Pertaining to health programme & schemes in elderly people & awareness, utilization & nonutilization level of the same

1. NATIONAL HEALTH PROGRAMME & SCHEMES FOR THE ELDERLY
Dr. J VINOTHINI
Junior Resident – 2
Department of Community Medicine
Banaras Hindu University

2. WORLD IS GETTING OLDER
Proportion of the world population aged 60 years are more
………………………………………………………………………………………....

3. Geriatrics = Geras Old Age + Latrike Medical Treatment
 As per “National Policy On Older Persons” Government Of India has adopted
“Senior citizen”/ “ Elderly” as ≥ 60 years
 60-74 years are Young old
 75-84 years are Middle old
 ≥85 years are Oldest old or Infirm

4. 1950 1975 2000 2025 2050
Elderly
population in
age 60& above
5.4 5.7 7.9 11.4 19.5
population in
age 75& above
0.9 0.9 1.3 2.3 5.2
Old- age
dependency
ratio
9.4 10.4 11.7 17.6 31.5
Sex ratio of
elderly
population (age
60 years)
98.1 104.1 94.2 96.7 95.1
Geriatric population growth rate – 1.9%

5. CHRONIC DISEASES
NCD – Cardiovascular, Metabolic & degenerative disorder .80% older population have at least one
chronic disease,77% have at least two.
Stroke- 2%
Chest pain- 20%
Asthma 11%
Hypertension- 17%
Diabetes – 7%
MUSCULOSKELETAL DISORDERS
 Second leading cause of disability worldwide.
 Loss of body weight /Skeletal muscle mass is common.
 Prevalence of MSD – 20%
HEALTH PROBLEMS IN ELDERLY PEOPLE

6. DISABILITY AND IMMOBILITY
 Age 60 & above – 21%
 Disabilities pertaining to movement – 25%
 Disabilities pertaining to vision – 25%
 Disabilities pertaining to hearing – 12%
MENTAL ILLNESS
 Dementia, depression, and Alzheimer are the most common mental health problems among the
elderly. Approximately 15% of older people are suffering from mental disorders in the world.
 Prevalence of depression in India – 34.4%
CO MORBIDITY & MULTI MORBIDITY
 23.3% of Indian men and 24.3% of Indian women in the age group of 60–69 years reported
multiple chronic diseases & 57% of the 80 plus age group

7. NATIONAL PROGRAMME FOR HEALTH CARE OF ELDERLY
MINISTRY OF HEALTH & FAMILY WELFARE

9. NPHCE
STRATEGIES
Expanding access to
health practices
through domiciliary
visits by trained health
workers
Dedicated outdoor &
indoor patients services
at PHC, CHC, DISTRICT
HOSPITAL & REGIONAL
GERIATRIC CENTERS
Health Man Power
Development for
Geriatric Services
Medical
Rehabilitation &
Therapeutic
Intervention
IEC through Mass Media,
Folk Media & other.
Camps for Regular
Medical Check-up.

10. Sub- Centre
Home-based center
CHC/PHC
Geriatric clinic on fixed days
District Hospital
10 bedded, Daily Clinic
Regional
Center
30 beds
NPHCE Framework

11. PACKAGE OF SERVICES AT DIFFERENT LEVELS UNDER
NPHCE
SUBCENTRE
 Health education related to healthy ageing
 Domiciliary visits
 Arranging supportive devices from PHC to
disabled ones
 Linkage with other support groups
PHC
 Weekly Geriatric Clinic
 Maintaining record for first visit of elderly
 Conducting routine health assessment
 Provision of medicines & proper advice
 Public awareness
 Referral for diseases

12. PACKAGE OF SERVICES AT DIFFERENT LEVELS UNDER
NPHCE
CHC DISTRICT HOSPITAL
 First Referral Unit for the elderly
 Geriatric Clinic – Twice a week
 Rehabilitation for physiotherapy &
counselling
 Domiciliary visits
 Referral of difficult cases to District
hospital/Higher Centre
 Regular dedicated OPD services
 Facilities for lab investigations & provision of
treatment
 Ten-bedded Geriatric ward
 Conducting camps for Geriatric Services
 Referral services for severe cases
 Existing specialities will provide services for
elderly people in need

13. PACKAGE OF SERVICES AT DIFFERENT LEVELS UNDER
NPHCE
REGIONAL GERIATRIC CENTRE
 Specialized OPD for the elderly
 Thirty – bedded Geriatric ward
 Facilities for lab investigations
 Tertiary health care

