Background: Traditionally, family members take care of older relatives in South Asian societies, and there is a strong reciprocal filial obligation through intergenerational family relations. The changing family structure, living arrangements, and out-migration have led to subsequent changes in reciprocal family support that influence the health and well-being of older adults. This scoping review aims to (1) map the evidence and prevailing motivations for family support including financial, instrumental, and emotional support that affect the health and well-being of older adults and (2) identify the research gaps in the academic scholarship available on motivation for family support to older adults given the changing demographic and societal dynamics in the South Asian societies. Methods: We followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Review (PRISMA-ScR) guidelines. Electronic databases PubMed, Embase, Scopus, and ProQuest were searched, and Google Scholar was used to identify grey literature. The screening of titles, abstracts, and full texts included 22 studies for analysis. Results: The included studies covered health indicators such as stress and/or depression, loneliness/isolation, loss of support/neglect, and level of satisfaction to illustrate well-being of older adults. The findings revealed that adult children recognised filial duties and responsibilities to provide care to older parents, whereas older parents provide cultural upbringing and care to grandchildren. Reciprocal care exchange, cultural expectations, and intergenerational transfers motivated adult children to be primary caregivers to their older parents. Intergenerational family care such as financial, instrumental, and emotional support is associated with a higher level of life satisfaction and lower level of depression and thus reported better health and well-being among older adults. Conclusion: Although intergenerational support is still a significant factor in determining the well-being of older adults in South Asia, this study shows the complexity of intergenerational ambivalence, where caregiving responsibilities lead to both emotional stress and a sense of obligation. Additionally, out-migration of adult children and subsequent physical absence also increase psychological distress and loneliness of older adults. This emphasises the need for policies that address both the emotional and financial aspects of elder care. The Madrid International Plan of Action on Ageing (MIPAA) policies can be adopted to ensure friendly and supportive environments and emphasise the health and well-being of older adults in developing countries. MIPAA highlights the importance of policies that promote intergenerational solidarity, active ageing, and social protection for older individuals.

Out-of-pocket expenditure (OOPE) directly reflects households’ financial burden for healthcare. Despite efforts to enhance accessibility and affordability through government initiatives and insurance schemes, OOPE remains problematic, especially in rural areas with inadequate public healthcare infrastructure. This study examines factors influencing OOPE in Karnataka’s Dakshina Kannada, Udupi, and Shimoga districts, investigating socioeconomic characteristics, healthcare infrastructure, and accessibility to inform policies for equitable healthcare access and reduced household financial strain. Using purposive sampling, 61 semi-structured interviews were conducted in rural and urban South Karnataka, recorded in Kannada after obtaining consent, and thematically analyzed. Results revealed mixed perceptions of healthcare quality, cost, and accessibility between government and private hospitals. Government facilities were lauded for improved infrastructure and affordability, while private hospitals were preferred for quality and personalized care despite higher costs. Health insurance significantly impacted OOPE reduction. Participants emphasized the need for increased awareness of government insurance programs and improved quality in public hospitals. The study concludes that private hospitals are favored for superior care despite expenses, while government hospitals are valued for affordability. Expanding insurance coverage and improving public awareness are crucial for enhancing healthcare accessibility and affordability.

This study investigated key physical and social barriers to accessing public transport in Dhaka, Bangladesh, and how the unequal accessibility of transport leads to the social exclusion of older adults. Employing a transport disadvantage perspective and drawing on visual surveys and in-depth interviews, the study explores the context and lived experiences of older adults using public transport in their everyday lives. Difficulty in accessing buses due to overcrowding and congestion, struggling to get on rickshaws due to height, avoiding CNG (an autorickshaw) and cabs due to high fares, disliking Laguna (a small four-wheeler human haulier for carrying passengers) for compact seating arrangements, undesirable behavior, and social attitudes discourage older adults from participating in social activities and produce a feeling of social isolation and exclusion. Hence, more inclusive transport policies are essential in low- and middle-income countries to reduce transport-related social exclusion and improve the well-being of older adults.

Background: The Ayushman Bharat Digital Mission (ABDM) aims to enhance healthcare delivery in India through digital integration. The ABDM, an essential part of India’s healthcare system, aspires to transform healthcare delivery through digitization, by emphasizing affordability, accessibility, and transparency. This qualitative study investigated the awareness, challenges, and perceptions of the ABDM among postgraduate students in coastal Karnataka, focusing on their experiences and interactions with digital health technologies. Methodology: A qualitative descriptive approach was employed, involving semi-structured interviews with 17 purposively selected participants from a health science university. The interviews were audio-recorded, transcribed, and analyzed using the NVivo 12 software for thematic analysis. Results: This study revealed that, while many students recognized the ABDM’s goal of establishing comprehensive digital health infrastructure to seamlessly integrate healthcare services and information systems, detailed knowledge about its functionalities, implementation processes, and challenges was limited. Participants highlighted the need for improved digital literacy and support to maximize the effective use of the ABDM. Conclusions: The successful implementation of the ABDM depends on overcoming major challenges such as poor awareness and concerns about data security. Addressing these issues will require focused educational campaigns, increased accessibility, and joint efforts by the government, healthcare providers, and technological partners.