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