Francois Farah Chief, Social Development Division

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Francois FarahChief, Social Development Division
Committee on Social Development New York,
February 2008
Population Ageing in the ESCWA Region
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1. Current Situation and Major findings
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Demographic changes in the Arab World
1950 2000 2050
Total Fertility Rate 7.0 4.2 2.2
Crude death rate per 1000 24.3 7.1 7.1
Life Expectancy at Birth 42.7 66.5 76.9
Percentage of the elderly (gt65 years) - 3.5 6.5
Number of Population (1000) - 300 165 631 218
Number of elderly (millions) - 10 40
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Percentage of population aged 65 and above in
Arab Countries, 2005
gt6
3-5
lt3
Source Economic and Social Affairs of the United
Nations Secretariat, World Population Prospects
The 2006 Revision and World Urbanization
Prospects The 2005 Revision, http//esa.un.org/un
pp,
5

• For the period 2000-2050, the rate of growth of
  the population aged 65 has been projected at 4
  -5 per cent, with an average annual growth rate
  of the oldest old (aged 80) estimated to exceed
  5 per cent in 11 Arab countries, including Kuwait
  and Qatar both at rates of more than 7 per cent.

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Percentage of population aged 65 above in Arab
Countries 2005 2050
gt15
7-15
lt7
Source Economic and Social Affairs of the United
Nations Secretariat, World Population Prospects
The 2006 Revision and World Urbanization
Prospects The 2005 Revision, http//esa.un.org/un
pp,
7
Demographic changes in the Arab World
1980 2000 2020
Percentage of population aged between 64-25 32.9 37.9 45.0
Elderly dependency ratio 6.4 6.2 7.8
Total dependency ratio 90.9 71.5 58.4
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The MIPAA Review Typical Characteristic

• The family has been the main source of support
  for older Arabs.
• The number of institutionalised older adults
  remains low in most countries.
• However
• Social changes brought about by modernization,
  decades of migration in the majority of
  countries, with the exacerbation of political
  violence in others, the family role may no longer
  be taken for granted in the near future.

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2. Major Achievements
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Government Measures in the implementation of
MIPAA

• Setting-up of National Committees
• In most cases, these national committees comprise
  representatives from the private and public
  sectors, and are usually headed by the minister
  of social affairs of member countries.

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Government measures in the implementation of
MIPAA

• Formulation of national policy, national plans
  of action, legislation
• Five countries have completed formulation of
  national policy Bahrain, Egypt, Jordan, Qatar
  and Syria. Lebanon is in the process of
  elaborating an integrated social plan of action.
  
• In many countries, existing general policies
  programmes often cover uncoordinated plans,
  activities projects that target old age. In
  general, providing care for older persons
  continues to adopt a welfare-based and
  service-oriented approach rather than a
  developmental, human rights and/or participatory
  approach.

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Government measures in the implementation of
MIPAA

• (1) Programmes and Services
• In many countries, health services have witnessed
  an increase in the number of specialized centers,
  day care centers, mobile clinics, particularly
  in GCC countries
• Some countries, such as Egypt, Jordan, Lebanon,
  have included geriatrics in medical faculties,
  studies on ageing issues at schools
  universities.

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Government measures in the implementation of
MIPAA

• Programmes Services (2)
• Some countries have introduced the family
  welfare programme, specialized broadcast
  channels to bridge inter-generational gaps.
• Utilizing the capabilities of older persons in,
  for example, tutoring students or teaching in
  eradication of elitracy classes, example Egypt.
  
• Implementing initiatives towards productive
  ageing, including granting of prizes to older
  persons who sustain being productive, such as in
  Egypt 7 Qatar.
• Training of concerned personnel, provision of
  brochures manuals for workers in the field of
  health care.

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Government measures in the Implementation of
MIPAA

• Programmes Services (3)
• Training ageing persons themselves on handicrafts
  and productive skills as a mean to raise money
  address cope with problems that are old
  age-related.
• Commemorating the annual International Day and/or
  the National Day of Older Persons has become a
  major national venue for raising awareness
  regarding ageing issues/ establishing broadcast
  channels for the elderly/ enhancing publishing of
  articles TV programmes.
• Some countries have initiated sports programmes
  /activities within the elderly clubs.
• In several GCC countries, widowed divorced
  elderly are provided with financial help by the
  government.

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Government measures in the implementation of
MIPAA

• National reports and needs assessment studies
• Most countries have started to prepare national
  reports on the situation of their elderly
  population.
• Many countries have established relevant database
  conducted needs assessment studies.
• Saudi Arabia National Plan of Action includes
  establishing a registry/database on older
  persons.

