According to “World Population Prospects: the 2017 Revision,” the number of older persons (those aged 60 years or over) is expected to more than double by 2050 and more than triple by 2100, rising from 962 million globally in 2017 to 2.1 billion in 2050. Globally, the population aged 60 or over is growing faster than all younger age groups.
Due to the improved quality of life in Bangladesh, people now live longer. There is a sizeable ageing population in the country today and the number of people over 60 years of age is increasing. For example, 6.8 percent of the population was aged over 60 years in 2010. Now the percentage is nearly 7.82. However, this rate in rural areas is comparatively higher, at 8.48 percent.
Most elderly people in Bangladesh suffer from problems such as lack of financial support, chronic diseases and absence of proper health and medicine facilities, exclusion and negligence, deprivation and socio-economic insecurity. The degree and extent of these vulnerabilities would likely intensify in near future. The plight of the elderly is extreme in villages. One of the most common tasks of the elderly is taking care of their grandsons and granddaughters. However, traditional family bonds and the community-based care system are gradually breaking down. And many elderly persons are neglected by their own children, be it in villages or cities.
Outside the household, there's little in terms of transport, healthcare and other infrastructure to make the lives of elderly people easier. For example, reserved seats for elderly citizens are barely ever “reserved” for them. Although this is a positive initiative in theory, in practice this is never implemented as many people end up occupying those reserved seats.
The Old Age Allowance (OAA) scheme is a significant one in terms of coverage, as it provides social protection in old age. The tax-funded OAA is a social pension paid to poor older people. The scheme which was introduced in 1998 currently covers 40 percent of the population aged 60 and over with a low monthly transfer amount of Tk 500 per beneficiary. However, the majority of poor older people in Bangladesh miss out on OAA benefits mainly due to targeting errors (over 50 percent of benefits go to non-poor older people and almost a third of the benefits go to those below the age of eligibility).
Let's not forget that elderly people have constitutional rights. The right to social security through public assistance in case of poverty arising from unemployment, illness or disablement, and other cases is mentioned in Section 15(d) under “Provision of Basic Necessities” of Part II of the Constitution. The right to basic necessities for all citizens such as food, clothing, shelter, education and medical care and the right to work and employment, recreation and leisure are mentioned in Sections 15(a), 15(b) and 15(c) as well.
Although the main emphasis of the Bangladesh Population Policy-2012 is to improve the status of family planning, maternal and child health including reproductive health services, it has paid considerable attention to the welfare of elderly people in the country. It emphasises upon measures to provide food and social security and shelter for the disadvantaged including the elderly, destitute, physically and mentally challenged persons, and to ensure a conducive environment for improved quality of life.
The National Health Policy-2011 sets 19 specific objectives for quality healthcare. Significant issues and concerns like accessibility to disadvantaged people, gender equity, immunisation, family planning, mobile clinics, climate-change-induced diseases and e-health have been addressed. Resource constraints, weak management, climate change, and unplanned urbanisation are some major challenges. Though this policy focuses on many aspects, it does not clearly explain health rights, psychosocial support, and care for elderly people.
The National Social Security Strategy (NSSS) of Bangladesh has committed to undertake many initiatives for the welfare of elderly people. The ruling Awami League government prepared a national policy for the aged and enacted the Parents Care Act 2013. A provision for Integrated Pension Scheme is envisaged in the Seventh Five Year Plan (2016-2020) of Bangladesh. The ruling party also made commitments in its present election manifesto to expand the social safety net for the elderly, raise awareness, earmark seats in public transports and residential establishments, provide healthcare at the grassroots level, and ensure senior-friendly entrances in hospitals, airports, buildings and different transports.
All these commitments will hopefully be translated into action. Life for the elderly, particularly those belonging to lower income groups, is extremely tough in Bangladesh and they are often mistreated by family members as well as the society. Neither do we have a culture where nursing homes are looked at in a positive light nor do we seem to have the will to build such homes to accommodate the large number of elderly people suffering in their own homes. The government has taken up a limited number of initiatives to establish homes for the elderly with modern amenities. With the ageing population in the country increasing, it is more important than ever for the government to design innovative policies, build more nursing homes with the required facilities where proper care will be given to the elderly, provide public services specifically targeted to older persons, and implement policies that address housing, employment, healthcare, infrastructure and social protection, among others.
Mohammed Mamun Rashid is Programme Manager, Civic Engagement, Transparency International Bangladesh (TIB).