Support for the twilight years

Aarti Dhar
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The 12{+t}{+h}Plan has a host of provisions to provide health services at various levels to the elderly whose number would touch 315 million by 2050

Coming of age:Old people are susceptible to chronic ailments.Photo: V.V. Krishnan
Coming of age:Old people are susceptible to chronic ailments.Photo: V.V. Krishnan

India is gearing up to look after its ageing population which is projected to touch 315 million by 2050 as against the present 90 million. A large proportion of this population would be women.

After having announced an ambitious National Programme for Health Care for Elderly (NPCHE) in 2010-11 to provide separate and specialised comprehensive health care to the senior citizens, the Ministry of Health and Family Welfare proposes to develop two National Institutes of Ageing in the 12th Five Year Plan.

The two institutes will be set up at the Madras Medical College and AIIMS, New Delhi with an objective to undertake research on ageing in addition to other things like providing health care to the senior citizens.

The institutes are part of the NPCHE which also proposes geriatric departments in eight regional medical institutions and State Medical Colleges. These are AIIMS; Institute of Medical Science, Banaras Hindu University, Uttar Pradesh; Sher-e-Kashmir Institute of Medical Science, Jammu & Kashmir; Government Medical College, Thiruvananthapuram; Guwahati Medical College; Madras Medical College; SN Medical College, Jodhpur and Grants Medical College and JJ Hospital, Mumbai.

The programme also provides for dedicated health care for elderly persons in 91 districts of 20 States with a geriatric unit at the district hospitals, rehabilitation units at community health centres and weekly geriatric clinic at primary health centres. Under the 12{+t}{+h}Plan, it is also proposed to develop 12 additional Regional Geriatric Centres in selected medical colleges of the country (in the first three years) while covering the remaining districts in a phased manner.

The NPCHE had been approved in 2010 at an expenditure of Rs. 288 crore for the remaining period of the 11{+t}{+h}Five Year Plan. This includes 20 per cent share of the State governments (excluding the expenditure on Regional Medical Institutes) amounting to Rs. 48 crore while the remaining is to be borne by the Centre.

As of now, the programme has been implemented in 70 districts and is expected to cover the entire country during the 12th Plan. Its main objective is to provide preventive, curative and rehabilitative services to the elderly persons at various levels of health care delivery. It also aims at strengthening referral system to develop specialised manpower and to promote research in the field of diseases related to old age.

The regional institutions are expected to provide technical support to the geriatric units at district hospitals whereas district hospitals supervise and coordinate the activities at the community health centres, primary health centres and sub-centres.

Close to 65 per cent senior citizens suffer from a chronic ailment of which arthritis/rheumatism, hypertension, cataract and diabetes are the most prevalent. About one-third suffer from two or more chronic ailments simultaneously. In general, morbidity levels tend to be higher among females across all age groups of elderly and also associated with socio-economic classes with expected rural-urban differentials.

In case of hospitalisation, an average senior citizen spends over Rs. 8,800 including for consultation, medicines and diagnostics. In the case of out-patient treatment, the average expenditure is about Rs. 1,230 — higher in urban areas than in the rural. In addition, the elderly also spend Rs. 500 or more every month towards medicines to treat their chronic illnesses.



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