In Bangladesh, one of the world’s poorest countries, a significant proportion of its most deprived citizens are elderly women living in rural areas, where healthcare access remains difficult. This article argues that as citizens, such elderly women, too, should have a constitutional right to healthcare access. Meeting this constitutional and human rights challenge is a joint obligation for the government and healthcare professionals. Yet, socio-economic discrimination and several cultural factors at individual, societal and institutional levels are known to limit access to healthcare services for elderly rural women in Bangladesh, who represent a highly vulnerable population group in Bangladesh regarding healthcare and healthcare access. This article first examines demographic ageing trends and then highlights key issues concerning the necessity of securing better healthcare for rural elderly women (REW) in Bangladesh.

Attention to culture and its impact on health care can improve the quality of care given, add to our understanding of health care among culturally diverse populations, and encourage a more holistic approach to health care within general care. Connection to culture is important to Aboriginal peoples, and integrating Aboriginal culture into general care in residential aged care facilities may contribute to improving care delivery and outcomes for residents. The literature to date revealed a lack of understanding of the capacity of residential aged care and the health practices of carers in relation to providing cultural care for Aboriginal people. This study aimed to explore how cultural care needs are maintained for Aboriginal residents from their own and their carers’ perspectives. Applying an Aboriginal centered research method, an Interpretive Descriptive Approach was used as a theoretical framework to explore data in this study. Semi structured audio-recorded interviews were conducted. An additional file provides a complete description of the interview questions used as a guide for the study [see Additional file 1]. Three Residential Aged Care Centres, in South Australia were used i.e., two rural from centres and one urban metropolitan centre. Seven Aboriginal residents and 19 carers participated in interviews. Data was transcribed and an interpretive analysis was employed to code the transcribed data for themes and sub-themes. The study was guided by an Aboriginal community advisory group with an aim to work under the principle of reciprocity; giving back to the communities, participants and those where the research results may have been relevant. Three themes emerged from the views of the residents and carers: (i) lack of resources and funding; (ii) care practice; and (iii) marginalisation of Aboriginal culture within aged care facilities. The findings suggest that carers and residents believe cultural inclusion in general care practices may enrich Aboriginal residents’ daily life, health and well-being in residential aged care facilities. This study may provide carers, aged care centre managers and policy makers with information on the need of resources, funding, organised care plan and management, and cultural competency of carers to be considered to improve Aboriginal aged care protocols for integrating cultural care into practice.

Quality of dementia care improves with a personalized approach to aged care, and knowledge of the disease process and unique care needs of residents with dementia. A personalized model of care can have a significant impact on the overall organizational culture in aged care homes. However, the dimensions of personalized aged care relating to dementia often remain under-managed. We aim to explore the factors that shape the dimensions of personalized dementia care in rural nursing homes using qualitative data of a mixed-method ‘Harmony in the Bush’ dementia study. The study participants included clinical managers, registered nurses, enrolled nurses and care workers from five rural aged care homes in Queensland and South Australia. One hundred and four staff participated in 65 semi-structured interviews and 20 focus groups at three phases: post-intervention, one-month follow-up and three-months follow-up. A multidimensional model of nursing home care quality developed by Rantz et al. (1998) was used in data coding and analysis of the factors. Three key themes including seven dimensions emerged from the findings: resident and family [resident and family centeredness, and assessment and care planning]; staff [staff education and training, staff-resident interaction and work-life balance]; and organization [leadership and organizational culture, and physical environment and safety]. A lack of consideration of family members views by management and staff, together with poorly integrated, holistic care plan, limited resources and absence of ongoing education for staff, resulted in an ineffective implementation of personalized dementia care. Understanding the dimensions and associated factors may assist in interpreting the multidimensional aspects of personalized approach in dementia care. Staff training on person-centered approach, assessment and plan, and building relationships among and between staff and residents are essential to improve the quality of care residents receive.

It is argued that spirituality acts as a powerful determinant of health and influences the general care experiences of older people living in residential aged care. This impact is significant, especially for Aboriginal residents, whose cultural and spiritual well-being is shown to be strongly connected with divine beliefs, land and community. This study, a qualitative exploration from conversational interviews with 7 Aboriginal residents and 19 carers, aimed to investigate how the Aboriginal residents’ spiritual well-being related to living in residential aged care in South Australia. Participants shared what spirituality meant to them and how spiritual needs are met in aged care centres for Aboriginal residents. Three major themes emerged from the views of the residents and carers: a lack of understanding of spiritual well-being; challenges around aged care plan; and practice and inadequate resources and funding. The main themes and sub-themes contributed to carers’ unawareness around the spiritual care needs of Aboriginal residents. This study concluded there was a requirement for changes in care management and staff approach, and management structure in order to integrate spiritual care into general care for Aboriginal residents in aged care.

Objective: This review aimed to explore and analyze the social determinants that impact rural women’s aged 60 years and older healthcare access in low or middle income and high income countries.Methods: Major healthcare databases including MEDLINE and MEDLINE In-Process, PsycINFO, PubMed, ProQuest, Web of Science, CINAHL and ERIC were searched from April 2016 to August 2016 and a manual search was also conducted. A rigorous selection process focusing on the inclusion of rural elderly women in study population and the social determinants of their healthcare access resulted in 38 quantitative articles for inclusion. Data were extracted and summarized from these studies, and grouped into seven categories under upstream and downstream social determinants.Results: Prevailing healthcare systems in combination with personal beliefs and ideas about ageing and healthcare were identified as significant determinants. Socioeconomic and cultural determinants also had a statistically significant negative impact on the access to healthcare services, especially in developing countries.Conclusion: Potentially, improvements to healthcare access can be achieved through consideration of rural elderly women’s overall status including healthcare needs, socioeconomic determinants and cultural issues rather than simply establishing healthcare centers.

Integration of religion in community health and wellbeing interventions is important for achieving a good life among faith-based populations. In countries hosting Muslim-minorities, however, relatively little is reported in academic literature on processes of faith integration in the development and delivery of interventions. We undertook a review of peer reviewed literature on health and wellbeing interventions with Muslim-minorities, with specific interest on how Islamic principles were incorporated. Major databases were systematically searched and PRISMA guidelines applied in the selection of eligible studies. Twenty-one journal articles met the inclusion criteria. These were coded and analyzed thematically. Study characteristics and themes of religiosity are reported in this review, including the religious tailoring of interventions, content co-creation and delivery design based on the teachings from the Quran and Sunnah, and applicability of intervention structures. We reviewed the philosophical and structural elements echoing the Quran and Islamic principles in the intervention content reported. However, most studies identified that the needs of Muslim communities were often overlooked or compromised. This may be due to levels of religio-cultural knowledge of persons facilitating community health and wellbeing interventions. Our review emphasizes the importance of intellectual apparatus when working in diverse communities, effective communication-strategies, and community consultations when designing interventions with Muslim-minority communities.