Who looks after India’s elderly?

India has no long-term care workers for people who are 65 years and older, according to a report by the International Labour Organisation


India has a relatively lower proportion of the elderly at 5.5% compared with most other countries, according to the study. Photo: HT
India has a relatively lower proportion of the elderly at 5.5% compared with most other countries, according to the study. Photo: HT

New Delhi: India will add 100 million to its working age population in the next decade and the aspirations of its youth are ever present in debates about the country’s economic potential. Hardly anyone talks about the elderly.

The government and the society seem “awfully ill-equipped” to manage a large number of growing and vulnerable segment of the elderly, vice president Hamid Ansari, 78, said earlier this year. A recent report by the International Labour Organisation (ILO) shows his concern is not entirely misplaced.

India has no long-term care workers for people who are 65 years and older, the report said. Leave alone Japan, which has a high aged population, other emerging countries such as China and South Africa have more workers looking after the elderly.

India has a relatively lower proportion of the elderly at 5.5% compared with most other countries, according to the study. However, that is about 66 million people, close to the population of the UK or France.

India also fares poorly in public expenditure for long-term care. The report, which surveyed 46 countries between 2006 and 2010, shows that public spending for long-term care for the aged in India constitutes a dismal 0.1% of the gross domestic product (GDP). While advanced countries such as Canada, Germany, Japan, the US and the UK spend a higher proportion of their national budgets, the condition is equally poor in China, Brazil and Mexico.

While the situation is certainly alarming, it is not a surprise, experts say. Care of the elderly is just another segment bearing the brunt of poor healthcare conditions in the country.

“It is the overall neglect of healthcare in general which is featuring here as well. There may be efficient health workers and facilities available to the elderly, but that is true only for the richest sections. That constitutes a very small percentage of the overall population,” said Sourindra Ghosh, research consultant at the Council for Social Development, a New Delhi-based think tank.

The healthcare infrastructure for the elderly is further squeezed, especially with lack of adequate resources for other sections of the population such as children under five years or pregnant women.

India spends about 1% of its GDP on public health, compared with 3% in China and 8.3% in the US. In December last year, the government slashed nearly 20% in its healthcare budget due to fiscal strains, sounding alarm bells for the sector.

“In India, healthcare spending has been going down despite promises. Whether it be healthcare or social assistance, the number of dedicated formal workers in this sector is poor,” said Imrana Qadeer, visiting professor at the Council for Social Development.

The population over the age of 60 years has tripled in the past 50 years in India and will persistently grow in the near future. The proportion of people in this age group in India is expected to increase to 12.7% of the population by 2030 from the current 5.4%.

Apart from government support, family has been the main source of support for older persons in India. Even that is slowly changing. Due to the migration of the working age people to other parts of India and destinations abroad, children often live away from their parents.

“India’s economy is rapidly developing—a situation that often leaves older people in precarious situations,” the report stated.