In the past few decades, concerns about “population explosion” have given way to joy about a “demographic dividend”.
About Demographic Dividend:
The Demographic Dividend is expected to give a push to economic growth due to the lower dependency ratio which results from having a larger proportion of the population in the working-age group.
The “Asian Tigers” — countries such as South Korea, Taiwan, Hong Kong and Singapore — as also China, have exemplified the benefits.
Data:
According to the NFHS-5, Life expectancy in India has risen from 50 (1970-75) to 70 years (2014-18).
According to National Statistical Office, In 2031, the old population as a percentage of the overall population is expected to reach 13.1%.
The old-age dependency ratio is expected to rise to 15.7 percent and 20.1 percent in 2021 and 2031, respectively.
Health Status of Elderly:
As per Longitudinal Ageing Study in India (LASI), 11% of the elderly suffer from at least one form of impairment (locomotive, mental, visual and hearing).
About 58 lakhs Indians die from non-communicable diseases (NCDs) in India annually.
Cardiovascular disease (CVD) prevalence is estimated to be 34% amongst 60-74 year olds.
Factors such as familial neglect, low education levels, socio-cultural beliefs, low trust on institutionalised health-care services and affordability affects the health of elders.
Inequity in health-care access compounds the problems for the elderly who are physically, financially and at times psychologically restricted.
Challenges faced by Elderly in India:
Large Aging Population:
India’s life expectancy has increased from 50 years (1970-75) to 70 years (2014-18), resulting in a population of 137 million elders (those aged 60 and above).
It is anticipated to climb by 40% to 195 million in 2031 and 300 million by 2050.
Changing health-care needs
In general, the aged population need additional medical treatment from a variety of sources.
The country’s main difficulty would be providing a wide range of high-quality, affordable, and accessible health and care services to the aged.
Lack of physical infrastructure:
Physical infrastructure is a key constraint to delivering comfort to the elderly.
Even in big cities, there are few facilities and professionals that can properly manage elderly health.
Population Explosion reaping “demographic dividend” benefits:
The anxieties about “population explosion” have given way to delight about a “demographic dividend”.
The “Asian Tigers,” which include South Korea, Taiwan, Hong Kong, and Singapore, as well as China, have demonstrated the advantages.
Financial insecurity:
Many elderly individuals are capable and eager to work beyond the traditional retirement age, but there are few options.
Furthermore, because so much is now done online or remotely, managing day-to-day money and planning for later life can be difficult for older generations.
Finding the right care provision
Many older persons require additional care when total independence is no longer possible.
Family members can sometimes offer this care, but combining this with job and other family duties can put a lot of strain on the caregiver.
Socio Economic Challenges: –
Family neglect, poor education, socio-cultural attitudes and stigma, low faith in institutionalized health-care facilities, and cost aggravate the situation for the elderly.
Inequity in health-care access exacerbates the challenges for the elderly As a result, the majority of them spend their lives neglected.
Unaffordable Healthcare:
The vast majority of the seniors come from lower socioeconomic backgrounds.
They are unable to afford health treatment, and their health continues to deteriorate.
Their inability to make a living accelerates the vicious cycle of bad health and exorbitant health bills.
Mental Issues:
The elderly are not just economically unproductive, but also reliant on family or others for help. This exacerbates their mental and emotional difficulties.
The government does offer programmes to help the elderly and address these challenges, but they are woefully inadequate.
Inadequate schemes
Despite the Ayushman Bharat plan, according to an NITI Aayog assessment, 400 million Indians are uninsured for medical expenditures. There is little doubt that a significant percentage of elderly are among the undiscovered.
According to a status report filed by the government before the Supreme Court of India in 2019, 16 states and union territories (‘of 35’) lacked a single ward/bed dedicated to senior citizens.
Need to protect the elderly population
Elderly peoples carry an immense experienceof their personal and professional life, society at large needs to channelise those experiences for a better tomorrow.
They can provide a vital generational linkfor the upcoming generation, such as providing support and stability to families and society at large.
Grandparents in joint families provide a crucial link for transferring values and morals to the younger generation. Thereby contributing towards bringing up better human beings and responsible citizens.
Acknowledging seniors’ contributions would help to make ours a more age-inclusive societythat does not pit one generation against the other.
Their deep cultural impressions and social experiences provide the necessary buffer against intolerance, violence and hatecrimes.
Government Schemes:
Integrated Programme for Older Persons (IPOP)
It aims to ensure improved quality of life for senior citizens by providing basic comforts like housing, food, medical care, entertainment, etc.
Rashtriya Vayoshri Yojana (RVY)
It is a central sector scheme that is funded by the Senior Citizens’ Welfare Fund.
All amounts that are not claimed from small savings accounts, PPF and EPF are transferred to this fund.
This scheme provides senior citizens belonging to the BPL category with aids and assistive devices to address age-related disabilities.
Artificial Limbs Manufacturing Corporation of India (ALIMCO) under the Ministry of Social Justice and Empowerment implements the scheme.
Indira Gandhi National Old Age Pension Scheme (IGNOAPS)
It is under the National Social Assistance Programme (NSAP) provides financial assistance to senior citizens belonging to the BPL category.
Central assistance of Rs.200 per month is provided to persons in the age group of 60-79 years and Rs.500 per month to persons of 80 years and above.
Varishtha Pension Bima Yojana (VPBY)
It is run by the Ministry of Finance was first launched in 2003 and then re-launched in 2014.
It is a social security scheme that gave a guaranteed minimum pension on a guaranteed minimum return on the subscription amount.
Pradhan Mantri Vaya Vandana Yojana (PMVVY)
It is launched in May 2017, aims to provide social security during the old age.
This scheme is a simplified version of the VPBY and will be implemented by the Life Insurance Corporation (LIC) of India.
Vayoshreshtha Samman:
It is a scheme of awards instituted by the Ministry of Social Justice and Empowerment and gradually upgraded to the status of National Awards, for institutions involved in rendering distinguished services for the cause of the elderly population, especially indigent senior citizens and to eminent senior citizens in recognition of their services.
Senior Citizens Saving Scheme (SCSS)
It is a government-backed savings instrument offered to senior citizens in India.
The deposit matures in five years and can be extended once for an additional three-year period.
National Programme for the Health Care of Elderly (NPHCE)
It is launched by the Ministry of Health and Family Welfare to address various health-related problems of the senior citizens.
The major objectives under the district level activities of the NPHCE are to provide dedicated health facilities in district hospitals, community health centres (CHCs), primary health centres (PHCs) and sub-centres levels through State Health Society.
The healthcare facilities provided under this programme are either free or highly subsidised.
Way Forward:
Home Consultations
They require specialised medical services like tele or home consultations, physiotherapy and rehabilitation services, mental health counselling and treatment.
Seniors-first approach
Seniors-first approach led to over 73% of elderly population receiving at least one dose and 40% being doubly vaccinated by October 2021.
Considering the success story, India should go with an elderly prioritised approach.
Funding
India needs to rapidly increase its public health-care spending, and invest in the creation of well-equipped medical care facilities, home health-care and rehabilitation services.
Infrastructure
Presently, India has a major deficit in infrastructure and skilled medical care resources, with 1.3 hospital beds, 0.65 physicians, and 1.3 nurses for every 1,000 people.
We need to accelerate implementation of programmes such as the National Programme for Health Care of the Elderly (NPHCE).
Schemes
The Ayushman Bharat and PM-JAY ecosystems need to be further expanded and similar, special health-care coverage schemes and services need to be created for senior citizens from the lower economic strata.
