WUNRN
LONG-TERM CARE PROTECTION FOR OLDER PERSONS: A REVIEW OF
COVERAGE DEFICITS IN 46 COUNTRIES
Direct Link to Full 115-Page ILO 2015 Report:
Due to the global demographic ageing, all countries are
challenged by growing longterm care (LTC) needs for older persons. However,
these needs are largely ignored and range very low on the policy agendas of
most countries. This paper has developed global estimates on LTC protection of persons
aged 65 and over.
http://www.ilo.org/global/about-the-ilo/newsroom/news/WCMS_406984/lang--en/index.htm
More than Half the World’s Older Persons Lack Quality Long-Term
Care – Older Women
A new ILO study reveals a global
shortfall of 13.6 million care workers undermining the delivery of quality
services to more than half of the world’s older persons.
Older
woman carrying her daily provisions, Masako, Kinsagani, Democratic Republic of
Congo
© Ollivier Girard / CIFORGENEVA (ILO News) – More than half of the
global population aged 65 and above, representing 300 million people, is
excluded from urgently needed long-term care (LTC), says the International
Labour Organization (ILO).
1 October 2015 - The new ILO study LTC protection
for older persons: A review of coverage deficits in 46 countries which covers 80 per cent of the
world population aged 65 and over finds extreme deficits in social protection
for older persons in need of long-term care due to a lack of 13.6 million LTC
workers worldwide.
In Africa, which lacks 1.5 million LTC workers, more than 90 per cent of older
persons do not receive long-term care services when in need. The most important
deficit in absolute numbers is observed in Asia and the Pacific where there is
a shortage of 8.2 million LTC workers meaning 65 per cent of the older
population is excluded from access to long-term care. Filling these gaps would
result in a great number of jobs created.
Deficits in legal LTC coverage towards universal coverage based on national
legislation, 2015 (total population, percentages)
Source: ILO estimates 2015, World
Bank, 2015 (population data in 2013)“We face these shortfalls despite the
fact that the bulk of care – up to 80 per cent of LTC work – is provided by unpaid
female family members of older persons. Their numbers exceed by far the numbers
of formal LTC workers in all countries,” explains Xenia Scheil-Adlung, ILO
Health Policy Coordinator and author of the study.
Closing the gap
According
to the ILO expert, the situation is aggravated by a complete lack of LTC
coverage in most social protection schemes. Only 5.6 per cent of the global
population lives in countries that provide universal LTC coverage.
While more than 48 per cent of the world’s population is not protected by
national LTC legislation, another 46.3 per cent are, to a large extent,
excluded from LTC coverage due to narrow regulations that limit benefits only
to the poorest. The latter forces many persons aged 65 and over to pay out of
their pockets for LTC services.
Global estimates of coverage deficits in LTC: Proportion of the world’s
population not protected by legislation, 2015
Source: ILO estimates 2015, OECD
2011, World Bank, 2015 (population data in 2013)“This deplorable situation
is reflected in the very low public LTC expenditure, which amounts to less than
1 per cent of GDP on average globally. The lowest public expenditure is found
in Africa, where the majority of countries spend 0 per cent of GDP on LTC,”
says Scheil-Adlung.
The most “generous” countries can be found in Europe but on average spend only
2 per cent or less of their GDP on LTC. As a result, the older population
living in developed and developing countries has to pay up to 100 per cent of
LTC out of their own pocket.
“The neglect of vital needs of older persons and the exploitation of unpaid
female family members is the result of many years of underinvestment in LTC
protection. Closing the gaps and providing universal LTC coverage would respect
the rights and dignity of both older persons and their caregivers and create
millions of jobs,” says Isabel Ortiz, Director of the ILO’s Social Protection
Department.
Age and gender discrimination
The
disregard of LTC needs points to age and gender discrimination – often referred
to as “ageism”. This is reflected in the systematic unequal treatment of older
persons needing LTC services compared to younger persons with similar
health-care needs, the ignorance of older persons’ rights, the large absence of
LTC workers and public underfunding.
Today’s ageism is also visible in the irrational fear expressed in the
prevailing public opinion that LTC is not affordable rather than seeing the
benefits of investing in LTC in terms of job creation and improved welfare of
the population.
While frequently age discrimination is not considered a serious concern, it has
the same social and economic impacts as other forms of discrimination and is
experienced by LTC recipients in the form of impoverishment, exclusion and
sometimes even abuse and violence in LTC environments.
The study suggests making LTC a top priority on the policy agendas of all
countries by:
·
guaranteeing universal LTC protection based on the core
principles of national social protection floors as outlined in ILO Recommendation 202 ;
·
financing through national social insurance schemes or taxes and
reducing out-of-pocket payments to a minimum;
· increasing the LTC workforce to make quality services available to all in need, generating much needed jobs.