Overlooked health and protection needs of older women in humanitarian settings: A qualitative study of practitioners

Global trends indicate increases in aging populations alongside humanitarian crises due to conflict, disasters, and climate change. However, the needs of older persons, and in particular, older women, are under-addressed in humanitarian programming. This invisibility is particularly evident in gender-based violence and sexual and reproductive health programming for older women. The present study sought to: (1) understand interconnected health and violence needs and priorities for older women in humanitarian settings; (2) identify the challenges and barriers across the ecological model that inhibit older women’s ability to respond to their interconnected health and violence needs; and (3) explore how different humanitarian settings may influence interconnected health and violence needs and priorities of older women. A global qualitative scoping study comprising in-depth interviews with 19 humanitarian practitioners was undertaken to understand the overall state of older women programming in humanitarian settings, how challenges related to violence or health concerns may materialize, and possible intervention strategies. Specific challenges centered on evacuation and mobility concerns, lack of visibility in humanitarian data, economic precarity and exploitation, elder abuse, and specific concerns related to hygiene and incontinence. Future work should include institutionalizing disaggregated data systems, designing universally accessible SRH and GBV programs, conducting participatory research directly with older women, and advancing community-based and intergenerational programming in partnership with local organizations to ensure an equitable, effective, and ethical humanitarian response for a globally aging population. Future research, including ethical analyses of resource allocation decisions, is warranted.Author summary: The health and protection needs of older women aged 60 years and above are often under-addressed in humanitarian emergencies. Better understanding these needs is important given both a globally aging population and increases in displacement and humanitarian crises over time. To address this gap, we conducted qualitative interviews with humanitarian practitioners to understand potential needs, challenges, and opportunities to support older women in crisis settings with a particular focus on sexual and reproductive health and gender-based violence. Practitioners highlighted concerns such as mobility challenges during displacement, ageist and sexist attitudes of providers, lack of older women’s visibility in humanitarian data systems, economic precarity and exploitation, elder abuse, and specific concerns related to hygiene and managing incontinence. Opportunities to improve humanitarian response may include improving data collection systems to ensure older women are captured, ensuring health and protection programming are accessible and non-discriminatory, and increasing partnerships with local older persons organizations.