The recently published United Nations’ “World Population Prospects” has attracted much media attention because of its projection that India will surpass China as the world’s most populous country next year, much sooner than originally expected.


What is the problem?

  • As India celebrates her own coming of age, turning 75 this year, the population projections suggest that the country is already home to 30 million persons who are 75 or older.
  • By 2036 timeframe, the World Population Prospects estimates there will be nearly 100 million persons older than 75 in India.
  • This is a staggering number of people who are no longer in the workforce and who are at a much greater risk to be living with and dying from a chronic, often disabling, health condition.


What are the issues for the elderly?

  • A hugely important question in the light of the population projections is the country’s preparedness for the exponentially increasing needs for care for people with chronic conditions like dementia.
  • Such care typically extends well beyond the narrowly defined clinical treatment of specific diseases and encompasses a range of services — in particular, primary care which integrates care for diverse health conditions, home-based nursing, palliative care and rehabilitation. 
  • There is no comprehensive, community-based, care system for elders. Families have to make their own arrangements through out-of-pocket payments for each service which is needed. Even if the family has the money, the services needed are not even available in most places. This means the vast majority of elders in India are left to their own devices.
  • In a country where civic infrastructure, such as public transport, is insensitive to the needs of persons with different abilities, many elders with disabling conditions will be trapped in their homes, eking out the last years of their lives alone and forgotten by society.


What can be done?

  • There is a solution which is in plain sight. One of India’s singular contributions to population health has been its deployment of frontline workers to deliver promotive and preventive healthcare.
  • India’s celebrated Accredited Social Health Activists (ASHAs) have been singularly responsible not only for the dramatic reductions in maternal and infant mortality contributing to our increased life expectancy, but also to achieving our impressive Covid vaccination coverage.
  • The ASHA program is a template for building a community-based workforce, anchored in the large and growing network of government Health and Wellness Centres across the country, to support the diverse health and social care needs for elders.
  • As the population projections show, India is rich with human resources who are young and looking for work and we could simultaneously address two population challenges by empowering working-age adults who are jobless in the service of elders.



What elders need, most of all, is a caring and compassionate person, with the requisite skills, to accompany them on the last journey of their lives. India’s ingenuity in leveraging community resources to address her complex problems presents a unique opportunity to make her a country which offers a hopeful future for both her elderly and her young people.


SourceThe Indian Express


QUESTION – As the ‘World Population Prospects’ report highlight that India will start ageing soon, we should focus upon providing elderly care as part of our social and health programmes. In this context, suggest what can be done to empower the elderly, especially with respect to healthcare.