1

NATIONAL APPROACHES TO ADDRESS THE

HEALTH OF ELDERLY PEOPLE
PRESENTERS:
ABINASH POUDEL (3)
ANISH OSTI (7)
ARUN PANT (8)
PRATIKSHYA KHADKA (26)
SABIGYA GYAWALI (27)
SAMIKSHA SHRESTHA (28)
 2

TABLE OF CONTENTS

 INTRODUCTION
 GERIATRIC HEALTH IN NEPAL
 NATIONAL APPROACHES
 CHALLENGES
 REFRENCES
 3
ELDERLY IN NEPAL
 In Nepal, 60 and above considered as elderly.
 Despite that, different practices in Nepal are operational:
 Civil servant retirement - 58 years
 University service retirement- 63 years
 Constitutional organs of government retirement age- 65.
 In Nepal, proportion of 60 years and above: 8.1%, majority are in their sixties
(69%).
 Female elderly are more than the males (97.7 sex ratio)
 Among 77 districts, Gorkha (12.75%) reported the highest,& Jajarkot (5.12%),
reported the lowest proportion of elderly.
 4
Geriatric health in Nepal
 Nepalese society is in a phase of modernization.
 There is modification in the cultural norms and traditional family
support systems for elderly in Nepal which have placed substantial
strain in caring elderly people.
 In Nepal, there were 1.5 million in 2001 and 2.1 million in 2011,
elderly inhabitants, which constitute 6.5 percent and 8.1% of the total
population in the country.
 During the years 1991-2001, the annual elderly population growth rate
was 3.39 percent, higher than the annual population growth rate of
2.3 percent.
 5
Civil Code 1963

 Section 11 of the chapter of court management has a provision

that the litigation of elder people above than 75 years or the
people physically retarded should put in third priority in the
hearing. Here, the first priority has given to person under custody
or the prisoner under trial and the second priority is to unclaimed
children below than 16 years.
 6
Local Self Governance Act 1998

 The Local Self Governance Act of 1998 includes provisions for protection of
– among other social groups – older people.
 The guidelines of the Ministry of Local Development include:
1. men and women above the age of 75 are eligible for a monthly allowance
of Rs.200
2. persons above 60 years of age who have no source of income, no family
support, no personal assets or widows who do not get their husband's pension
are eligible for monthly allowance of Rs.150.However, 26% of eligible older
people are deprived of these social security schemes due to complicated
procedures.
 7
Senior Citizen Policy 2002

 Addressing the institutional infrastructure, the Senior Citizen

Policy of 2002 declared all 75 women’s development offices
also as focal points on ageing issues.
 8
Senior Citizens Health Care Services
Programme.

 In 2004 the government initiated the state funded senior citizens

health care services programme. This programme included free
medical services for senior citizens and senior citizens health
facilities fund.
 Later, Geriatric Health Service Implementation Guideline 2077 was
enforced to implement geriatric friendly health services in
different hospitals.
 9
National Plan of Action for Senior Citizens 2005

 The Plan addresses issues such as social security, health and nutrition, participation,
education and entertainment, as well as legal questions.
 Following the adoption of the Madrid International Plan of Action on Ageing,
government formulated a National Plan of Action for Senior Citizens in 2005.
 In connection with the national action plan, identification cards for older person are
being issued.
 To carry out policy and advisory work, a high level Senior Citizen Coordination
Committee was established.
 The Committee initiates and oversees activities aimed at improving living conditions
for older persons in all five development regions.
 10
Senior Citizen’s Act 2006

 It shall be the duty of all to provide necessary services, facilities and

assistance to the senior citizens in any public vehicles, public undertakings,
medical services, religious and public places.
 The concerned owners or operators of such types of public motor vehicles
as may be specified by the Government of Nepal by publishing a public
notice shall reserve at least Two seats in such vehicles for the senior
citizens and give them a concession of at least Fifty percent on the
passenger fare.
 Each organization providing health services shall provide health services by
giving priority to the senior citizens.
 11
Senior Citizen’s Act 2006

 Such organization providing health services as may be specified by

the Government of Nepal shall give concession of at least Fifty
percent on the fees chargeable on the treatment in such
organization of senior citizens in the specified number.
 Other organizations providing public services including drinking
water, electricity and telephone shall give priority to the senior
citizens while providing such services. ​
It shall be the duty of each family member to maintain and care the
senior citizen according to the economic status and prestige of the
member.
 12
Senior Citizen’s Act 2006

