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This paper reports on an innovative survey of long-term care facilities for older people in the Argentine city of La Plata. It applies a range of qualitative methodologies, including a clandestine audit conducted by older people living in the community. The paper pays particular attention to the types and availability of services, perceived quality and the rigour of regulatory processes. It finds that there has been a rapid growth in the availability of formal services, but that there are many gaps in provision, especially for older people with complex care needs. There are strong indications that service quality is uneven and, in some cases, this amounts to the contravention of basic human rights. State regulation is hampered by institutional fragmentation and weak governance. A wider set of expert interviews and the limited available published information indicate that these findings are unlikely to be exceptional, and that similar issues affect rapidly emerging long-term care systems in many low- and middle-income countries. [ABSTRACT FROM AUTHOR]

Background and Objectives There is very little information about the appropriateness of procedures for admitting older people into care homes in low and middle-income countries like Argentina. This study provides the first systematic study of practice and assesses the extent to which current practice respects fundamental human rights. Research Design and Methods We apply different methods, including document review and national survey analysis. The study also includes a case study of a single city, La Plata, which draws on local key informant interviews, focus group discussions in different neighborhoods, and a clandestine surrogate patient survey led by local pensioners. This innovative design provides a highly triangulated and contextualized data set. Results Many older people admitted to care homes did not have high levels of care dependency. Care homes did not usually require or even seek the informed consent of older people, regardless of their cognitive status. There were indications of coercive admission by family members, sometimes in order to obtain access to older people's homes and other property and finances. Discussion and Implications The study indicates the widespread abuse of the fundamental human rights of tens of thousands of older people in Argentina. There is a need for researchers, policy-makers, and civil society to acknowledge the scale of abuse and develop safeguards. [ABSTRACT FROM AUTHOR]

This article reflects on two experiences of applying qualitative life course research in development studies. The first methodology centred on the elicited narratives of older people in Buenos Aires exploring their lifetime relations with their children and their current well-being. The second employed semi-structured interviews with young adults in Zambia to investigate their trajectories towards economic empowerment. In both methodologies, the roles of linked lives and of wider social, economic and political changes were central. The article contributes to critical reflection on methodological choices and trade-offs, by focusing on dilemmas that arise from a desire to address policy makers and more quantitatively-orientated researchers. It explores three themes: the challenges of making sense of disparate narratives of linked lives; the possibilities for engaging with individual subjectivities; and different strategies for situating individual experiences in dynamic social, economic and political contexts. [ABSTRACT FROM AUTHOR]

Many have presumed that in developing countries, contact with children is beneficial to older people's wellbeing, and particularly that women receive more support from children than men because of their lifelong commitment to family responsibilities. This study questions these stylised notions through an analysis of 22 life histories of older women and men living in a district with high rates of social exclusion in Buenos Aires, Argentina. It focuses on the subjective accounts of relationships with children and grandchildren and their influence on current wellbeing. The life histories reveal complex lived experiences and the significance of key events. The informants speak of the anxiety and harm caused by struggling children, about problems of remote relations with successful children, and of the insecurity of the neighbourhood. The analysis contrasts a materialistic interpretation of the influence of children on older people's wellbeing with the informants' more holistic evaluation of family relationships. By applying a life-course framework, we demonstrate that children may be a key source of vulnerability for older people, that the gendering of parent-child relations and later-life wellbeing is nuanced, that both local and national conditions influence relationships with specific children, with implications for the intergenerational transmission of wellbeing. [ABSTRACT FROM AUTHOR]

Social assistance programmes involving cash transfers to poor and vulnerable households have become a major focus of development policy in recent years. This article compares the experiences of three such programmes in Latin America: Oportunidades in Mexico, Jefes y Jefas de Hogares in Argentina, and Brazil's social pension. Particular attention is given to each programme's administrative effectiveness, as well as their impacts on poverty, human capital, and household and gender dynamics. More broadly, the article assesses whether these schemes live up to their billing as 'best practice' for developing countries, and how they relate to wider shifts in the political economy of welfare provision. It concludes that experiences have been mixed, that claims about positive outcomes are sometimes exaggerated, and that the potential of these programmes to substantially re-orientate welfare systems and promote equitable public policies remains limited. [ABSTRACT FROM AUTHOR]

Social health insurance (SHI) has gained popularity in recent years as a health-care funding mechanism for developing countries in Latin America and beyond. This is reflected in a number of high-profile conferences sponsored by international agencies, and a profusion of externally funded reform projects. This article assesses the potential of SHI to provide a sound model of health-care financing, drawing on the experiences of Argentina and Mexico. It uses four criteria to assess the performance of SHI: coverage, equity, effectiveness and sustainability. The article begins by outlining key principles of SHI and comparing it to other models of health-care financing. It then gives a comparative overview of four SHI programmes in Argentina and Mexico, before analysing their performance in greater detail. The article finishes by extracting lessons from this comparative analysis, both for the countries studied and for global debates on SHI. [ABSTRACT FROM AUTHOR]

In November 2002 the World Bank published a report on the Argentine health sector. The report accurately portrays the complexity and severity of the problems facing the health care system. It stresses that these problems are not purely a product of the country's economic collapse, noting that the system has suffered from long-standing structural problems and inefficiencies. Curiously, the report makes no mention of the leading role played by the World Bank in health reform efforts during the 1990s. This paper demonstrates that these reforms did much to worsen pre-existing weaknesses of the sector. The paper criticises the content of the reform agenda and the manner in which it was produced, arguing that these were reforms in which considerations of public health were less significant than conformity to the wider model of neo-liberal social and economic development prevailing at the time. It also highlights problems of implementing the reform agenda, which reduced the coherency of the reforms. The paper goes on to examine the impact of the crisis, noting links with the preceding reforms. It identifies a number of insights and lessons of potential value to other countries which are pursuing similar policies. [ABSTRACT FROM AUTHOR]

The article examines the problems facing a programme to finance health care for pensioners in Argentina, known as PAMI. The programme is accumulating large deficits and many of its services are of doubtful quality. PAMI’s problems and its resistance to reforms are put in the wider context of Argentina’s liberalised health–care system, neo–liberal adjustment and flawed governance. The Argentine experience has relevance for other developing countries with weak state regulatory capacity, and points to the dangers of delegating health financing of older people to the private sector. [ABSTRACT FROM AUTHOR]

Analyzes the role of the public sector in providing social insurance and assistance to the elderly in Argentina between the late 19th century and the present day. Public sector's monopoly of insurance and assistance provision; Exclusion of private and voluntary sectors; Monopolies' failure to provide satisfactory levels of welfare; Gradual process of pluralization.

Background and Objectives: There is very little information about the appropriateness of procedures for admitting older people into care homes in low and middle-income countries like Argentina. This study provides the first systematic study of practice and assesses the extent to which current practice respects fundamental human rights., Research Design and Methods: We apply different methods, including document review and national survey analysis. The study also includes a case study of a single city, La Plata, which draws on local key informant interviews, focus group discussions in different neighborhoods, and a clandestine surrogate patient survey led by local pensioners. This innovative design provides a highly triangulated and contextualized data set., Results: Many older people admitted to care homes did not have high levels of care dependency. Care homes did not usually require or even seek the informed consent of older people, regardless of their cognitive status. There were indications of coercive admission by family members, sometimes in order to obtain access to older people's homes and other property and finances., Discussion and Implications: The study indicates the widespread abuse of the fundamental human rights of tens of thousands of older people in Argentina. There is a need for researchers, policy-makers, and civil society to acknowledge the scale of abuse and develop safeguards., (© The Author(s) 2018. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)