Title: Health and care of an ageing population: Alignment of health and social systems to address the need

Abstract

Population ageing is both an achievement and challenge, an achievement as longevity is the result of successful prevention and control of diseases, decreasing fertility rates and overall socio-economic development. It is at the same time a challenge as the increasing number of older people and the resultant demographic shift are accompanied by the need to adjust and scale up the social and health care systems. Comprehensive efforts based on country contexts are required in the following areas: (a) older persons and development, (b) health and well-being and (c) enabling and supportive environments to address population ageing needs. This article, however, focuses only on three most crucial issues, that is, livelihood, health care systems and care of the older dependent people. Person-centred care, integration and functional capacity are highlighted. Further, ageing in place or living in one’s own home, community or a place with the closest fit with the person’s needs and preferences is considered very important for healthy ageing. In terms of enhancing livelihood, major policy changes and reforms to improve the social security systems and expanding coverage as well as increasing the amounts to minimum subsistence levels are highlighted. Another area which needs to be strengthened is the tradition of existing family support systems. The health systems alignment required are reflected for each health system building block, and focuses mainly on (a) developing and ensuring access to services that provide older-person-centred care; (b) shifting the clinical focus from disease to intrinsic capacity; and (c) developing or reorienting the health workforce to provide care as per alignment. Mechanisms for alignment of long-term care systems best suited to meet the needs of dependent older people are also advocated.

Biography

Dr Sangay Thinley worked in the Bhutan health services for 25 years at various levels including as the Health and Education Secretary (2000-2003) under the erstwhile Health & Education Ministry and as Health Secretary (2003- 2005) after bifurcation of health and education, and with the WHO South-East Asia Regional Office in Delhi from 2006 in various senior level capacities before retiring in 2014. Currently he pursues keen interest in health system and services and is he/a/an i. Chairman of the Board, Bhutan Cancer Society ii. Member of the Governing Council of the Khesar Gyalpo University of Medical Sciences, Bhutan iii. Chair of the National Committee on Polio Eradication and Measles/Rubella Elimination iv. Member of Board of Trustees of the Royal Society for Senior Citizens (Bhutan), and v. Adjunct Professor at College of Health Systems Management, Naresuan University (Thailand).