly of the Dena province.

Improving the lifestyle, health care, increasing age and life expectancy have provided the old age phenomenon in the communities. According to the records of world health organization (WHO), there were 600 million elderly people in the world in the year 2000 that will reach to 1.2 billion in 2025 and 2 billion in 2050. Accordingly, the elderly people have the fastest population growth rate among different age groups and about two third of the elderly population in the world live in the developing countries such as Iran.

Statistical indices show that the trend of elderly population in Iran has started. In 1996, public census showed that 6.62% of Iranian population is formed by the people over 60 years of age. This rate was 7.26% in the 2006 census and it is predicted for this rate to increase to 11.5% by 2026. The increasing trend of the elderly population in Iran shows that the authorities will face tremendous problems regarding the elderly people. Hence, old age and specific conditions of the elderly, as well as providing physical, mental and social health of them are among the problems that require special attentions.

Although increasing the population of the elderly is considered as a success in health and social/economic development policies, but it is regarded as a main challenge for the present era. Increasing the population leads to prevalence of inabilities that pressurize caring, health and social systems. Thus, regarding the needs or receiving health and therapeutic services, comprehensive and complementary care and services for the elderly, getting informed from the health conditions and the differences in prioritizing service and care provisions, and also new caring services for different age levels of the elderly are verily felt, By increasing the elderly population, the governments are obliged to be more considerate about that population. Enormous investments are used in today’s industrial world, for the requirements of that age group that include the needs such as treatments, rehabilitation, paper nutrition, dwelling and leisure times. Developing countries confront great problems in providing the service to this population. Not only they have no ability for providing different public services in this respect but also they could not provide proper responses to the elders principle needs. Performing health promotion behaviors is one of the best ways for people to control their health.

The possibility in death, for the people who have unhealthy lifestyles shows a 20% increase for the duration of 5 years. These results emphasize the importance of maintaining the healthy lifestyle from the beginning of life and with no consideration of vascular diseases history. Changes in the lifestyle of the people affected by cardiovascular diseases have more potential shares in reducing vascular problems than medicinal treatments of hypertension and high cholesterol. By convincing more people to maintain and obtain healthy lifestyles, there will be considerable reduction in emergence and disabilities due to cardiac problems. Health promotion behaviors in the elderly have potential effects in promoting health and quality of life and reducing the cost of health care services.

The cost of having a normal weight in adults is almost $ 1,584 less than the obesity due to the diagnostic examinations, doctors’ fees and medicine. In the era of increasing health care costs, it is predicted that national costs can be reduced by healthy lifestyle promotion that reduces the emergence of disability and hence the need for health services. A great share of annual cost for health care in United State is related to cigarettes (8%), alcoholic beverages (2-3%), obesity (1-9%) and inactivity (2%).

According to the studies, the health promoting lifestyle helps the increase in quality of life. Also the presented data about the main reasons of mortality indicate that 53% of mortality reasons is related to the lifestyles and unhealthy behaviors. The fulfilled studies about the lifestyle and health promoting behaviors in Iran show that the most prevalent cause of morality in age groups over 50 years of age that includes cardiovascular diseases, cancer, pulmonary diseases and accidents is related to prevalent preventive risk factors dependent on the lifestyles. Despite the importance of issue the studies and researches in regards to effective factors on the elderly lifestyle and health promotion behaviors by using suitable theoretical frameworks is not sufficient.

One of the widespread models used in various studies in the world is the Pender model of health promotion. The presented model by Pender is comprehensive and predictive, used for analyzing health promotion behaviors. In other words, this model exhibits the theoretical framework that is used for discovering effective factors on health promotion behaviors and hence, it could be appropriate for improving health and the quality of life. In 1987, Pender described his health promotion model as a framework for expressing healthy behaviors that is based on the movement of individuals towards a positive situation for improving the health; his model emphasizes the importance of cognitive processes and controlling the behaviors. There are several reasons for choosing this model as study framework.

• The health promoting behaviors have complex natures that affected by several factors. This model can provide a suitable framework to understand these behaviors
• Family support, friends and health care workers are considered as important factors for obligations regarding healthy behaviors. Hence, this model that introduces health care workers, friends and family as important resources for the obligations towards healthy behavior seems to be effective in creating the required behavior
• This model is used for a wide range of healthy behaviors such as hearing protections, primary diagnosis of cancer, admitting drugs and medicine, etc., and it seems that it has general applications in all the healthy behaviors, but it has not been considered in different populations
• Although widespread research has been done on the health for the elderly, but there have been few research about health promotion behaviors and effective factors on the health of old people on the basis of Pender model in this class of population
• Although HPM model has been used as a framework for some studies, but it has not been adequately used as a causation model in health behaviors of different communities.

