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India Ageing Report 2023: Key Insights And Recommendations For Elderly Care – IMPRI Impact And Policy Research Institute

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India Ageing Report 2023: Key Insights and Recommendations for Elderly Care

Policy Update
Yashica

“This comprehensive report is a valuable resource for scholars, policymakers, program managers, and all stakeholders involved in elder care. Older people have contributed significantly to society, and they deserve nothing less than our best efforts to ensure their well-being.” 

Ms. Andrea. M. Wojnar, UNFPA India Representative and Country Director Bhutan

 Introduction

Population ageing has in recent times become a prominent phenomenon in developing nations. With reduced fertility and mortality rates in third-world countries, there has been a rise in the proportion of the older population i.e. 60 years and above. Not an exception to the phenomenon, senior citizens account for 14% of the total population of India, as per the Population Projections Report, 2020. It is estimated to increase to 20.8 per cent by 2050.

Due to the ageing population and its significant implications for health, economy and society in India, it is essential for the concerned institutions to focus on the data and recommendations provided in the India Ageing Report 2023 released by The United Nations Population Fund (UNFPA) in partnership with the Population Research Centre (PRC); Institute for Social and Economic Change (ISEC), Bangalore; Institute of Economic Growth (IEG), Delhi; and Tata Institute of Social Sciences (TISS), Mumbai. Continuing the 2017 report, this report is divided into 8 chapters focusing on the condition, institutional response, COVID-19 impact and the way forward in the context of the older population in India.

The Whole of a Society Approach

Chapter 1 focuses on the major international efforts made in the case of the population ageing phenomenon. From the 1982 Vienna International Plan of Action on Ageing to the 1991 United Nations Principles for Older Persons, the UN General Assembly focused on providing a basis for governments to formulate policies with respect to the older population. The phenomenon has been additionally placed by the General Assembly in the context of strategies for eradicating poverty and focus on health infrastructure (United Nations Decade of Healthy Ageing), considering the phenomenon of a quadrupled older population in developing countries by 2050. The ‘whole of a society’ is the larger consensus of the international framework.

India’s Ageing Population Dynamics

Chapter 2 focuses on key highlights from the data generated by the Longitudinal Ageing Survey in India, 2017, the Census of India, Population Projections by the Government of India (2011–2036) and

World Population Prospects 2022 by the United Nations Department of Economic and Social Affairs. This section gives insights into the social status, economic status, health and living arrangements of the elderly as population ageing poses a significant challenge to these areas when it comes to nation-building. With significant variations in the doubling rate across Asian countries, especially India, focusing on the data presented by these reports is the need of the hour.

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Doubling time of the elderly population based on annual growth rate during 2010–2020
Source: India Ageing Report 2023

In India, the elderly population is on the verge of surpassing the young population with variations at the state level. Most of the southern states and a few northern states including Himachal Pradesh and Punjab reported a higher elderly population than the national average in 2021. In contrast, states such as Bihar and Uttar Pradesh saw a decline in the share of the elderly population, which is expected to increase by 2036 depending on the state response in terms of health and education infrastructure.

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Projected share of the elderly population, in India and states, 2021 versus 2036
Source: India Ageing Report, 2023

As per the Ageing Index, the southern region also saw a higher old-age dependency ratio. This would indicate increased dependency on the younger generation in terms of social, financial and caregiving needs by the older generation. In contrast, the Union Territories and North-East region saw a lower dependency ratio compared to the national average. 

This demographic transition is influenced by concepts such as feminisation and ruralisation. With women living longer than men, there is a higher incidence of widowhood in India. Physical and mental deterioration as an impact of the ageing process and a need to focus on health infrastructure should also be one of the key concerns when it comes to policy formulation.

Response from Government

Chapter 3 delves into the various policies and programmes formulated by the government based on Article 41 of the Indian Constitution which mandates the well-being of senior citizens. The National Policy on Older Persons (NPOP) was the first policy that took into account demographic change and acknowledged population ageing in 1999. Other social schemes include the Atal Vayo Abhyuday

Yojana (AVYAY), the Rashtriya Vayoshri Yojana. India has focused significantly on the health and housing of senior citizens with measures such as setting up a Senior Citizen’s Welfare Fund, the Vayomithram project, the Anubhav portal for retired government officials and courses on geriatric caregiving by the National Institute of Social Defence (NISD).

Moreover, senior citizens are also beneficiaries of several concessions, tax benefits and rebate schemes.  Additionally, India has been a signatory to various global conferences and initiatives on ageing. 

Response from Community-Based Organisations

Apart from the policy interventions by the government, the report also discusses efforts undertaken by community-based organizations and the associations of older persons in Chapter 4. These organizations hold awareness programmes for their members and the elderly living in the community. Additionally, they organize social activities such as get-togethers, recreational activities, religious discourses, picnics, educational lectures by experts, income generation programmes, counselling services and voluntary work to engage the elderly. Such organisations include Alzheimer’s and Related Disorders Society of India, ARDSI and Bharat Pensioners Samaj.

Although such CBOs receive grants from national and international organizations, corporations might not get involved because it’s challenging to measure outcomes relative to the funding allocated, given the nature of the work involved.

Corporate Sector and the Welfare of Citizens

Nevertheless, under Schedule VII of the Companies Act, 2013, corporate enterprises are required to spend 2 per cent of their net profits averaged over three preceding financial years for social development. Chapter 5, focuses on corporate social responsibility (CSR) with respect to senior citizens. CSR focus areas include developing vocational skills, setting up old age homes, benefits for armed forces veterans and so on.

