ELITE (Enhancing Living Experiences of the Elderly)

Overview:

Project ELITE is a hybrid implementation research initiative by MGIMS, Sevagram that promotes healthy ageing through integrated, community-based strategies. It empowers older adults to practice self-care while creating supportive environments through elderly recreational spaces and collaboration with health, education, and local governance systems.

Although Indian society traditionally respects older adults, rapid social change has increased ageism, social isolation, and limited opportunities for their meaningful participation in community life. ELITE addresses this challenge through a social engineering approach to build an Age-Integrated Society, where people of all generations learn, work, and celebrate together.

A key component, SAHJEEVAN Group (Group of older adults), fosters regular interaction among older adults, children, adolescents, and families through structured intergenerational activities. Older adults share their knowledge, skills, and life experiences, while younger generations develop empathy and positive attitudes towards ageing. By embedding intergenerational engagement into community systems, ELITE reduces ageism, strengthens social participation, and creates healthier, more inclusive communities for all ages.

The ELITE Project transformed how older adults are perceived and engaged within rural communities by shifting them from passive recipients of care to active contributors to family and community life. Through Sahjeevan Groups, intergenerational engagement, and a cascade training model, the project strengthened social connectedness, reduced ageist attitudes, and promoted healthy ageing.

The project trained 169 ASHAs, 11 ASHA Facilitators, nearly 400 Older Adult Master Trainers, and approximately 2,500 Older Adult Peer Trainers, creating a cascading model for sustainable community impact. The intervention reached thousands of older adults across rural communities through regular Sahjeevan meetings, health promotion community activities, and intergenerational engagement activities.

By shifting older adults from being viewed as passive recipients of care to active agents of change, the ELITE Project has demonstrated that community-led, intergenerational approaches can successfully promote healthy aging while strengthening families, communities, and primary healthcare systems. The project provides a scalable and sustainable model that can be adapted for similar rural settings across India and other low- and middle-income countries.

Purpose/Objectives: The project aimed to:

  1. Empowering Elderly for Healthy Aging: Implement community-based strategies for elderly self-care and promoting healthy and happy aging through Health and Wellness Centers.
  2. Enhancing Intergenerational Integration: Promote elderly involvement in early childhood and adolescent well-being to foster age-integrated societies.

For older participants:

  • Improve physical, mental, and social well-being. 
  • Enhance self-care, confidence, and leadership skills. 
  • Increase social participation and reduce loneliness. 
  • Empower older adults as mentors, peer educators, and active contributors to their families and communities. 

For younger people: 

  • Foster positive attitudes toward ageing and challenge age-related stereotypes. 
  • Strengthen intergenerational understanding, empathy, and mutual respect. 
  • Encourage learning from older adults through shared experiences, knowledge, and community activities. 
  • Promote stronger family and community relationships across generations. 

The participants:

Who were they?

  • Older adults (community members aged 60 years and above) 
  • Accredited Social Health Activists (ASHAs) 
  • ASHA Facilitators 
  • Community Health Officers (CHOs) 
  • Auxiliary Nurse Midwives (ANMs) 
  • Children, adolescents, caregivers, and other community members participating in intergenerational activities How many took part: 
  • 69 ASHAs 
  • 11 ASHA Facilitators 
  • Nearly 400 Older Adult Master Trainers 
  • Around 2,500 Older Adult Peer Trainers 
  • 20,000 older adults and community members participated through Sahjeevan Groups and community events. 

What were the age ranges:

  • Older adults: 60 years and above 
  • Children and adolescents: Approximately 3–18 years 
  • Frontline health workers: Adult participants (approximately 21–60 years)

How were they recruited/involved:

Older adults voluntarily joined Sahjeevan Groups through community mobilization and village outreach. Older Adult Master Trainers were purposively selected based on their interest, leadership potential, and ability to train and motivate peers. ASHAs, ASHA Facilitators, CHOs, and ANMs participated through nominations from the district health system. Participants were engaged through structured training programmes, peer-led learning, monthly Sahjeevan Group meetings, and intergenerational community activities delivered using a cascade training approach.

What were the benefits/outcomes for the older people?

The ELITE project has created measurable improvements at the individual, family, community, and institutional levels. Older adults report increased confidence, improved self-care practices, greater social participation and enhanced physical and mental well-being. They experienced reduced loneliness, stronger peer support, greater respect within their families and communities, and increased opportunities to contribute as mentors and peer leaders. The project has also increased awareness of healthy ageing and ageism among teachers, students, ASHA workers, and local institutions, encouraging more age-friendly practices within schools, health services, and village governance.

What were the benefits/outcomes for the younger people?

Through intergenerational activities, children and young people have developed greater respect and empathy towards older adults, more positive attitudes towards ageing, strengthened relationships with older adults, and gained opportunities to learn from their knowledge, experiences, and life skills while families have strengthened relationships by involving grandparents more actively in household, educational, and community life.

What were the benefits/outcomes for the community?

The project strengthened community cohesion by promoting age-friendly practices, reducing ageist attitudes, and encouraging collaboration across generations. Sahjeevan Groups and Sahjeevan Centres created sustainable community platforms that continue to support healthy ageing, social inclusion, and active participation of older adults.

Activities/Events:

The ELITE Project established Sahjeevan Groups in every participating village to create a supportive platform for older adults to connect, learn, and actively participate in community life. These groups served as the foundation for peer support, leadership, and community engagement.

