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HelpAge International
Citizen views of MIPAA implementation 5 years on
Sylvia Beales HelpAge International
12th February 2007
www.helpage.org
What MIPAA calls for
ageing to be incorporated into global development agendas
the right of older people to an equal share of development resources
halving of old age poverty and hunger by 2015 in line with MDG 1
governments to include older people in national-development and social policy processes
specific actions on issues of concern for older people and their families – including health, social protection, HIV/AIDS, violence and abuse, emergencies
collaboration between governments, civil society, international agencies and the private sector
A bottom up, participatory review process
Promotes the active involvement of older persons who have often been overlooked
Encourages development of social capital, as people begin to organize and develop essential networks to promote their interests and their well being
Provides a tool for better decision making, for improving policies and programmes, and for improving governance
HAI MIPAA review - methodology
Collect basic information
Interviews with national ministries and local government representatives
Interviews with older people
Comment and analysis from older people’s organisations
Presentation of findings at national level
Joint planning on next steps with Ministries, ageing focal points and civil society
Preliminary findings
Five countries: Kenya, Moldova, Serbia, Uganda, Vietnam
Problems with data collection
no data available
general data on older people not disaggregated by sex or age
Poverty data amongst older people not generally available
Low awareness of MIPAA
Amongst
Older people
Local government structures
National government structures
Some countries engaged in awareness raising through workshops – eg Kenya, Vietnam, Senegal – more in pipeline
Older people in national policies
Poverty Reduction Strategies Uganda: OP issues in 5 year health sector plan but not specifically in the PEAP/PRS Serbia: OP issues recognised in 2002 PRS as group for poverty alleviation Moldova: 2004 PRS provides for social insurance for older persons National Plan on Ageing Serbia: National Strategy on Ageing, 2006 Uganda: draft policy before Parliament Kenya: draft policy being submitted to cabinet
Levels of older people’s participation vary
Resources allocated to older people
National budgets do not allocate resources for older people
Allocated resources for poverty reduction do not target older people’s poverty, nor acknowledge rate of population ageing
Limited resourcing for public assistance programmes which include older people - but they have to compete with other groups
Development partners not yet sensitive to older age issues
Health provision
Moldova: medical insurance for pensioners; primary, outpatient services and hospitalised treatment
Uganda: basic health care is limited by distances to health facilities and cost of drugs
Vietnam: free health insurance for all those over 90; 6% of all older people have free health insurance; 13% of older people benefit from healthcare fee remittances at provincial health centres
Kenya: all ages eligible for National Insurance Health Fund
Social pension provision
% over 60 receiving a social pension
Moldova 12.4 %
Kenya Zero
Serbia n/a
Uganda Zero
Viet Nam 2 %
Older people’s experience
“Encouraging older people to take part in healthcare activities, through regular medical check-ups and consultations has contributed to older people living a healthy useful and happy life” Bui Van Con, 71, Vietnam
“One more problem is that the older people do not know of their rights, our Constitution does not provide for a separate article which would stipulate that older people have the right to participate in social life , not to be excluded from society” Tatiana Reabov, 77, Moldova
“…when I went to the district hospital the young man there with a white coat told me that I was not sick, that I was just too old and my problem was aging for which they had no medicine… and when I asked him to at least get some drugs for my back pain he said that we old people just waste drugs…he went ahead and called the next patient without listening to my plea….”76 year-old male, Kenya
Health Free health care Improvement in health services Free transport Improved attitudes of health care providers Decent housing and living environment Food security and nutrition
Income and economic security Social pensions Increased levels of social pension (Moldova, Vietnam) Lower age of eligibility for social pensions (eg Vietnam is 90) Recognise and act on older carers needs (HIV/AIDS, migration)
Overall better provision of linked social protection (health, social care, social pensions)
Older people’s recommendations
Participation
• In family, community and society
• In development activities
• In dialogue with authorities
Leading to an environment where they are not stigmatized and treated as second rate citizens
Older people’s recommendations
Rights• Sensitisation and civic education on rights of older
persons • Legal representation• Property rights especially of older woman• Personal security
Need for affirmative action ie Convention on rights of older persons
Older people’s recommendations
Older people’s poverty
Women Men Total in poverty
% of total population
Moldova 35 % 29 %
Kenya
Serbia
Uganda 336,918 323,705 64 % 38%
Viet Nam 34 % 29 %
Sources: various