Stretching the social protection system beyond capacity: tensions between governance capacity and conceptualisations of elder care in nursing homes in Indonesia

Abstract

PurposeAgeing is a global concern that poses many challenges for governments, particularly in relation to the pressing issue of how to provide adequate social protection for the increasing number of elderly. Alongside rapid social and demographic transformation, Indonesia is especially challenged by the increasing number of elderly in need of formal care that is stretching the capacities of government and necessitates improvements in the social protection system. This study examines governance capacity in nursing homes and offers recommendations for improving the social protection system.Design/methodology/approachThe research presents a qualitative case study of government aged care centres in East Java and the experiences of residents and staff of three centres managed by the Provincial Social Service of East Java. The case study is based on ethnographic fieldwork, semi-structured interviews with 32 informants comprising directors, managers, staff and elderly residents of nursing homes.FindingsThe research finds that while social protection is in place, governance capacities at the provincial and local level are thinly stretched. The research highlights the tensions between existent governance capacities – in terms of mobility, decision-making, implementation and established local structures of governance and management – and the inability to meet the increasing demands for government elder care services and resources amidst broader societal transformations such as shifts in cultural framing of familial care of elderly. The findings point to the importance of understanding the dynamic relationship between governance capacity and the shifting terrains of elderly care due to societal transformation.Originality/valueThe research brings attention to the pivotal role that governance capacity plays in shaping the experiences and challenges of local government level elder care provision and the growing need for elder care in the face of an ageing population and shifts in kinship and family elder care arrangements. Elder care is not simply about addressing basic needs but also the quality and dignity of elderly and this is not easy to address where social protection systems are stretched beyond capacity. Recommendations are provided for enhancing government policy and expanding the scope for building cross-sectorial partnerships.