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3. Challenges
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Challenges facing the older population in Arab
countries

• The current generation of older persons in
  most Arab countries exhibits certain social and
  economic vulnerabilities that have important
  implications for their health care.
• Social Challenges
• Economic Challenges
• Health Challenges

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Social Challenges

• Education indicators
• Low education levels of older people
• Wide disparity among Arab countries regarding
  level of education, reflecting illiteracy rates
  at 95 in Yemen, 40 in Jordan
• Gender Disparity
• Wide disparity between the educational levels of
  men and women.

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Social Challenges

• As a result of modernization and changing life
  style, family members no longer provide care
  for their frail elderly, particularly those
  with special needs.
• High percentage of widowhood leads to increase
  in the number of female-headed families. Elderly
  women living alone amount to 20. This generates
  loss of social status and causes vulnerability
  and many psychological health problems.

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Economic Challenges

• Due to the absence or small old-age pensions the
  majority of older men continue to work after the
  legal age of retirement (a substantial per cent
  of men in Yemen continue to work beyond age 80
  years 21, in Lebanon Jordan 11-14)
• The vast majority of Arab women do not work in
  the formal sector, their contribution is limited
  to the informal sector. Consequently older women
  are dependent upon the benefits of the
  breadwinner, when available.

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Health Challenges

• High levels of chronic diseases, comparable in
  some countries, such as Kuwait, Jordan Lebanon
  to those found in developed countries. In other
  countries, mainly Arab African countries,
  communicable infectious diseases prevail.
• High prevalence of difficulties in activities of
  daily living being reported in Egypt, Jordan,
  Lebanon, Tunisia (varying between 25 38).
• Lack of qualified cadre and geriatric specialists
• Inaccessibility or unavailability of specialized
  home services, and total lack of social or
  economic support to the family.

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Towards successful ageing

• Ageing should be considered as a serious
  challenge. Countries, policy makers, civil
  society and individuals in the region ought to
  focus on integrated social policy and address
  ageing-related issues within the approach of A
  Society for all ages.
• Sharing the responsibility is essential. A
  multi-sectoral approach, securing the active
  participation of all partners (individuals/family/
  civil society/NGOs) should be based on the
  concept of Life-cycle approach

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4. Future priorities for action in the region

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Enabling and Supportive Environment

• Goal
• A supportive environment promotes social
  integration and autonomous ageing and contributes
  to development.
• Underpinning issues in the Arab countries
• Lack of a clear plan on how to accommodate the
  specific characteristics and needs of older
  persons for them to be able to live independently
  and move around autonomously.
• Compared to older persons in urban areas, those
  living in rural remote areas in Arab countries
  are likely to be at a greater disadvantage.
• Shrinking/diminishing financial ability of
  families to sustain their economic support to
  their elderly .

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Active Participation of population ageing in
Development

• Goal
• Active participation of older people in all
  aspects of the development process is essential
  to the policy making process and to successful
  ageing. It also limits marginalization, promotes
  empowerment and increases ownership and inclusion
  in the shaping of practice.

Nothing about us without us Help The Aged, UK
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Active Participation of population ageing in
Development

• Underpinning issues in the Arab countries
• Public participation and legislative
  representation of older persons appear to be
  related more to the position of the older persons
  often associated with economic and political
  power, than to institutionalized policy
  structures and processes.
• Relatives tend to adopt a paternalistic approach
  and replace older persons in assuming
  responsibility for several familial decisions,
  including health-related matters concerning the
  older persons themselves.
• Prevailing negative stereotypes about ageing and
  older persons as frail dependent members, coupled
  with the lack of associations that represent
  their interests/needs.

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Two essential points

• Sharing responsibility between
• The individual (life style)
• A society for All Ages
• Integrating ageing-related issues in development
  plans for all ages (upgrading education,
  nutrition, healthy life style, job/economic
  opportunities in younger years would lead to
  better quality of life during ageing.

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5. Cooperation by the UN system to assist
Member States in implementing the Plan of Action
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The Way Forward

• The UN to join efforts to ensure that all
  sectors and partners undertake their
  responsibilities in coordination.
• The UN system is called upon to promote an
  integrated social policy, premised on equity,
  equal opportunity and intergenerational
  solidarity and human-rights.
• Policies should aim at
• Providing adequate social security and health
  care in old age,
• Enabling older people to remain active and to
  live independently in their own communities

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The Way Forward

• The UN should uphold and facilitate the setting
  of
• a social support system, formal and informal
• Enhancing the abilities of the family to take
  care
• of older persons within the family environment.
• Promoting active participation and mainstreaming
• aging policies in development
• Generating research and data for the benefit of
• evidence-based policies/programme.

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Demographic dynamics epidemiological change
NGOs
Social economic characteristics
Family support system
Formal sector
Life-cycle approach
Resources
Resources
Needs
Needs
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Thank you