Population ageing and healthcare: challenges of access and options for elderly in India

Abstract

As per World Population Survey carried out by Department of Economic and Social Affairs of the United Nations in 2013, Population ageing is taking place in nearly all the countries of the world. The global share of older people (aged 60 years or over) increased from 9.2 per cent in 1990 to 11.7 per cent in 2013 and will continue to grow as a proportion of the world population, reaching 21.1 per cent by 2050. This process may lead to a relative reduction in the proportion of children and to an increase in the share of people in the main working ages and of older persons in the population. Ageing results from various parameters to include decreasing mortality, declining fertility and availability of better health care specifically in urban area. The projections as per the study show that older persons will be increasingly concentrated in the less developed regions of the world due to comparatively faster ageing. By 2050, nearly 8 in 10 of the world s older population will live in the less developed regions. The phenomenon of population ageing is becoming a major concern for the policy makers all over the world, for both developed and developing countries, during last two decades. But the problems arising out of it will have varied implications including healthcare for underdeveloped, developing and developed countries. India has got a unique distinction considering the phenomenon of population ageing. India differs widely with other countries in its rich cultural heritage which directly affects the living arrangement of elderly people. The effect of population ageing is in nascent stage and suitable policy may develop untapped economic potential of elderly people. The conventional living patterns among the elderly have changed drastically following the reduction in fertility and the increase in life expectancy at older ages. In India, the traditional practice has been for people to live with their children in old age; this is not necessarily with the intention of receiving support; often the rest of the family also benefits from the arrangement. Due to change in social scenario resulting slowly due to nuclear family system compounded by electronic gadget culture, new age children have started distancing themselves from parents at a juncture when they really need them. Nuclear family emotion system gives rise to clinical problems or symptoms usually developing during periods of heightened and prolonged family tension.Maintenance and Welfare of Parents and Senior Citizens Act, 2007 was brought into effect as a follow up of Older Persons (Maintenance, Care and Protection) Bill, 2005 in order to ensure financial and social security to elderly person, however the policy did not deliberate upon health issues related with rehabilitation. The policy aims to treat elderly people of rural and urban India equally whereas a lot of studies have clearly indicated need for specific policies aimed for elderly people for rural area and different policies for different states. This need is felt due to definition of poverty, l iving arrangement and disease profile in rural area differs widely with that of urban area. The population ageing will result in tremendous burden on health care and rehabilitation of elderly people for the government and the society. National Health Policy was first evolved in 1983 and later revised in 2002. The policy was reviewed in 2012 where in major objective of ensuring acceptable Standard of Good Health and More Equitable Access to Health Services across entire country was reiterated. Though priority was laid out for Preventive and First Line Curative initiatives for Primary Health Level, however the health management and rehabilitation problems for elderly was not discussed. A comprehensive Health management and Rehabilitation policy for Elderly people is not existing. As our country population ages, this scenario is going to result in tremendous loss of our elderlyin absence of adequate data collection required for Health Management and Rehabilitation policy. Though various studies have been carried out for living arrangements and its impact on health status of elderly people, however involvement of elderly in society for economic growth has not been addressed. Further no survey has been carried out to make available micro-data on the diverse aspects of the lives of elderly people so that a sustainable social security system could be established in India. Elderly people can play an important role in building the nation because of their immense experience. Loss of elderly compounds the loss, and hence top priority is required for formulating and implementing the policy. This policy memo addresses the glaring issues data insufficiencies with regard to distinct population ageing for rural and urban population, possible living arrangements, requirement and format for recording micro data on the diverse aspects of the lives of elderly people , possible key dimension of health policy including access and options for elderly and possible avenues for elderly to significantly contribute to society.