Ageing population: Are we ready to ensure proper care?

The country's population is still predominantly young, but a sharp increase in the proportion of those over 60 years of age could leave it ill-prepared to provide them with care.

The number of people in the age group in the latest census was over 1.53 crore, which is around 9.28 percent of the total population of 16.51 crore. In the 2011 census, this group constituted 7.48 percent of the population.

The 1.8 rise in percentage points between the two censuses is the sharpest increase between consecutive censuses in the country's history.

According to the United Nations Population Fund (UNFPA), by 2050, people aged 60 and above in Bangladesh will number 3.6 crore and constitute 22 percent of the total population.

This is consistent with global trends. According to the World Health Organization, by 2030, one in six people in the world will be aged 60 years or over.

Demographers and economists said the healthcare system and existing facilities are not sufficient at all for care and support of a growing number of elderly citizens.

Under the social welfare ministry, there are currently six old-age homes. Several shelters and traditional old-age homes are also run by charities.

Contacted yesterday, Ashraf Ali Khan Khasru, state minister for social welfare, said, "There are all kinds of arrangements for senior citizens. Elderly allowance is being given. Ten percent of seats at all government orphanages are reserved for senior citizens. But if people do not go there, we cannot do anything."

Continued rise in life expectancy isone of the reasons behind the ageing population, the experts said.

"Our society is not ready to take care of the ageing population. The issue is not well integrated into the government's development strategy and it is also not an integral part of our economic planning," noted economist Hossain Zillur Rahman told The Daily Star.

He said the issue should be viewed from a more strategic viewpoint. "For example, the birth rate is declining. So, would it be wise to open new primary schools? Are we developing facilities in our cities for elderly people?"

Selim Raihan, professor at the Department of Economics of the University of Dhaka, said, "It is an issue of concern. Both home-care and healthcare facilities are inadequate for the ageing population. We don't have good old-age home facilities."

He said out-of-pocket expenditure for healthcare is gradually increasing and will put pressure on the elderly population with little or no savings.

"We have to invest in the care economy. Social protection should be expanded, otherwise the elderly will be a big burden for the state," he said.

According to the Health Economics Unit, Bangladeshis have to pay 68.5 percent of their total treatment costs out of their own pockets.

It said patients spend 64 percent of their health expenses on drugs, while 23 percent is used on hospital expenses and eight percent for diagnosis purposes.

The ruling Awami League in its election manifesto in 2018 pledged that it would ensure health service free of cost for children less than a year old and citizens over 65. But it is yet to be implemented.

The AL government has taken some initiatives like an old-age allowance and a universal pension scheme. "But the government needs a comprehensive approach to address the issue," said ASM Atiqur Rahman, a professor at Dhaka University's Institute of Social Welfare and Research.

Paraphrasing a John F Kennedy quote, he said, "We could add years to life but could not add life to years. This has become a big challenge for the elderly."

He said the number of people aged 80 years and above are also on the rise, and elderly women form a majority of that group.

"There is no preparation at state level to address this serious problem. There are no steps for long-term care," he said.