Human autonomy and health system responsivenes in developing countries: The position of the elderly decsion making inhealth care in Kenya

Observance of autonomy in health care delivery to the elderly isvariably compromised globally following the demographic transition of the 21^st century that got many nations unprepared to meet health care needs of this group. As an element of health systems responsiveness, the review examined the implementation of autonomy in caring for the elderly with focus to Kenya. The hypothesis is that the observance of autonomy in health care delivery is compromised. The paper analytically reviewed the global to regional perspectives of the implementation. Findings are that both the health care providers, the elderly and the community contribute significantly to compromise autonomy in health care delivery. Key features include negative verbal utterances and negative attitudes that negates conducive participatory decision making environments. However, there are also good practices that promotes and enhance observance of autonomy when caring for the elderly. Theories that anchor promotion of autonomy include economic efficiency and psychological theories. Elderly persons who get the opportunity to participate in their care experiences good physical and mental wellbeing which translate to optimal aging. Improvement in observing autonomy in caring for the elderly can be achieved through health promotion, specialized training in gerontology and community sensitization.