Vietnams experience in promoting healthy ageing Dr. Pham Vu Hoang - - PowerPoint PPT Presentation

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Vietnam’s experience in promoting healthy ageing

• Dr. Pham Vu Hoang

Director of Center for Population Research, Information and Database General Office for Population and Family Planning Ministry of Health, Viet Nam

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Contents

Recommendations Experiences from Vietnam Population ageing in Vietnam

Population ageing in Vietnam

Series 1, Vietnam, 20 Series 1, Japan, 26 Series 1, China, 26 Series 1, England, 45 Series 1, Spain, 45 Series 1, Poland, 47 Series 1, Hungary, 53 Series 1, Canada, 65 Series 1, America, 69 Series 1, Australia, 73 Series 1, Sweden, 85 Series 1, France, 115 Years

 The proportion of older people (60+) in the total population increased from 6.9% (1979) to 7.1% (1989), 8.12% (1999) and 8.9% (2009). In 2011, Vietnam has officially shifted into the “ageing population” structure when the proportion of

• lder people (60+) made up 9.9% (8,655,324

people), especially the proportion of older people (65+) was 7%. In 2016, older population is 11 millions and proportion is 11.9%.  Time for transition from “Aging population” to “Aged population” in Vietnam is 20 years, shorter than other countries, even those with better development level.

Tỷ trọng dân số 60+ (%), 1989, 7.1 Tỷ trọng dân số 60+ (%), 1999, 8 Tỷ trọng dân số 60+ (%), 2009, 8.7 Tỷ trọng dân số 60+ (%), 2019, 11.2 Tỷ trọng dân số 60+ (%), 2029, 16 Tỷ trọng dân số 60+ (%), 2039, 20.4 Tỷ trọng dân số 60+ (%), 2049, 24.8 Proportion of older people 60+ years (%) Transition from “population aging” to “aged population”

Source: Vietnam GSO, Population and Housing Survey 1989, 2009; Population Change and Family Planning Survey 2013, 2015

1. The older group has the highest increase: Between 1989 and 2013, the total population increased 1.53 times, the population group 0-14 decreased, the population in working age (15-59) increased 1.7 times, while the older population (60+) increased 2.1 times.

• 2. The oldest age group increases the

most in

• lder

population: It is estimated that in 2049, the proportion of

• lder people 80+ would increase 5.4

times from 0.7% to 3.8% compared to 1989, while younger age groups would increase slowly.

Tỷ trọng dân số 60+ (%), 1989, 7.1 Tỷ trọng dân số 60+ (%), 1999, 8 Tỷ trọng dân số 60+ (%), 2009, 8.7 Tỷ trọng dân số 60+ (%), 2019, 11.2 Tỷ trọng dân số 60+ (%), 2029, 16 Tỷ trọng dân số 60+ (%), 2039, 20.4 Tỷ trọng dân số 60+ (%), 2049, 24.8 Age group 1989 2009 2013 2015 60-64 2.4 2.3 2.9 3.7 65-69 1.9 1.8 1.8 2.4 70-74 1.4 1.7 1.6 1.7 75-79 0.8 1.4 1.3 1.4 80+ 0.7 1.5 1.8 2.1

Characteristics of older people in Vietnam

Population ageing in Vietnam

• 3. There are big gaps among older age

groups in different areas: More than two-thirds (66.8%) of older people live in countryside (GSO, 2014).

• 4. Women make up a large part in the older age

group: There is a big gap in gender structure of the older age group in Vietnam. The higher the age, the bigger gap in gender structure. In 2015, in the group age 60-79, there is one male per 1.3 female; in group age 80+ this ratio is 1/per 1.8, and in group 85+, 1/2.1. The main reason for this gap is women’s higher life expectancy.

Age group Number of females/100 males 60-69 122 70-79 152 80+ 187

Source: Vietnam GSO, Population Change and Family Planning Survey 2013, 2015

Characteristics of older people in Vietnam

Population ageing in Vietnam

 Life expectancy at birth: 73.3 years. Male: 70.7 years, Female: 76.1 years (GSO, 2015)  Healthy life expectancy of male: 63.2 years; Female: 70.0 years; average number of years with diseases of male elderly: 8 years; of female elderly: 11 years (WHO, 2015).  Self-reported health condition: healthy: 4.8%; normal: 29.8; weak and very weak: 65.4%  Disease model of older persons: Each has about 2.7 diseases, mostly chronic diseases

Bệnh, Blood Pressure , 46, 46% Bệnh, Osteoart hritis, 34, 34% Bệnh, Cardiova scular, dental, pulmona ry, and

• ther

chronic diseas…

Blood Pressure Osteoarthritis Cardiovascular, dental, pulmonary, and other chronic diseases

Percent of older persons with chronic diseases (%), 2011

Source: VNAS, 2011

Health Condition of older persons

Population ageing in Vietnam

 Older persons’ functional decrease increase by age. They need help and support (long-term care).

