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Aide-memoire
The proportion of persons aged 60 years and over
in the world will double between 2000 and 2050, from
10 to 21 per cent. Population ageing is poised to
become one of the greatest challenges in the coming
decades with vast economic, social and other consequences.
Among the world’s older population, 52 per cent
lived in Asia and the Pacific in 2002 and this is
projected to increase to 59 per cent in 2025. The
region is the fastest ageing region of the world.
Population ageing as well as smaller family size
and lower population growth rates as a result of rapid
declines in fertility and mortality have emerged as
new issues challenging several countries in the Asian
and Pacific region. Mortality reduction will continue
to be an overriding policy goal, which would further
enhance the ageing process. As a result, the number
of older persons in the region is increasing at the
rate twice as high as the growth rate of the total
population. Furthermore, as the region is inhabited
by over 60 per cent of the global population, the
absolute size of older population is a major concern.
The social, economic and health implications of this
absolute size of older persons are so profound and
far-reaching that improving living conditions and
providing income security, social welfare and medical
services to older persons are some of the major challenges
faced by many countries in the region.
Family life has also undergone a profound transformation
in South, South-East and East Asia. Family structures
have changed because of modernization, including industrialization
and urbanization that encompassed a majority of society
in the region. As a result, family size shrank as
a function of decreased fertility, delayed marriages,
and increased divorce rates. At the same time life
expectancy increased due to advances in medical technology,
improved access to quality reproductive health services,
wider vaccination coverage, improved hygiene and nutrition
standards as well as increased access to safe water.
Changes in family structure combined with demographic
ageing resulted in formidable challenges in the provision
of care for older persons, usually provided by the
younger family members. Changing perceptions about
the social status of older persons, internal and international
migration resulting in a decline of inter-generational
co-residency, the changing social roles of women in
society in addition to a reduced number of individual
offspring as well as overall rapid economic development,
may have prompted state institutions to reconsider
care and support that were mostly provided by family
members and to conceive of possible state-based welfare
measures and/or private sector insurance systems for
older persons.
Many countries in the region do not have sufficient
national social security for older persons. Families
continue to provide support to older people and in
many societies of the region, the tradition of older
persons co-residing with their family members is generally
the norm. However, traditional means of family support
are steadily eroding in most societies. As health-care
infrastructure is already weak in many countries of
the region, the additional burden of caring for older
persons will further stretch it. The rising number
of older persons on the one hand, and the declining
number of the younger population on the other will
mean that there will be a shortage of caregivers for
the older population. With an increasing number of
younger women entering the labour force, often away
from home, the availability of caregivers for older
persons is also decreasing. With rapid urbanization,
globalization and migration experienced by many countries
in the region, the situation is further worsening,
leading to many older persons being left in the rural
areas without caregivers.
In response to the challenges posed by population
ageing, the Second World Assembly on Ageing, convened
by the United Nations at Madrid in April 2002, adopted
the Madrid International Plan of Action on Ageing
(MIPAA), setting policy direction and enquiry in three
major areas: (a) ageing and development; (b) health
and well-being into old age; and (c) enabling and
supportive environments for ageing. In September 2002,
governments in Asia and the Pacific adopted the Shanghai
Implementation Strategy: Regional Implementation Strategy
for the Madrid International Plan of Action on Ageing
2002 and the Macao Plan of Action on Ageing for Asia
and the Pacific 1999, which recommended actions to
be taken in the MIPAA priority areas.
While the Madrid International Plan of Action on
Ageing (MIPAA) encourages flexible retirement policies
and practices and calls for a removal of disincentives
to work beyond retirement age, it stresses “the
primary responsibility of Governments in promoting,
providing and ensuring access to basic social services,
bearing in mind specific needs of older persons”1.
With particular regard to economic and social well-being
of older persons, MIPAA urges to “develop and
implement policies aimed at ensuring that all persons
have adequate economic and social protection during
old age” 2and to
“organize, as a matter of urgency where they
do not exist, social protection/social security systems
to ensure minimum income for older persons with no
other means of support”. 3
As pointed out in MIPAA, informal care is of a complimentary
character and does not replace professional care.
Governments committed themselves to “providing
older persons with universal and equal access to health
care and services, including physical and mental health
services. 4
Recognizing and accommodating the caring responsibilities
of increasing proportions of workers for older family
members, MIPAA suggests to develop “family-friendly
and gender-sensitive policies aimed at reconciling
work and care-giving responsibilities”.
5 In addition, primary health care,
long-term care, social services and other community
services should be coordinated for maximal effectiveness.
Among its key actions, the Shanghai Regional Implementation
Strategy on Ageing calls specifically for the establishment
of a “sustainable social protection/social security
systems now” and “a regulatory framework
for occupational and private pension provision”.
6 In addition, Member States are requested
to “develop an age-appropriate primary care
system integrated with current primary health systems”
and to “improve access to and the quality of
long-term care for older persons and develop social
support systems to enhance the ability of families
to take care of older persons within the family”.
7
Various policy interventions benefiting older persons,
including pensions and long-term care provisions,
exist in some countries of the region. They are instruments
of social protection and poverty reduction. However,
these inter-generational transfers and their impact
on the quality of life of older persons, require further
assessment vis-à-vis informal family and community-based
systems.
While there is increasing recognition and concern
about ageing and its ramifications, and while many
countries in the region are taking measures to deal
with the challenges of ageing to create a “society
for all ages”, research on this important issue
is limited and very little is known about the problems
and needs of the older persons. In this regard, the
Plan of Action on Population and Poverty adopted at
the Fifth Asian and Pacific Population Conference
held in Bangkok in 2002 recommended to “support
research, establish databases and the sharing of experiences
on ageing and its economic and social implications
and differentials, including among others, the economic
situation, sources of support, living arrangements,
gender differentials and health care and other needs
by income class and sociocultural background”.
In order to address the above-mentioned issues, the
Economic and Social Commission for Asia and the Pacific
(ESCAP), United Nations Population Fund (UNFPA) and
United Nations Department of Economic and Social Affairs
(DESA) will jointly organize a seminar entitled “Social,
Health and Economic Consequences of Population Ageing
in the Context of Changing Families” in Bangkok
from 25 to 27 July 2007.
The proposed Seminar will provide a comprehensive
overview of the causes and socio-economic and health
consequences of population ageing, giving special
attention to the changing family, which has traditionally
provided care for older persons in the region. The
Seminar will examine existing ageing-specific programmes
and policies to explore the provision of social protection
and social security systems, including private sector
insurance to older persons, and will also identify
the problems and needs of the older persons in relation
to informal and formal care as well as long-term care
services. Finally, the lessons learned from the Seminar
will be used to make policy recommendations for future
planning to meet the above challenges.
- Article 13, Political Declaration
of the Second World Assembly on Ageing
- Madrid International Plan of
Action on Ageing, para. 52 (a)
- Madrid International Plan of
Action on Ageing, para. 53 (b)
- Article 14, Political Declaration
of the Second World Assembly on Ageing
- Madrid International Plan of
Action on Ageing, para. 28 (i)
- Shanghai Implementation Strategy,
p.3
- Shanghai Implementation Strategy,
p.7/8
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