The proof of a truly developed country lies in the fact that it not only nurtures its youth, but takes equal care of its elders as well.
Over the past few decades, concerns about the “population explosion” have given way to joys about the “demographic dividend”. The latter is expected to spur economic growth due to its low dependency ratio, resulting in a larger proportion of the population in the working age group. The “Asian tiger” – countries such as South Korea, Taiwan, Hong Kong and Singapore, as well as China, have exemplified the benefits.
NFHS-5 data
The large youth population is also expected to encourage innovation and entrepreneurship. Not surprisingly, then, youth are focusing on many programs to facilitate their education, entrepreneurship, sports training etc., but also welfare. The same should be the case not only from an economic point of view, but especially from a health point of view. Poor health, like insufficient education, may well eliminate demographic gains. Of concern is data from the latest National Family Health Survey (NFHS)-5, which indicates that although much progress has been made, metrics for infant and child health remain dismal, some as low as five years. . First.
Yet, when we focus on youth, there is both a need and a benefit to look at the other end of the spectrum as well. Life expectancy in India has increased from 50 (1970-75) to 70 years (2014-18); As a result, the number of elderly people (over 60 years) is already 137 million, and is expected to increase by 40% to 195 million in 2031 and 300 million by 2050. While one view would see them as dependents (and, therefore, a drag on the economy), a rather different view would see them as a potential asset: a vast resource of experienced, knowledgeable people. Turning them from dependents into productive members of society depends on two primary factors: their health and their capabilities.
changing health care needs
In general, the elderly population requires a greater range of medical attention. According to the first Longitudinal Aging Study (LASI) in India, 11% of the elderly suffer from at least one type of impairment (movement, mental, visual and hearing). It is estimated that 5.8 million Indians die of non-communicable diseases (NCDs) annually in India, and the prevalence of cardiovascular disease (CVD) is estimated to be 34% between 60–74 years, compared to those above 75 years of age. has increased to 37%. As we move towards a demographic where the growth rate of the elderly is much higher than that of the youth, perhaps the biggest challenge facing the country is to provide quality, affordable and accessible health and care services to the elderly. They require an array of specialized medical services at home including tele or home counselling, physiotherapy and rehabilitation services, mental health counseling and treatment as well as pharmaceutical and diagnostic services. These needs are especially clear now, with the elderly being advised to stay indoors as a precaution against the novel coronavirus pandemic.
According to the 2016 Healthcare Access and Quality Index (HAQ), India improved its HAQ score from 24.7 in 1990 to 41.2 in 2016. However, we are still well below the global average of 54 points, ranking at 145 out of 195. Country. The low HAQ is made worse in small towns and rural areas where basic quality health care services are very inadequate. Factors such as family neglect, low education levels, socio-cultural beliefs and stigma, low trust and affordability in institutional health care services exacerbate the situation for the elderly. Inequality in health care access exacerbates problems for the elderly, who are already physically, financially and at times psychologically restricted in understanding, responding to and seeking medical care across various diseases. As a result, most of them live out their years in neglect.
inadequate plans
Health care for the elderly, unfortunately, has been greatly neglected. A large proportion of the elderly are from the lower socio-economic strata (many of them destitute). They are unable to afford the cost of health care and always slip into poor health. The inability to earn a living has intensified the vicious cycle of poor health and the affordable cost of health. As a result, they are not only financially unproductive but also dependent on the support of family or other people. This, and poor physical health, exacerbate their mental and emotional problems. The government has schemes that cover the elderly and wants to take care of these issues, but they are completely inadequate.
Despite Ayushman Bharat, the government’s health insurance scheme for the underprivileged, and private health insurance, a NITI Aayog report suggests that 400 million Indians have no financial cover for health expenses. It can be ensured that the exposed people include a large number of elderly people. Both the Center and the states have pension plans for the elderly, but they offer a nominal amount as low as ₹350 to ₹400 per month in some states. It is also not universal.
A 2007 law requires states to ensure designated facilities for the elderly in each district hospital, led by doctors with experience in geriatric care. Yet, a status report filed by the government in the Supreme Court of India in 2019 states that 16 states and union territories (’35’) do not have a single ward/bed dedicated to the elderly.
opportunities in challenges
Given the range of diverse challenges, can India take care of its growing population? The success of the COVID-19 vaccination strategy gives hope: a seniors-first approach has led to more than 73% of the elderly population receiving at least one dose and nearly 40% to be double vaccinated by October 2021.
Keeping the demographic trends in mind, India should re-imagine its entire health care policy for the next few decades with a priority approach to the elderly. Since senior citizens require the most diverse range of health care services, all other age groups will benefit from creating adequate services for them. Apart from legislating health care and insurance policies for the elderly, India needs to take some measures aggressively while finding opportunities in the midst of this challenge.
India needs to rapidly increase its public health care spending, and invest heavily in building well-equipped and staffed medical care facilities and home health care and rehabilitation services.
Currently, India has a major shortage of infrastructure and skilled medical care resources, with 1.3 hospital beds, 0.65 physicians and 1.3 nurses for every 1,000 people. In the next decade, we have the capacity to add over 30 lakh beds, 1.54 million doctors and 24 lakh nurses. We need to expedite the implementation of programs like the National Program for Health Care of the Elderly (NPHCE). There is a need to further expand the Ayushman Bharat and PM-JAY ecosystem and similarly, there is a need to create special health care coverage schemes and services for senior citizens from the lower economic strata. National Digital Health Mission has tremendous potential to expand medical consultation to the interior parts of the country. However, this requires a digital literacy campaign for senior citizens.
These necessary steps will help transform the elderly into a vast resource for socio-cultural and economic development, giving a completely different approach to the “demographic dividend”. After all, the proof of a truly developed and caring nation is not only how it nurtures its young but also how it takes care of its growing population.
Kiran Karnik is the chairperson and author of HelpAge India. His latest book is ‘The Decisive Decade: India 2030: Gazelle or Hippo’.
https://news.bharattimes.co.in/elders-are-assets-not-dependents/