Hence, regarding the importance of the subject and due to lack of previous studies, this research was done for the aim of considering effective factors on health promotion behaviors and health status of the elderly in Dena, according to some of the components of the Pender model. The resulted information could describe the efficiency of Pender health promotion model, in describing selected variables in Iranian old people.

CHAPTER THREE

Methodology

3.0.      Introduction

This chapter focuses on methodology used in the field to collect the data which includes the research design, study population, sample size, sampling procedure, the pilot study,procedure of data collections, methods of data collection, and analysis.

3.1.      Research design

The research design refers to the overall strategy that you choose to integrate the different components of the study in a coherent and logical way, thereby, ensuring you will effectively address the research problem; it constitutes the blueprint for the collection, measurement and analysis of data.  Further, Fred Ochieng (2009) referred to research design as the arrangement of conditions for collecting and analyzing of data in manner that aims to combine relevancy to research purpose with economy in procedure.

The researcher used qualitativeapproach during the study which according to Sotirios (2005) is the deliberate attempt to understand. According to Koul (1997) qualitative approach is the one which is used to find out people’s attitudes and perceptions of how they understand the situation they live in.

Patton (1982) emphasized that qualitative data provides depth and detail whereby depth and detail emerge through direct quotation and careful description. The researcher preferred to use qualitative approach because it helped the researcher to understand in depth the points of view of other people, their levels of emotion their characteristics, their attitudes, values and experiences as suggested by Patton.It was the best option for the researcher because it was time saving and data will be easily got from the respondents directly.

3.2.      Population

Kakooza (2002) referred to population as the totality of all subjects under investigation. The study population is referred to as a group of respondents chosen by the researcher from the entire area of study (Sebukulu, 2000). Therefore, the study targets the elderly persons, local Government officers and the care takers of the elderly personsbecause they had rich and detailed information about the livelihoods of the elderly persons in Kira Municipality.

3.3.      Sample size

According to Mbabazi (2008), a sample is the part of population that is deliberately selected to investigate of the parent population. Also Kakooza (2002) refers to a sample as a part of population.

The researcher will use a sample size of seventeen (17) respondents, ten (9) were elderly persons, three (3) care takers, 4 Municipal officers and one (1)Uganda Reach the Aged Association (URAA) official.

3.4.      Sampling techniques

Sampling techniques refers to the way at which a researcher gets the sample of the respondents (Mbabazi 2008). Therefore, the respondents of the study will be obtained by use of purposive sampling in which purposive sampling according to Oliver .P (1998) refers to a form of non-probability sampling in which decisions concerning the individual to be included in the sample are taken by the researcher, based upon a variety of criteria which may include specialist knowledge of the research issue, or capacity and willingness to participate in the research. Also, Kakooza (2002) defines purposive sampling as a type of sampling where a researcher selects a sample that is just convenient without going through random sampling.

This technique was chosen because it enables the researcher to get information from relevant source which ensures relevancy of data and information.

3.5.      Methods of data collection

Mani (2004) refers to data collection as the process of gathering the information from the field using the established methods. Evons (1998) defines methods of data collection as tools which are used in data collection process.

The questionnaire regarding health promoting lifestyle profile 2 (HPLP2) will be used for measuring the rate of health promotion behaviors. The data will be collected by personal interviews and face to face method for completing the relevant questionnaire and will be analyzed by SPSS software version 20 and also proper tests.

The researcher will also use a semi structured interview guide of which interview according to Okirialnisio (1995) involves conversation between interviewer and the interviewee for specific purpose or one to one interaction between reporters and respondents. This method will be used by the researcher because it helped to give vivid information from the field as well as providing direct procedure for studying various aspects of human behaviour which was the only effective way to gather data in particular situation.

3.8.      Procedure for data collection

Wayne (2001) refers to data collection procedure as a way through which research process is going to be completed and measured.

Therefore, if the research started with writing a research proposal, after the completion of the research proposal and final approval by the University supervisor, then the student obtained an introduction letter from the department of community and disability studies of Kyambogo University. The letter was taken to Kira Municipality Chief Administrative Officer (CDO) to seek permission of collecting data from the area. Then the Municipality CDO introduced the student to Kira town council and to the chairman LCI who introduced the student tothe various participants where the research was carried out. Fromthere, the researcher made appointments with the participants on the days of collecting data using observation and the semi structured interview guide and data was recordedusing a pen, ruler and papers then the raw data was summarized and edited. Final completion was done by the researcher; the raw data was transferred to a computer by typing, then printed and bound together using the hard cover. The report was approved by the supervisor and finally the report was submitted to the department of community and disability studies.

3.9.      Data analysis

Data analyzing is the process of organizing and synthesizing in such a way that research question can be answered and hypothesis can be tested. (Denise, et al 2010)

The study was purely qualitative where qualitative data collection method was used and was presented in form of description and explanation through narration of personal experiences by participants.  Data was recorded on paper and then analyzed. Clustered and defined words were used theoretically from which conclusions were drawn.

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