 This Act has enforced the concept of Central Senior Citizens Welfare
Committee and District Senior Citizens Welfare Committee.
 Formation, duties and powers of those committee are also clearly
mentioned.
 Additionally, Senior Citizens Welfare Fund was also established.
 13
Senior Citizen Rule 2008

 Functions, duty and rights and procedure of meeting of a central and

several district Senior Citizens Welfare Committee are mentioned.
 The court, while issuing an order to keep on infirm senior citizen and
a senior citizen having completed the age of seventy five years
having sentenced to imprisonment to be kept in a care centre.
 Operation of Senior Citizens Welfare Fund is also guided.
 Arrangement of unclaimed Senior Citizens.
 14
Works of government of Nepal to improve
health of elderly people

 provision for protection and social security of senior including

health services.
 Conduct orientation and sensitization sessions for health workers
and FCHVs on geriatric health care.
 Provide training on hypertension, diabetes and cervical cancer
screening to primary health care workers and carry out regular
screening services for senior citizens to detect cases as early as
possible.
 15
CONT…

 Expand the services by prioritizing senior citizens of underserved

areas to ensure their affordability in equitable manner
 Carry out vaccination services against influenza, pneumococcal,
shingles/ zoster and tetanus to prevent and mitigate the health risk
of senior citizens.
 Provide free medical care services for senior citizens suffering from
Alzheimer’s and geriatric related disease like parkinson, asthma,
heart disease, kidney disease and cancer.
 Provide free health care and protection services for physically and
mentally incapable, helpless and unprotected senior citizens.
 16
CONT…

 Collaborate with professional agencies, civil society, organisations

and private sectors agencies for supportive main stream geriatric
health issues into national plan and budget.
 Lunch mass media campaign like radio shows television
programmes and online events promoting education and
awareness on geriatric wellbeing, self-care and preventive
measures in response to COVID -19.
 17
Three Year Plan Approach paper (2010/11-
2012/13)
 The Three Year Plan Approach paper (2010/11-2012/13) has adopted the following
strategy for older persons:
1. make policy and institutional provisions to utilize knowledge, skills and experience
of senior citizens
2. expand access of older persons to economic and social security programmes
3. promote and expand economic and social security programmes by enhancing
coordination among government, non-government, private cooperative and
community sectors as well as local government bodies
4. launch special programmes targeting senior citizens who are abandoned, victims of
violence, and those with some degree of disability and vulnerability
 18
Geriatric Health Service Strategy 2021-2030 (2022)

 Vision: “A meaningful, quality and healthy life for all senior citizens”
 Goal : To enable senior citizens to lead active and quality lives on the
basis of optimum health protection and effective health service delivery.
 Objectives : Lifelong health promotion and protection Inclusive and
accountable health service delivery Multisectoral collaboration for
effective geriatric health
 19
CONTI…

8 Strategies:​
 Promote healthy living​

 Enhance health protection​

 Improve access to quality services​

 Inclusive health system​

 Professional competence​

 Social health insurance reform​

 Institutionalize senior health concerns​

 Coordination and harmonization​

 20
Challenges faced by the Elderly
 :

1. Limited Healthcare Access

-Limited access to quality Healthcare services, especially in rural areas
2. Financial Insecurity
-due to inadequate retirement savings
-can lead to dependence on family support, which may not always be
sufficient
3. Social Isolation
-common problem
-loneliness as younger generations migrate for work
 21
CONT……….

4. Mistreatment and elder abuse

-major social problem
5. Chronic health conditions
-heart diseases, stroke, cancer, diabetes
 22
References

 Senior Citizens Act , 2006 Nov. 24, Nepal Law Commission

 Senior Citizens Rule, 2008, Nepal Law Commission
 Nepal Report on High-level Meeting on the Regional Review of the Madrid International Plan of Action on
Ageing (MIPAA) , ECONOMIC AND SOCIAL COMMISSION FOR ASIA AND THE PACIFIC
 POLICY AND PROGRAMMES FOR OLDER PERSONS IN NEPAL, Department of Economic and Social
Affairs (DESA), Division for Social Policy and development (DSPD) , United Nations
 Geriatric Health Service Strategy 2078/79 to 2086/87 - (2021-2030)
 https://kathmandupost.com/national/2019/05/30/senior-citizens-welcome-increase-in-allowance-but-say-they-are-
not-fully-happy
 https://www.helpage.org/news/older-people-are-prioritised-on-paper-but-not-in-reality/
 https://medium.com/@ramjee07/elderly-care-in-nepal-challenges-progress-presents-a-compelling-narrative-of-cha
llenges-and-a4482b4c8a0d
23