Monthly Sahjeevan Group meetings, facilitated by trained ASHAs, were conducted in each village. The meetings focused on healthy ageing, self-care, social interaction, problem-solving, and peer support while providing opportunities for older adults to share experiences and build stronger social connections.

To strengthen capacity, ASHAs and Older Adult Master Trainers received structured refresher training every three months, enabling them to continue peer-led activities and sustain community engagement.

The project also organized intergenerational activities, community celebrations, and festival events that brought together older adults, children, adolescents, and families to foster mutual respect, reduce ageism, and strengthen social bonds. Recreational activities, health awareness sessions, and exposure visits, including trips for older adults, promoted well-being, confidence, and social participation.

Additionally, Sahjeevan Centres were established in selected villages, providing dedicated community spaces where older adults could regularly meet, interact, learn, participate in group activities, and support one another. Together, these activities created vibrant, age-friendly communities that encouraged active and meaningful ageing.

Evaluation:

ELITE adopts a robust mixed-methods monitoring and evaluation framework where participants and beneficiaries are engaged to do the monitoring and evaluation. Evidence is gathered through baseline and midline assessments, feedback forms, and Kirkpatrick's training evaluation model, alongside innovative participatory tools such as Spider Web exercises, Most Significant Change stories, Ripple Effect Mapping, and Participatory Learning and Action (PLA) methods to measure change at personal, family, group, and village levels. Case studies, personal stories, dissemination meetings, and co-learning workshops further document community experiences and guide program improvement.

What would be done differently in the future?

Future implementation will focus on strengthening the sustainability and scalability of the programme. This includes expanding the ELITE model to additional villages, increasing the number of Sahjeevan Centres, and establishing stronger linkages with existing government health and social welfare programmes. Greater involvement of family members, caregivers, schools, and local community organizations will be encouraged to enhance intergenerational engagement beyond organised activities.

The project will also introduce more structured long-term follow-up of participants to better measure changes in health, social connectedness, and quality of life over time. Routine and rigorous monitoring will be strengthened to improve programme evaluation and decision-making.

Funding:

The ELITE project is funded and supported by the Indian Council of Medical Research (ICMR), Govt. of India.

Sustainability:

  • Project ELITE has built a strong foundation for long-term sustainability through community ownership, local capacity building, and institutional partnerships. Currently, 133 intergenerational groups are active across more than 100 villages, providing regular opportunities for older adults, children, adolescents, and families to learn, support, and engage with one another.
  • A key sustainability strategy is the establishment of Sahjeevan Kendras (Co-existence Intergenerational Centres) community-supported spaces that serve as permanent hubs for elderly group meetings, intergenerational activities, health education, and social participation. These centres are being expanded through community contributions and local leadership, fostering ownership beyond the project period.
  • ELITE has also developed a committed network of self-motivated elderly Master and Peer Trainers, who voluntarily continue mentoring groups and promoting healthy ageing within their villages. Their efforts are complemented by the capacity building of ASHA workers and other frontline healthcare workers, embedding project knowledge within the existing public health system and strengthening continuity of care.
  • The project's evidence and implementation model are being shared with the ICMR, a key technical advisory body to the Government of India and other stakeholders to support scale-up and policy integration. These ongoing efforts aim to facilitate wider adoption through government programmes and create sustainable, age-friendly communities beyond the current project area.
  • Building on the project's success, additional intergenerational activities, community events, health awareness programmes, exposure visits, and festival celebrations will continue to strengthen relationships between generations and promote active ageing. Efforts are also underway to expand the ELITE model to additional villages, strengthen partnerships with the district health system, and integrate the programme into routine community health activities. The continued involvement of ASHAs, frontline health workers, community leaders, and older adults will help ensure that the project's benefits are sustained and scaled to reach more communities.

Priorities:

The ELITE Project closely aligns with the mission of Mahatma Gandhi Institute of Medical Sciences (MGIMS), Sevagram, which is committed to improving the health and well-being of rural communities through excellence in community-based healthcare, education, and research. The project reflects MGIMS's emphasis on preventive and promotive health, community participation, and evidence-based interventions that address emerging public health challenges. By promoting healthy and active ageing through community engagement, strengthening the capacity of frontline health workers, and generating research evidence to inform policy and practice, the ELITE Project contributes directly to MGIMS's priorities of improving rural health, fostering community empowerment, and developing sustainable, scalable models of care. The project also reinforces MGIMS's commitment to innovation, interdisciplinary collaboration, and translating research into meaningful community impact.

National Objectives:

The ELITE Project contributes to the National Health Systems Resource Centre (NHSRC) Guidelines on Comprehensive Primary Health Care for Older Persons by promoting healthy and active ageing through community-based, person-centred care. The project strengthens the capacity of frontline health workers (ASHAs, ANMs, and CHOs), encourages early identification of older adults' health and social needs, and improves access to age-friendly services at the community level. The project also aligns with the Government of India's priorities under the National Programme for Health Care of the Elderly (NPHCE) by promoting healthy ageing, reducing social isolation, encouraging community participation, and supporting functional ability and well-being among older adults. Through Sahjeevan Groups, intergenerational engagement, and community-led interventions, the project complements national efforts to build age-friendly communities and strengthen primary healthcare for India's ageing population.

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