Proof of a truly developed country lies in the way it not only nurtures its young but also cares for its elders equally
What is 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.
What NFHS-5 data indicates?
Younger population
A larger youth population will give an impetus to innovation and entrepreneurship.
As desired the young are in focus, with many programmes to facilitate their education, entrepreneurship, sports training as well as their well-being.
The focus must not only be from an economic viewpoint, but also from the health perspective. Poor health could nullify the demographic advantage.
The metrics for infant and child health continue to be at dismal.
Senior Citizens
Life expectancy in India has risen from 50 (1970-75) to 70 years (2014-18).
As a result the number of elders (over 60 years) is expected to increase (195 million in 2031, and 300 million by 2050.)
Rather than looking at them as dependents converting them to productive members of society depends on two factors - their health and their capabilities.
What is the current health status of Senior Citizens?
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.
Though in 2016 Healthcare Access and Quality Index (HAQ), India improved its score (24.7 in 1990 to 41.2 in 2016) it ranks 145 out of 195 countries.
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.
With rising elderly population the biggest challenge is providing quality, affordable and accessible health care services to the elderly.
Are Government Schemes adequate enough?
The Government does have schemes but are inadequate.
Despite Ayushman Bharat, the Government’s health insurance scheme for the deprived, and private health insurance, a NITIAayog report indicates that 400 million Indians do not have any financial cover for health expenses. (largely elders)
Both the Centre and States have pension schemes for the elders, but these provide as low as ₹350 to ₹400 a month in some States. Even this is not universal.
A 2007 law requires States to ensure earmarked facilities for elders in every district hospital, headed by a doctor with experience in geriatric care.
Yet, a status report filed by the Government in the Supreme Court of India in 2019 stated that 16 States and Union Territories (‘of 35’) did not have a single ward/bed dedicated to elders.
How should we address this issue?
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.
Creation of adequate services for them will benefit all other age-groups.
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.
Over the next decade, we have the potential to add more than 3 million beds, 1.54 million doctors and 2.4 million nurses.
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.
The National Digital Health Mission has tremendous potential to expand medical consultations into the interiors of the country.
However, this requires a digital literacy campaign for senior citizens.
These essential steps will help to convert elders into a massive resource for socio-cultural and economic development, giving an altogether different perspective to “demographic dividend”.
