ABSTRACT The government of Bangladesh has implemented a range of Social Safety Net Programs (SSNPs) aimed at alleviating poverty and improving the well‐being of vulnerable groups, including older adults, persons with disabilities, widows, and destitute women. This study focuses on identifying the key problems and challenges associated with the effective implementation of the Old Age Allowance Program (OAAP) in Bangladesh. By integrating empirical analysis with relevant theoretical frameworks, the research provides a comprehensive assessment of the country's policy implementation processes. This study employed a phenomenological approach, using qualitative data to explore the barriers and challenges faced by implementers in executing the program. The results indicate that bureaucracy, political interference, and ineffective public administration are key barriers to policy implementation in Bangladesh. Specifically, the implementation of the OAAP was hindered by bureaucratic leadership, inadequate budgeting, poor coordination, a lack of accountability, and a failure to integrate planning. This study has theorized policy implementation and proposed a theoretical framework tailored to developing countries, aiming to support future research and foster deeper engagement with mainstream policy studies.
Renewed public awareness of the impact of social isolation on health and wellbeing, particularly among younger and older adults, has prompted greater investment in resources to promote social connection. However, little has been done to address the specific connectedness needs of the 85+ age demographic, one of the fastest growing demographics in the U.S. This exploratory, mixed‐methods study draws on cross‐sectional data collected in 2024 from a longitudinal panel of the over‐85 age demographic to examine how a sample of the 85+ perceive and experience friendship in the latest phase of life. Findings underscore the strong value the oldest‐old placed on their friendships and their longevity, the challenges of making friendships, including diminishing opportunities and openness toward new connections, the shifting composition of the friendship network in later life, and the influence gender can have on these relationships. Results highlight an opportunity for policies across many levels to acknowledge and address friendship as an important social relationship influencing health and wellbeing in later life, including local investment in community‐based social programming and awareness campaigns, state‐wide expansion of mobility solutions for older riders, and a national focus on expanding broadband and device access and coverage for services under Medicare. While this study is not generalizable to all 85+‐year‐olds, it represents a starting point for further research and policy advocacy that includes a consideration of the role of friendship in influencing social health in the latest phase of life.
Social disconnection—isolation and loneliness—is increasingly recognized as a key determinant of older adult health. Cognitive-behavioral interventions can improve social connection for disconnected older adults, yet access can be challenging. Brief interventions that can be integrated into existing infrastructure and programming (e.g., crisis or emotional support phone lines) are urgently needed. One promising approach is Connection Planning, a theory-based and evidence-informed behavioral strategy for promoting feelings of social connection. A pilot program development project was conducted to implement Connection Planning with callers to a statewide Senior Loneliness Line. Partners from the state health authority, social service organization, and an academic research team collaborated to implement and evaluate the program. Factors that facilitated participant engagement with the program included provider characteristics (e.g., empathic) and program characteristics (e.g., scheduling flexibility). Challenges to implementing the program included program promotion and enrollment difficulties and the introduction of new structured elements into calls. Additional needs for training and funding to support program sustainability were identified. Building social infrastructure to promote social connection in older adulthood requires concerted effort from stakeholders across sectors. We discuss the challenges and lessons learned from this cross-sector collaboration to pilot a social connection program for older adults at the state level and suggest opportunities to leverage funding mechanisms and implementation science principles that could support success of future efforts to develop policies and practices that are responsive to older adult social needs.
Global shifts in longevity, fertility, and partnership have disrupted nuclear family relationships, resulting in a growing population who are unpartnered, childless, or who do not include their partners and children in their core discussion networks. Lacking nuclear family ties in a core discussion network could lead to lower satisfaction with one's network which, in turn, is associated with poorer health. Yet, it is unclear if being unpartnered and/or childless (family structure) or being partnered with children but not reporting them as members of your discussion network (network structure) are associated with lower network satisfaction and if these associations are contextualized by gender and global development. We examine the extent to which family structure and core discussion network structure are associated with network satisfaction by analyzing data from the 2015 (57,389 individuals in 18 countries) and 2021/2022 (64,934 individuals in 28 countries) waves of the Survey of Health, Ageing and Retirement in Europe (SHARE). Logistic regression results stratified by sex and level of country development indicate that lacking nuclear family ties in a core discussion network is associated with lower network satisfaction, with gendered patterns: men are more dissatisfied without partners, while women are more dissatisfied without children. These associations are consistent across countries but somewhat attenuated in highly developed contexts. As family structures continue to transform, we recommend an increased emphasis on nonnuclear family ties in research and policy to more effectively reduce risks of unmet social and emotional needs in aging populations.
Social sciences research has linked the experiences of caregivers to gendered experiences over the life course; a few studies have crossed these findings with sexual orientation, often introducing stigma and other social impacts. We directly asked caregivers themselves about the perceived influences of gender and sexual orientation on their caregiving experiences. Twenty-three straight women, 15 straight men, 14 lesbian women, and 13 gay men spousal/partner dementia caregivers were interviewed about their caregiving experiences, including the advantages and disadvantages of their gender and sexual orientation in caring for their spouse/partner; these interviews were recorded, transcribed, and content analyzed. Four superordinate themes accounted for advantages, and the same number of comparable themes were found for disadvantages; together, these represent: empathy and emotional expression; bridging household management and relationship tasks; societal factors; and reference to bodies. The synthesis of these findings is illustrative; for example, straight women reported their emotional facility and household management histories as advantages; they also felt burdened and somewhat weighed down by both. Straight men similarly spoke of their emotional reserve as both an advantage and disadvantage—and similarly referencing household management (not trained in the former case, not prepared in the latter). Gay men and lesbians noted the stigma and discrimination that colored their caregiving experiences; they also saw how these struggles became strengths. These data help reinforce and animate existing interpretations of caregiver behaviors, add new nuance and perspective, and offer detail for policy and practice interventions rooted in gender and sexual orientation identities.
