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India's Elderly Population

2023 OCT 5

Mains   > Social justice   >   Welfare Schemes   >   Vulnerable & Backward sections

IN NEWS:

  • The United Nations Population Fund, India (UNFPA), in its recently released "India Ageing Report 2023," has said that the percentage of the elderly population in India is projected to be over 20% of the total population by 2050.
  • The report also said that with the decadal growth rate of the elderly population of India currently estimated to be at 41%, it is likely that the elderly population will have surpassed the population of children (aged 0 to 15 years) in the country by 2046.
  • Also, recently, the Ministry of Social Justice and Empowerment organised 'Samajik Adhikarita Shivirs' camps at 72 locations simultaneously to distribute various types of aid and assistive devices to over 12814 pre-identified senior citizens under the Government of India's Rashtriya Vayoshri Yojana scheme.

HIGHLIGHTS OF INDIA AGEING REPORT 2023:

  • Inter-state variation:
    • The report said that most states in the southern region and select northern states such as Himachal Pradesh and Punjab reported a higher share of the elderly population than the national average in 2021, a gap that is expected to widen by 2036.
    • Compared with southern and western India, the central and northeastern regions have a younger group of states.
  • Old-age dependency ratio:
    • The report also found that in the southern region, the old-age dependency ratio (elderly people per 100 people between 15 and 59 years) was higher than the national average at around 20, as is true of western India at 17. Overall, Union Territories (13) and the north-eastern region (13) reflected lower old age dependency ratios.

STATISTICS:

  • The elderly population (aged 60 years or above) in India accounted for 8.6% of the total population in 2011. Of which 53 million are females and 51 million are males.

CHALLENGES AND CONCERNS RELATED TO INDIA'S ELDERLY POPULATION:

  • ‘Feminisation’ and ‘ruralisation’ of older population:
    • The India Ageing Report 2023 says challenges facing India’s ageing population are the feminisation and ‘ruralisation’ of the older population in India, and policies must be framed accordingly. Data show that women in India, on average, have a higher life expectancy at the age of 60 and 80 when compared with men.
    • For instance, as per the UNFPA Report titled ‘Caring for Our Elders: Early Responses’ the sex ratio of the elderly has increased from 938 women to 1,000 men in 1971 to 1,033 in 2011 and is projected to increase to 1,060 by 2026. Also, the report observed that as many as 71% of elderly people in India were living in rural areas.
  • Lack of physical infrastructure:
    • Most spaces in homes and public spaces are insensitive to elderly needs. Lack of access to assistive equipment makes the thing worse.
  • Changing family structure:
    • The emerging prevalence of nuclear family set-ups in recent years, the elderly is likely to be exposed to emotional and physical insecurity in the years to come.
    • There is an upward trend in the number of elderly staying alone or with spouse only from 9.0% in 1992 to 18.7% in 2006.
  • Lack of Social Support:
    • The elderly in India are much more vulnerable because of the less government spending on social security system.
    • Insurance cover that is elderly sensitive is virtually non- existent in India and in addition, the pre-existing illnesses are usually not covered.
    • Pension and social security is also restricted to those who have worked in the public sector or the organized sector of industry.
  • Social Inequality:
    • Elderly are a heterogeneous section with an urban and rural divide where they are less vulnerable in rural areas. There is also a divide on account of gender.
    • In a case study, it was found that a major proportion of the elderly women were poorer; received the lowest income per person; had the greatest percentage of primary level education; recorded the highest negative affective psychological conditions; were the least likely to have health insurance coverage and they recorded the lowest consumption expenditure.
  • Availability, Affordability and Accessibility of Health Care:
    • Geriatric care is relatively new in many developing countries like India with many practicing physicians having little knowledge of the clinical and functional implications of aging
    • Most of the government facilities such as day care centres, old age residential homes, counselling and recreational facilities are urban based.
  • Economic Dependency:
    • About 85% of the aged had to depend on others for their day to day maintenance. The situation was even worse for elderly females. (52nd round of NSSO). Poverty act as a multiplier of the risk of abuse.
  • Issues of the public health system
    • Lack of infrastructure, limited manpower, poor quality of care and overcrowding of facilities affects a focussed elderly care in our public health systems.

GOVERNMENT INITIATIVES:

