{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:49:35Z","timestamp":1792788575026,"version":"4.5.0"},"reference-count":41,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2021,3,4]],"date-time":"2021-03-04T00:00:00Z","timestamp":1614816000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Centre for Injury Prevention and Research Bangladesh"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>There are currently 1.5 million indigenous people in Bangladesh, constituting 1.8% of the total population and representing one of the country\u2019s most deprived communities. This study explores the health status and quality of life along with their determinants among indigenous older people in Bangladesh in order to fill the knowledge and evidence gap on this topic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A mixed-methods approach was deployed in October 2019 in the Sylhet division of Bangladesh which involved a cross-sectional survey among 400 indigenous older adults (200 males, 200 females) from 8 tea gardens using a pre-tested semi-structured questionnaire. Ten in-depth interviews were also conducted with providers of the tea garden health facilities. Descriptive analysis, multiple logistic and multi-nominal linear regression were performed to explore associated factors around health and quality of life.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the total respondents, the majority (79.5%) had chronic diseases, with visual difficulty being predominant (74%) among the conditions. Almost all (94%) of the respondents experienced delays in receiving treatment and poverty was identified by most (85%) as the primary cause of those delays. Extreme age, being male, living alone and low family income were significantly associated with suffering from chronic conditions. Furthermore, having a chronic condition and extreme age were found to be significantly associated with a low quality of life. Health service providers identified lack of logistical support in the health facilities, the economic crisis and lack of awareness as the major causes of poor health status and poor health seeking behaviour of the indigenous older adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Indigenous older men in extreme old age are more vulnerable to adverse health conditions and poor quality of life. Health literacy and health seeking behaviour is poor among indigenous older adults generally and there is a huge gap in the health services and social supports available to them.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0247957","type":"journal-article","created":{"date-parts":[[2021,3,4]],"date-time":"2021-03-04T13:35:15Z","timestamp":1614864915000},"page":"e0247957","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":28,"title":["Health and wellbeing of indigenous older adults living in the tea gardens of Bangladesh"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2265-2742","authenticated-orcid":true,"given":"Farah Naz","family":"Rahman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1817-3730","authenticated-orcid":true,"given":"Hafiz T. A.","family":"Khan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Md. Jahangir","family":"Hossain","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony Obinna","family":"Iwuagwu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,3,4]]},"reference":[{"key":"pone.0247957.ref001","unstructured":"United Nations. World Population Ageing 2019 [Internet]. New York; 2020 [cited 2021 Jan 23]. Available from: moz-extension:\/\/51283610-bdfc-4ef6-b5d5-59f36c2b1343\/enhanced-reader.html?openApp&pdf=https%3A%2F%2Fwww.un.org%2Fen%2Fdevelopment%2Fdesa%2Fpopulation%2Fpublications%2Fpdf%2Fageing%2FWorldPopulationAgeing2019-Report.pdf."},{"issue":"4","key":"pone.0247957.ref002","first-page":"814","article-title":"World Population Ageing 1950\u20132050","volume":"28","author":"G McNicoll","year":"2002","journal-title":"Popul Dev Rev"},{"key":"pone.0247957.ref003","article-title":"Life expectancy at birth, total (years)\u2014Bangladesh","author":"The World Bank","year":"2019","journal-title":"Data"},{"issue":"3","key":"pone.0247957.ref004","first-page":"261","article-title":"Population challenges for Bangladesh in the coming decades","volume":"26","author":"PK Streatfield","year":"2008","journal-title":"J Heal Popul Nutr"},{"issue":"33","key":"pone.0247957.ref005","first-page":"34","article-title":"Population ageing in Bangladesh and its implication on health care\u2014Middlesex University Research Repository","volume":"9","author":"R Kabir","year":"2013","journal-title":"Eur