The country is surely witnessing a demographic shift as the 60+ population continues to rise. In the 2011 census, the number for the 60+ population stood at 103 million which was 8.6 percent of the population. The number will likely reach 319 million in 2050, growing at around 3 percent annually, as revealed by the Longitudinal Ageing Society of India (LASI). What is important to understand from these statistics that signal the ageing tsunami lying ahead for the country is that there will be a sharp rise in numbers of mortality and morbidity across the country.
The country not only has to tackle age-related psychological and ailments issues, but also has to gear up to promote rehabilitation and preventive care solutions in senior care. With a rapidly growing elderly population, India is faced with the Herculean task of providing basic senior-friendly urban infrastructure. So, is India ready to deal with these numbers?
Let’s outline the key challenges faced by the elderly population in accessing healthcare in India.
1. Physical Barriers
Physical barriers include declining social engagement, reduced mobility and limited reach of the healthcare system. Further, physical infrastructure is one of the major deterrents to ensuring care for elderly people. For example, in India, there are just a few public ramps or purpose-built homes for older citizens who are unable to move.
2. Social Barriers
Social barriers are shaped by various axes of social inequality - gender, religion, caste, socioeconomic status etc. Moreover, with the rising number of nuclear families, elder care management is becoming difficult. Also, managing home care for the elderly is a challenge as multiple elderly home care service providers provide different services and only a few provide it all altogether.
3. Lack of Financial Support
There is little private or public financial support for the elderly in the country. Also, out of the majority of the working population, only a few are eligible for the pension, which further adds to the woes. Health cost keeps rising in old age and there is very low penetration in senior health insurance which also has an extremely poor pay-out history. Health affordability is another challenge.
4. Poor Emergency Response Infrastructure
The emergency response infrastructure for elderly people is quite ill-developed. This also includes the availability of ambulances for hospitalisation. The problem is bigger for senior citizens living alone who fear accessing an emergency facility if required.
The Solutions
The motive is to ensure affordable, accessible and quality health care for all. But, how to go about it? India is a big country with a lot of diversity & one solution cannot fit in all situations. So, here are some ways to boost healthcare for the elderly.
1. Public-Private Partnership
It would be great if public and private authorities come together and collaborate to promote not only physical but also, psychological health of the elderly, who are hard hit by loneliness, depression and anxiety due to pandemic. The pandemic has exposed the gaps in our healthcare system and we need to pay urgent attention to it and come up with corrective measures - improvement in health financing & drug procurement, community participation in health, relaxing physical and financial norms for healthcare etc.
2. Leverage Digital Technology
The increasing penetration of the internet in remote areas and the rising adoption of technology and digital solutions in healthcare presents a great opportunity for healthcare service providers to leverage these in senior care as well.
3. Compulsory Health Insurance for All
In India, financial protection for health spending is majorly in the form of insurance and savings. However, health insurance in India has limited i.e. only a small chunk of the population has subscribed to some medical insurance plan. The low cover of insurance is another problem. It is high time to address the problem and improve the insurance market that remains limited and fragmented.
4. Promote Home Care
We must promote the use of telemedicine or online medical appointments, a medical check-up at home, online pharmacy delivery etc. Tele-health and remote monitoring of vitals with wearable devices are not only time saving and cost-effective but also, a very efficient way for improving healthcare facility. If citizens are taught about virtual health care and its benefits, the healthcare facility will improve at a significantly high rate.
5. Subsidized Life-Saving Medicines
An "essential drugs and medical devices" list should be created by centre or states for both traditional and allopathic medicine systems. This will help in curbing price inflation for critical products to ensure their affordability and accessibility.
Summing Up!
In order to ensure efficient care for the elderly population and create an effective foundation, we need to broaden stakeholder engagement at every level. Also, we need to focus on capacity building, improvement at the systemic level by adopting technology. The ultimate motive of the healthcare system should be to successfully address the needs of our ageing population in addition to improving healthcare for all.
The author, Dr Mamta Mittal is the founder of Seniors First. Views expressed are personal
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