15. NATIONAL POLICY ON OLDER PERSONS (NPOP) 1999

16. ELEMENTS OF NPOP
 Pension Scheme
 Lower income tax rate & exemptions
FINANCIAL
SECURITY
 Setting up Geriatric wards & training on Geriatric
Specialized Care
 Expanding Mental Health Services for elderly
HEALTH
CARE &
NUTRITION
 Government & Private Housing Schemes for elderly
SHELTER

17. ELEMENTS OF NPOP
 Information to elderly people about wellness in old age
 Evolving changes in lifestyle
EDUCATION
 Identifying extremely vulnerable elderly who are disabled,
chronically sick
 Assistance to voluntary organizations to construct & maintain old
age homes, day care center, supply of disability- related aids &
appliances
 Providing welfare funds for elderly with support from corporate
sector, trusts, charities, individual donors & involvement of NGOs.
WELFARE

18. ELEMENTS OF NPOP
 Encourage Medical colleges, Nurses & Para medical institutions
to introduce COURSES ON GERIATRIC CARE.
 Research & Documentation in elderly care
 NGO supported specialized training in Geriatric care.
RESEARCH
&
TRAINING
 Involvement of social media in creating awareness among
elderly people
SENSITIZING
THE MEDIA

19. What is integrated program for
older person?
NATIONAL SOCIAL ASSISTANCE PROGRAM
(1995)
Indira Gandhi National Old Age Pension Scheme (2007)
Indira Gandhi National Disability Pension Scheme (2009)
Indira Gandhi National Widow Pension Scheme (2009)
National Family Benefit Scheme

20. hideState Old age pension Widow pension Disability pension
Andhra Pradesh[16] 2250 2250 3000
Bihar[17] 100 100 100
Delhi[18][19][20] 100 250 250
Haryana[21] 2250 2250 2250
Himachal Pradesh[22] 300 350 250
Jammu and Kashmir[23] 100 100 100
Kerala[24] 1400 1400 1400
Maharashtra[25] 100 150 150
Odisha[26] 30 30 30
Rajasthan[27] 500 500 250
Sikkim[28] 100 200 150
Tamil Nadu[29] 400 400 400
Telangana[30] 2000 2000 3000
Uttar Pradesh[31][32][33] 150 150 100

21. RECENT INITIATIVES UNDER NPOP
PM SURAKSHA BIMA YOJANA
Covers
accidental
death risks
Provides a
cover of Rs.
2 LAKH for a
premium of
Rs. 12 per
year
9.40 crore
enrolled as
on 8th April
2016
Launched by Prime Minister Shri Narendra Modi
on 9th May 2015 in Kolkata
VARISHTHA PENSION BIMA YOJANA
2017

22. RASHTRIYA VAYOSHRI YOJANA
Assisting less privileged
ELDERLY CITIZENS ( Aids & Devices )
1
REDUCED
VISION
2
HEARING
IMPAIRMENT
3
TEETH
LOSS
4
LOCOMOTOR
DISABILITY
SENIOR CITIZEN WELFARE FUND
 Unclaimed deposits from Insurance
Companies, Post Office Savings &
Public Provident Fund & Employees’
Provident Fund money will be
deposited .
 SCWF utilizes these funds for the
benefit of Senior Citizens &
General Welfare of the society

24. Rural Urban Men Women
IGNOAPS 58% 49% 59% 52%
IGNWPS 45% 42% 43% 45%
Annapurna Scheme 0 0 16% 9%
0%
10%
20%
30%
40%
50%
60%
70%
Awareness of Social Security Schemes among Elderly
IGNOAPS IGNWPS Annapurna Scheme

25. Awareness of Social Security Schemes among Elderly

26. UTILIZATION OF SOCIAL SECURITY SCHEMES
RURAL
BPL Household – Elderly – 29% (IGNOAPS)
BPL Household – Elderly widows – 24% (IGNWPS)
RURAL > URBAN
Non BPL Household – Elderly men – 16% (IGNOAPS)
Non BPL Household – Elderly widows – 15% (IGNWPS)

27. REASON FOR NON UTILIZATION
 30% of the elderly men report that the process of getting benefits is cumbersome.
 24% of the people experiencing problems in producing the required documents
 26% of the people not applied for an old-age pension
 35% of the beneficiaries report a delay in receiving financial assistance
 17% of the people experiencing problems in producing the required documents
 10% not interested in getting pension
IGNOAPS
IGNWPS