  • National Policy on Older People (NPOP):
    • It envisages State support to ensure financial and food security, health care, shelter and other needs of older persons, equitable share in development, protection against abuse and exploitation, and availability of services to improve the quality of their lives.
    • The policy also covers issues like social security, intergenerational bonding, family as the primary caretakerrole of Non-Governmental Organizations, training of manpower, research and training.
  • Maintenance and Welfare of Parents and Senior Citizens Act 2007:
    • Elderly who cannot support themselves can demand maintenance for their children.
    • Also, the Act legally empowers the elderly to claim their property back from their children if the condition of maintenance is not satisfied.
  • Atal Vayo Abhyudaya Yojana (AVYAY):
    • AVYAY is an umbrella scheme, effective since 1st April 2021.
    • AVYAY brings together articulation of each of the current schemes, future plans, strategies and targets and maps it with schemes/programmes, accountabilities, financials and clear outcomes.
    •  For instance, the SAGE (Seniorcare Aging Growth Engine) initiative under AVYAY is aimed at promoting private enterprises to bring out innovation in products to benefit elders. The SAGE portal will provide “one-stop access” to elderly care products and services by credible start-ups. It was brought out based on the recommendations of the Expert Group on the silver economy. 
    • Features of AVYAY: https://ilearncana.com/details/Atal-Vayo-Abhyuday-YojanaAVYAY/3453
  • Atal Pension Yojana:
    • The subscribers would receive the fixed pension of Rs. 1,000 – Rs.5,000 per month from the age of 60 years onward, depending on their contribution.
    • This would prevent the economic compulsion to work in the later years of life.
  • Health Insurance for Senior Citizens:
    • Rs.100 billion of unclaimed funds under EPFO and Small Savings would be utilised for providing health insurance cover to the elderly.
  • National Programme for Health Care of Elderly (NPHCE):
    • It is an articulation of the International and national commitments of the Government as envisaged under the UN Convention on the Rights of Persons with Disabilities (UNCRPD)
    • Components:
      • Access to promotional, preventive, curative and rehabilitative services to the elderly through community based primary health care approach
      • Build capacity of the medical and paramedical professionals as well as the care-takers within the family for providing health care to the elderly.
      • Provide referral services to the elderly patients through district hospitals, regional medical institutions
      • Convergence with National Rural Health Mission, AYUSH and other line departments like Ministry of Social Justice and Empowerment.
  • National Social Assistance Programme (NSAP)
    • Under which old-age pensions and family benefits are provided to BPL families.
    • The scheme under NSAP for the elderly is the Indira Gandhi National Old Age Pension Scheme (IGNOAPS).
  • National Institute of Social Defence (NISD)
    • It undertakes the development of a cadre of geriatric caregivers in the family and community for the welfare of older persons.
    • Certificate course on geriatric bedside assistance and care-giving, certificate course in geriatric care for voluntary agencies, dementia-care programmes
  • UN Decade of Healthy Ageing (2021–2030):
    • It is a global collaboration, aligned with the last ten years of the Sustainable Development Goals, that brings together governments, civil society, international agencies, professionals, academia, the media, and the private sector to improve the lives of older people, their families, and the communities in which they live.
  • South Asia Partnership on Ageing:
    • The Kathmandu Declaration 2016 (under SAARC) reaffirms commitments to the Older Peoples’ Rights enshrined in the Vienna International Plan of Action on Ageing, the United Nations Principles for Older Persons.

BEST PRACTICE:

  • ‘Vayomithram’ by Governmnet of Kerala:
    • This scheme aims to provide health care and support to elderly residents in the corporation/municipal areas.
    • The project mainly provides free medicines through mobile clinics, palliative care and a help-desk to the old.
    • The project is implemented in collaboration with the urban local bodies (municipalities).
  • Kerala Police Janamaithri Suraksha:
    • The police help to monitor the senior citizens by interacting with them on phone, visiting them regularly, organizing field visits and advising them on their personal problems.

EXAMPLES OF NGOs IN GERIATRIC CARE:

  • Agewell Foundation
  • Ekal Nari Shakti Sangathan
  • HelpAge India

WAY FORWARD:

  • In situ ageing:
    • The United Nations Population Fund's India Ageing Report 2023 suggested that the government should encourage in situ (at home) ageing as much as possible by creating short-term care facilities like creches or day-care facilities, citing better care when elderly people live with their respective families.
  • Platform for community interaction:
    • Increase the avenues for older people to participate in local issues, in resident associations, set up and manage spaces for community interaction, to leverage their knowledge and experience as a resource.
    • For instance, the India Ageing Report 2023 called for the government to encourage the creation and running of elderly self-help groups.
  • Capacity building:
    • Peripheral health workers and community health volunteers should also be trained to identify and refer elderly patients for timely and proper treatment
  • Regulation:
    • The growing informal industry of home care providers urgently needs regulation.
    • There should be mandated guidelines so that a large pool of certified and affordable trained home care givers can help provide basic support, prevent unnecessary hospital admissions, and keep the elderly in the familiar environs of their homes as far as possible.
    • For instance, the India Ageing Report 2023 suggested that the government must bring all old-age homes under regulatory purview.
  • Medical education:
    • Geriatric pharmacotherapy needs to be included as a component of undergraduate and postgraduate education in medicine as well as in other disciplines like nursing and pharmacy
  • Infrastructure:
    • Creation of a network of old age homes, both in the private and public sector
    • Guidelines for making public infrastructure accessible to old age people with necessary assistive supports
  • Data collection exercises:
    • The India Ageing Report 2023 found that there is a lack of credible data on various issues related to the elderly in India, and more could be done by including questions on relevant and emerging issues related to older persons in the upcoming data collection exercises of the National Sample Survey, the National Family Health Survey, and the Census of India, respectively.
  • Awareness generation:
    • As the India Ageing Report 2023 suggested, the government must work on increasing awareness about schemes for older persons.
  • Value education:
    • To inculcate the moral obligation upon the children to take care of their parents, we need to incorporate values and ethics in school curriculum.

PRACTICE QUESTION:

Q. “Rapid urbanization and rise of nuclear families in India requires more focus on geriatric issues”. Comment