One such example is that of the NSE Foundation which serves as the operational entity responsible for executing the Corporate Social Responsibility (CSR) endeavours of the NSE (National Stock Exchange of India Limited) Group. One of its initiatives includes collaborating with the local communities to set up multi-speciality health camps depending on the needs of the elderly in the villages.

Reach and Utilization of Social Security Schemes and Healthcare by Older Persons

Chapter 6 highlights the loopholes within the social security schemes and problems faced by the elderly while accessing such schemes. Non-receipt of the funds, less awareness in rural areas about the schemes, a gap between awareness and actual utilisation, excessive paperwork and complex processes make it difficult for the elderly population to avail of benefits from these schemes.

COVID-19 Pandemic and the Elderly

During the COVID-19 Pandemic, the vulnerable sections of society particularly included senior citizens. Chapter 7 highlights the need for better preparedness to assist older persons in such type of humanitarian situations.

While the government did try to conduct massive vaccination and awareness drives throughout the country, they were restrained by factors such as population size, administrative and logistical challenges, misinformation and distrust among people. HelpAge India, the government’s helpline has been criticised by the majority of the elderly for not being effective, rather the NGOs/CBOs operated more efficiently at the local level.

Areas of Improvement

Lastly, Chapter 8 focuses on the steps that government, community-based organisations and the private sector should take to enhance the quality of life of older persons in the country. Some of these include obtaining regular feedback from users and conducting frequent audits to ensure that services and benefits reach the elderly population efficiently, collaborating with civil society institutions, media and the private sector in implementing policies. Additionally, future policymaking requires an emphasis on systematic data analysis. 

In case of government response, government departments should coordinate efforts to ensure elderly-friendly programs, such as prioritizing geriatric care training and addressing the needs of elderly women. Capacity development of government officials at the district level and training personnel in geriatric care are necessary for comprehensive elderly health care. Moreover, collaboration with voluntary organizations and private players can bridge gaps between the government and the older population, ensuring targeted assistance and maximizing outreach.

Community-based organizations act as facilitators between project beneficiaries and government officials, enhancing project design and implementation through community input and allowing for adjustments for better outcomes and increased outreach. Corporate Social Responsibility (CSR) funds become essential for CBOs in order to function. Government intervention and research proposals related to elderly issues can open access to CSR funds.

The private sector nonetheless has been involved in elderly care, such as Tata Trusts collaborating with the Ministry of Social Justice to expand the National Elder Help Line and partnerships for digital health interventions. Private sector initiatives aim to address elder issues while aligning with government programs like the Sansad Adarsh Gram Yojana (SAGY) and NITI Aayog’s aspirational districts initiative.

Most importantly, collaborating with Panchayati Raj Institutions (PRIs) and promoting intergenerational solidarity will aid in community development.

Conclusion

India’s claim towards its position as a ‘Vishwa Guru’ coupled with its transition towards a developed nation, will require it to address issues associated with such transition. With the population pyramid of India changing its shape, population ageing becomes one such issue. To ensure the well-being and dignity of older citizens in the country, the concerned authorities need to consider the “India Ageing Report 2023” as the guide to take action and support its ageing population.

References 

  1. The Hindu. 2023. “Caring for the old: The Hindu Editorial on the United Nations Population Fund’s India Ageing Report 2023.” September 29, 2023. https://www.thehindu.com/opinion/editorial/caring-for-the-old-the-hindu-editorial-on-the-united-nations-population-funds-india-ageing-report-2023/article67357816.ece.
  2. “India ageing report 2023 unveils insights into elderly care challenges and solutions.” 2023. UNFPA India. https://india.unfpa.org/en/news/india-ageing-report-2023-unveils-insights-elderly-care-challenges-and-solutions.
  3. Lakshman, Abhinay. 2023. “India ageing, elderly to make up 20% of population by 2050: UNFPA report.” The Hindu, September 29, 2023. https://www.thehindu.com/sci-tech/health/share-of-elderly-projected-to-double-to-20-by-2050-india-ageing-report/article67353547.ece.
  4. Mint. 2023. “India’s elderly population to outstrip children by 2050, warns report.” September 28, 2023. https://www.livemint.com/news/india/indias-elderly-population-to-double-by-2050-surpassing-number-of-children-warns-report-11695865492972.html.
  5. PIB. 2023. “India Ageing Report 2023 Unveils Critical Insights into Elderly Care in India.” September 27, 2023. https://pib.gov.in/PressReleaseIframePage.aspx?PRID=1961168.
  6. Press Information Bureau. 2023. “Press Information Bureau.” December 5, 2023. https://pib.gov.in/PressReleasePage.aspx?PRID=1982752.
  7. “TECHNOLOGY FRAMEWORK FOR INDIA’S ROAD FREIGHT TRANSPORT.” 2023. UNFPA India. https://india.unfpa.org/sites/default/files/pub-pdf/20230926_india_ageing_report_2023_web_version_.pdf.

Yashica is a Research Intern at IMPRI and currently pursuing B.A. Political Science Honours from Sri Venkateswara College, University of Delhi.

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Acknowledgment: The author would like to thank Tanu Paliwal, Christeena Sabu and Swetha Shanker for reviewing this article and giving their valuable insights.
This article was posted by Aasthaba Jadeja, a visiting researcher at IMPRI.

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