Projects

Improving vision and health of elders in Nuwara Eliya district, Sri Lanka:

Sri Lanka is one of the fastest ageing countries in the world with over 12.2% of its population over the age of 60 years. Older people make an important economic and social contribution, but age-related visual impairment and non-communicable diseases often limit this. There is strong evidence that higher levels of social participation are directly and indirectly associated with better health in old age. Currently, no evidence is available on the health impact of participation in Elders’ Clubs in low-income settings: a sustainable and affordable healthy ageing strategy.

This study includes a randomized controlled trial that will measure the impact of the Elders’ Clubs on health-related quality of life; the study will also document lessons about addressing the health and vision problems of older people that will be useful in Sri Lanka and in the region.

A woman is screened by an eye health promoter

Objectives:

The aim of our study is to improve the health, including eye health, and well-being of older people aged 60 years and above, through the establishment and support of Elders’ Clubs in Sri Lanka. Our objectives include:

Primary objective

To assess the effectiveness of community-based Elders’ Clubs (Intervention) compared to no Elders’ Club (Control group) on the quality of life of older people in Nuwara Eliya District in Sri Lanka.

Secondary objectives

1) To assess the impact of participation in Elders’ Clubs on health, well-being, health related behaviour, and social and economic outcomes of older people in Nuwara Eliya District in Sri Lanka.
2) To describe key health and vision problems, health related behaviours, service access, social participation, care, and key demographic and socio-economic factors among older people to inform the planning and implementation of the Better Vision, Healthy Ageing Program and to assist policy makers.
3) To assess health seeking behaviour, and the barriers and enablers to access and uptake of health services.
4) To assess and explore feasibility, acceptability, costs and sustainability of introducing and supporting Elders’ Clubs.
5) To evaluate the effectiveness of the Program’s support to improve eye health care services in Nuwara Eliya district.

A woman talks about her experience of cataract surgery

Activities:

The Elders’ Clubs are being introduced and supported in the Better Vision, Healthy Ageing (BVHA) Program area. The study is a cluster-randomized controlled trial (cRCT), nested in the BVHA Program. The cRCT will be conducted in randomly selected clusters within the Program area. Forty (40) clusters consisting of GN Divisions (local administrative divisions) have been randomly selected proportionate-to-size. These clusters will be randomly assigned to have community-based Elders’ Clubs introduced and supported after the baseline data collection (Intervention arm) or later after the endline data collection (Control arm).

Data will be collected to assess impact of Elders’ Club participation on health-related quality of life after 15 months. After that, Elders’ Clubs will also be introduced in the Control GN Divisions and supported for nine months until the end of the Program. In this way only 20 of the 93 GN divisions in the Program area will have the intervention delayed, and all the GN Divisions will have Elders’ Clubs introduced and supported within the Program period. The GNs will continue to support the Control arm Clubs after the Program ends, and efforts will be made to engage key stakeholders, such as estate management, to ensure ongoing support for the Elders’ Clubs.

The trial intervention is the establishment of, and support for, Elders’ Clubs at the community (village or tea estate) level. The intervention consists of Elders’ Clubs and Elders’ Committees (made up of one male and one female leader from each Elders’ Club). The intervention includes:

  • Financial support to assist the set up and implementation of elders clubs
  • Monthly phone calls or visits from program officers
  • Loan of equipment or musical instruments etc
  • Health information materials
  • Visits by District Medical Officers and Estate Medical Assistants for health screening
  • Social and cultural activities

Timeline

June 2012 - June 2016

Outcomes

It is expected that participants in the intervention group will have greater access to health services and improved self-reported quality of life.

Collaborators

Ministry of Health, Sri Lanka;
Central Province Department of health, Sri Lanka;
PALM Foundation;
Kandy Eye Centre;
Ministry of Social Services, Sri Lanka;
Sarvodaya;
Berendina;
Plantation Human Development Trust;
Gamini Jayakody, Central Province Department of Health, Kandy, Sri Lanka;
Saman Senanayake, Kandy Eye Centre, Sri Lanka;
Kapila Edussuriya, Kandy Eye Centre, Sri Lanka;
Roshan Shajehan, PALM Foundation, Sri Lanka;
Bob Casson, University of Adelaide

Funding

The Fred Hollows Foundation

Health Issue

Contact Details

For any general enquiries relating to this project, please contact:

Kelly Durrant

Senior Manager, Maternal and Child Health

Telephone

+61392822192

Email

kelly.durrant@burnet.edu.au