Sci J"},{"key":"pone.0247957.ref006","author":"United Nations","year":"2007","journal-title":"Indigenous Peoples, Indigenous Voices: The UN Permanent Forum on Indigenous Issues"},{"key":"pone.0247957.ref007","article-title":"Indigenous Peoples Overview","author":"The World Bank","year":"2020"},{"key":"pone.0247957.ref008","author":"World Directory of Minorities and Indigenous Peoples","year":"2019","journal-title":"Bangladesh\u2014Minority Rights Group"},{"key":"pone.0247957.ref009","author":"IWGIA","year":"2020","journal-title":"Indigenous Peoples in Bangladesh"},{"key":"pone.0247957.ref010","author":"Kapping Foundation","year":"2018","journal-title":"Factsheet Bangladesh"},{"issue":"1","key":"pone.0247957.ref011","article-title":"Health care and aboriginal seniors in urban Canada: Helping a neglected class","volume":"2","author":"BB Beatty","year":"2011","journal-title":"Int Indig Policy J"},{"key":"pone.0247957.ref012","first-page":"1","volume-title":"International Journal for Equity in Health","author":"C Davy","year":"2016"},{"key":"pone.0247957.ref013","author":"A Booth","year":"2005","journal-title":"The Health Status of Indigenous and Non-Indigenous Australians"},{"issue":"1","key":"pone.0247957.ref014","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1111\/j.1753-6405.2010.00473.x","article-title":"The comparison of health status and health services utilisation between Indigenous and non-Indigenous infants in Australia","volume":"34","author":"L Ou","year":"2010","journal-title":"Aust N Z J Public Health"},{"key":"pone.0247957.ref015","volume":"43","author":"LP Gallardo-Peralta","year":"2018","journal-title":"Quality of life in indigenous and non-indigenous older persons in the north of Chile"},{"issue":"2","key":"pone.0247957.ref016","volume":"6","author":"H Thommasen","year":"2006","journal-title":"Impact of chronic disease on quality of life in the Bella Coola Valley"},{"issue":"2","key":"pone.0247957.ref017","doi-asserted-by":"crossref","first-page":"98","DOI":"10.3329\/jemc.v4i2.19677","article-title":"Nutritional Status of Settler and Indigenous Women of Reproductive Age Group in Khagrachari District, Bangladesh","volume":"4","author":"MM Haque","year":"2014","journal-title":"J Enam Med Coll"},{"issue":"3","key":"pone.0247957.ref018","first-page":"353","article-title":"Healthcare-seeking behaviour among the tribal people of bangladesh: Can the current health system really meet their needs?","volume":"30","author":"SA Rahman","year":"2012","journal-title":"J Heal Popul Nutr"},{"issue":"2","key":"pone.0247957.ref019","first-page":"1672","article-title":"Determinants of antenatal and postnatal care visits among indigenous people in Bangladesh: A study of the Mru community","volume":"11","author":"R Islam","year":"2011","journal-title":"Rural Remote Heal"},{"issue":"4","key":"pone.0247957.ref020","first-page":"385","article-title":"Self-Assessed Health Status among Ethnic Elderly of Tea Garden Workers in Bangladesh. Ageing Int","volume":"44","author":"MK Hossain","year":"2019","journal-title":"Internet]"},{"key":"pone.0247957.ref021","article-title":"Survival under Threat: Human Rights Situation of Indigenous Peoples in Bangladesh","author":"AIPP","year":"2014","journal-title":"Asia Indigenous Peoples Pact"},{"key":"pone.0247957.ref022","author":"MA Rahman","year":"2016","journal-title":"An Enquiry into the Living Conditions of Tea Garden Workers of Bangladesh: A Case Study of Khan Tea Estate A Dissertation"},{"issue":"4","key":"pone.0247957.ref023","doi-asserted-by":"crossref","first-page":"67","DOI":"10.18848\/2160-1909\/CGP\/v03i04\/35125","article-title":"Chronic Non-Communicable Diseases among the Elderly in Bangladesh Old Age Homes","volume":"3","author":"T Taskin","year":"2014","journal-title":"Int J Aging Soc."},{"key":"pone.0247957.ref024","author":"M Mohammad Munsur Ismail Tareque","year":"2010","journal-title":"Determinants of Living Arrangements, Health Status and Abuse among Elderly Women: A Study of Rural Naogaon District, Bangladesh"},{"issue":"12","key":"pone.0247957.ref025","doi-asserted-by":"crossref","first-page":"2270","DOI":"10.1017\/S1368980009005096","article-title":"The multidimensional background of malnutrition among rural older individuals in Bangladesh a challenge for the Millennium Development Goal","volume":"12","author":"T Ferdous","year":"2009","journal-title":"Public Health Nutr"},{"key":"pone.0247957.ref026","first-page":"32","article-title":"Health Status and Health Needs among the Aged Population in Chapai Nawabganj District of Bangladesh","volume":"23","author":"MM