Elderly in India – UPSC GS2

Context:
  • In the future, India is likely to experience an increasingly elderly population.
  • Instead of looking at them as a drag on the economy, they should be seen as a massive resource of experienced, knowledgeable people. This can be realized by focusing on their health and their capabilities.
What are the healthcare needs of the elderly?
  • The elder population suffers from familial neglect, low education levels, socio-cultural beliefs and stigma and low trust in institutionalized healthcare services.
  • As per Longitudinal Ageing Survey in India (LASI), 11% of the elderly suffer from at least one form of impairment (locomotor, mental, visual and hearing).
  • Non-communicable diseases claim the lives of 58 lakh Indians.
  • Cardiovascular diseases are estimated to be 34% amongst 60-74 years old.
  • They require an array of specialized medical services at home, including tele or home consultations, physiotherapy and rehabilitation services including mental health counselling and treatment.
Why existing schemes are inadequate?
  • As per the Healthcare Access Quality Index (HAQ), India improved its score from 24.7 in 1990 to 41.2 in 2016. But India is still below the global average of 54 points.
  • The government provides insurance, but as per the NITI Aayog report, 400 million Indians do not have financial cover for health expenses.
  • The pension schemes for the elderly provide very low-income Support.
  • A 2007 law(Maintenance and Welfare of Parents and Senior Citizens Act)required the state to provide geriatric care services in every district hospital. But as per a report filed in Supreme Court in 2019, 16 states and union territories did not have a single bed dedicated to elders.
  • A large proportion of elders are from lower socio-economic strata.
  • They are unable to afford the cost of healthcare and slip into poverty.
  • Poor health implies poor earning capacity.
  • So they are economically unproductive and also dependent on support from family. This adds to their mental stress.
  • So, the net result is poor physical and mental health.
What steps should be taken by India?
  • 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. India should prioritize elderly health care over the next few years and decades.
  • Increase public healthcare spending: Apart from legislating pro-elderly healthcare and insurance policies, India needs to increase its public healthcare spending and invest heavily in the creation of well-equipped medical healthcare, home healthcare facilities and rehabilitation services.
  • Programmes: India should accelerate the implementation of programmes such as the National program for health care of the elderly. The Ayushmann Bharat and PM-JAY ecosystems should be further expanded to cover senior citizens from lower economic strata. National Digital Health Mission has the potential to expand medical consultations into the interiors of the country. These steps will help convert the elderly into a massive resource for social-cultural and economic development, giving a totally new perspective to the demographic dividend.

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