Exploring Telehealth Readiness in a Resource Limited Setting: Digital and Health Literacy among Older People in Rural India (DAHLIA).

Tshepo Mokuedi Rasekaba,Rebecca Mckechnie,Riya Johnson,Vinaya Rani G,Irene Blackberry,Pratibha Pereira

doi:10.3390/geriatrics7020028

Tshepo Mokuedi Rasekaba, Rebecca Mckechnie + Show 4 more

Open Access

https://doi.org/10.3390/geriatrics7020028

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Abstract

An ageing population, disproportionally affecting developing countries, increases demand on healthcare systems. Digital health offers access to healthcare for older people, particularly those residing in rural areas, as is the case for 71% of older adults in India. This research examined technology uptake and digital and health literacy (eHEALS) among a sample of 150 older adults in rural Mysore and Suttur, India. The study utilised mixed-method, with descriptive analysis of quantitative data and thematic analysis of qualitative data. Low rates of digital (11%) and health literacy (3–27% across domains) were identified. Mobile phone ownership was 50%, but very few owned or used a smartphone and less than 10% used the Internet to contact health professionals. Qualitative analysis found low technology usage, driven by limited exposure and confidence in using digital devices. Barriers to usage included poor traditional literacy and physical aspects of ageing like poor vision. Social support from neighbours, family and local primary healthcare staff may enable adoption of digital health. Access to healthcare through digital means among Indian rural older adults needs to consider low rates of both digital and health literacy and leverage the value of support from family and primary healthcare providers.

Highlights

Of concern are the potential economic and social implications that an increasing ageing population may have on communities and healthcare systems [2–4]
Affordability and transport are already the top two barriers to health service access reported by older people in low to middle income countries [1,9]. This is salient among those residing in rural areas, as health care services are often clustered in urban centres, requiring extensive travel for those visiting from smaller towns and communities [1,9]
With a large proportion of older adults already experiencing difficulties accessing healthcare due to health or geographic factors, and with this number set to increase with the ageing population, it is imperative to identify methods to bridge inequities in healthcare access for older adults and to alleviate rising costs to the healthcare systems

Summary

Introduction

The World Health Organisation anticipates that by 2050 the number of people aged over 60 years will have doubled to over two billion, up from 900 million in 2015 [1] The effect of this demographic change will be experienced disproportionately, with the greatest increases in aged populations occurring in developing countries. Ageing is associated with increased risk of chronic conditions such as hearing loss, diabetes, cardiovascular disease, chronic obstructive pulmonary disease, cataracts, Alzheimer’s and other dementias, depression and osteoarthritis [1]. These conditions challenge the independence and quality of life of older people [5], exerting a significant burden on individuals, communities and healthcare systems [2]. With a large proportion of older adults already experiencing difficulties accessing healthcare due to health or geographic factors, and with this number set to increase with the ageing population, it is imperative to identify methods to bridge inequities in healthcare access for older adults and to alleviate rising costs to the healthcare systems

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Conclusion