Rahman","year":"2009","journal-title":"Indian J Gerontol"},{"issue":"1","key":"pone.0247957.ref027","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/13603110701201775","article-title":"Exclusion of indigenous children from primary education in the Rajshahi Division of northwestern Bangladesh","volume":"13","author":"P Sarker","year":"2009","journal-title":"Int J Incl Educ"},{"issue":"2","key":"pone.0247957.ref028","first-page":"1672","article-title":"Determinants of antenatal and postnatal care visits among Indigenous people in Bangladesh: a study of the Mru community\u2014PubMed","volume":"11","author":"M Islam","year":"2011","journal-title":"Rural Remote Heal"},{"issue":"1","key":"pone.0247957.ref029","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1093\/geront\/gnr085","article-title":"Development of short versions for the WHOQOL-OLD module","volume":"52","author":"J Fang","year":"2012","journal-title":"Gerontologist"},{"key":"pone.0247957.ref030","volume-title":"Traditional occupations of indigenous and tribal peoples: emerging trends","author":"ILO","year":"2000"},{"key":"pone.0247957.ref031","article-title":"How Vulnerable are Bangladesh\u2019s Indigenous People to Climate Change?","author":"BG Gunter","year":"2011","journal-title":"SSRN Electron J."},{"key":"pone.0247957.ref032","author":"WHO","year":"2018","journal-title":"Life Expectancy in Bangladesh"},{"issue":"1","key":"pone.0247957.ref033","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/S0167-4943(03)00019-0","article-title":"Gender and rural-urban differences in reported health status by older people in Bangladesh","volume":"37","author":"ZN Kabir","year":"2003","journal-title":"Arch Gerontol Geriatr"},{"key":"pone.0247957.ref034","volume-title":"BRAC University Journal","author":"IMS Kalam","year":"2006"},{"issue":"4","key":"pone.0247957.ref035","first-page":"406","article-title":"Prevalence and patterns of multimorbidity among elderly people in rural Bangladesh: A cross-sectional study","volume":"29","author":"MA Khanam","year":"2011","journal-title":"J Heal Popul Nutr"},{"issue":"5","key":"pone.0247957.ref036","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1177\/1403494809102778","article-title":"Nutritional status and self-reported and performance-based evaluation of physical function of elderly persons in rural Bangladesh","volume":"37","author":"T Ferdous","year":"2009","journal-title":"Scand J Public Health"},{"issue":"1","key":"pone.0247957.ref037","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1177\/101053950301500102","article-title":"Health Needs and Health Status of the Elderly in Rural Bangladesh","volume":"15","author":"GMM Hosain","year":"2003","journal-title":"Asia-Pacific J Public Heal"},{"issue":"2","key":"pone.0247957.ref038","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1177\/101053950101300208","article-title":"Differing health and health-seeking behaviour: ethnic minorities of the Chittagong Hill Tracts, Bangladesh","volume":"13","author":"SM Ahmed","year":"2001","journal-title":"Asia Pac J Public Health"},{"issue":"3","key":"pone.0247957.ref039","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1177\/0898264306286198","article-title":"Social capital and quality of life in old age: Results from a cross-sectional study in rural Bangladesh","volume":"18","author":"J Nilsson","year":"2006","journal-title":"J Aging Health"},{"issue":"3","key":"pone.0247957.ref040","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1016\/j.jaging.2004.07.006","article-title":"Role and function: Aspects of quality of life of older people in rural Bangladesh","volume":"19","author":"J Nilsson","year":"2005","journal-title":"J Aging Stud."},{"issue":"1","key":"pone.0247957.ref041","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1080\/03630242.2016.1153020","article-title":"Utilization of maternal health care services among indigenous women in Bangladesh: A study on the Mru tribe","volume":"57","author":"RM Islam","year":"2017","journal-title":"Women Heal"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0247957","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,3,4]],"date-time":"2021-03-04T13:36:07Z","timestamp":1614864967000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0247957"}},"subtitle":[],"editor":[{"given":"Filipe","family":"Prazeres","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2021,3,4]]},"references-count":41,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2021,3,4]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0247957","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,4]]}}}