Male, Seeing, 28 Male, Hearing, 21 Male, Moving, 22 Male, Remember ing, 19 Male, Disability, 40 Male, Multi- disability, 24 Female, Seeing, 34 Female, Hearing, 25 Female, Moving, 29 Female, Remember ing, 26 Female, Disability, 46 Female, Multi- disability, 31 Male Female Cơ cấu mức độ khuyết tật, Failure in performi ng 4 functio…

Cơ cấu mức độ khuyết tật, Very difficult, 7, 7% Cơ cấu mức độ khuyết tật, Difficult , 33, 33% Cơ cấu mức độ khuyết tật, No difficult, 58, 58%

Failure in performing 4 functions Very difficult Difficult No difficult

Percent of older persons with disabilities, 2015

Source: MOH, Joint Annual Health Review 2016 Source: UNFPA, 2009

Percent of older persons with functional loss (self-reported), 2009

Health Condition of older persons

Population ageing in Vietnam

Experiences from Vietnam

• Constitution (1946 )
• No specific policy for the elderly

2000 - Now 1995 – 1999 1945 – 1994

• Additional regulations and policies on caring

and promoting the role of older people issued

• 1995, The Vietnam Association for the Elderly

established

Vietnam’s policy system on elder people has been improved. Since 2000, a number of policies on caring and promoting the roles of older people has been issued in responding to the increasing trend in the number of older people of the total population.

• 2000, Ordinance on the Elderly
• 2009, Law on the Elderly
• Constitution (2013)
• National Action Program on Older People, 2012-2020.

Policies and Programs on older people

WHO (2015), World Report on Ageing and Health. A public-health framework for Healthy Ageing:

• pportunities for public-health action

Experiences from Vietnam

Central Province District Commune

 Health care for older persons in integrated in the current health system at four level: central, province, district, commune.  Central Geriatric Hospital  63 provincial general hospitals (geriatric ward)  Private hospitals  629 district hospitals, 700 district health centers  544 regional clinics  private hospitals, private clinics  11,100 commune heath stations  Village health unit  private clinics, family doctors Professional General Health care system for older persons

Health Services

Experiences from Vietnam

In 2012, 9 millions older persons had 29 million visits.  14% health check-up  77% outpatient treatment  9% inpatient treatment Health Check-up, Clinics, 5 Health Check-up, District hospitals, 4 Health Check-up, Central Hospitals, 3 Health Check-up, Private health facility, 1 Health Check-up, Others, 1 Outpatient treatment, Clinics, 16 Outpatient treatment, District hospitals, 22 Outpatient treatment, Central Hospitals, 13 Outpatient treatment, Private health facility, 15 Outpatient treatment, Others, 11 Inpatient treatment, Clinics, 1 Inpatient treatment, District hospitals, 4 Inpatient treatment, Central Hospitals, 4 Inpatient treatment, Private health facility, 0.5 Inpatient treatment, Others, 0.1 Inpatient treatment Outpatient treatment Health Check-up Use of health services among older persons by type of service, 2012

Source: VHLSS, 2012

Health Services

Experiences from Vietnam

The government encourages the development of long-term care models.  Community-based care  Institutional care Community-based care Institutional care Public NGO, civil society Private Public NGO, civil society Private

Village health workers Volunteers Inter- generational clubs Community- based volunteers Home care services Day care centers Family doctors Social protection centers Nursing homes/ centers Nursing institutions

Long-term Care Models

Experiences from Vietnam

Care for material life

• Older people (80+) are

provided with health Insurance card for free, priority at health check-up.

• Reduction in transportation fare

(20%)

• Retired older people (pensions);
• Older people (80+) with neither

pensions: 270,000 VND/person/month

• Lonely older people: older

people (60-80): 405,000 VND/person/month;

• lder people (80+): 540,000

VND/person/month

• Older people live in social

protection centers. 1,080,000 VND/person/month

Care for mental life

• Having the right to join the

Vietnam’s Association of the Elderly.

• Program for older persons on

mass media.

• Older people are encouraged in

the following aspects: cultural, educational, sports, tourism economic and recreational activities; they are encouraged to promote their talents, knowledge and good qualities in participating socio-cultural activities.

Age-friendly environment Text

Health of older persons The Government, ministries (Health, Labour, Culture) provide regulations and guidelines on care for material life (food, clothing, travelling), spiritual life (education, information, sport, recreation, social relations, religion/belief and contribution) and health care for older persons.

Age-friendly Evionment

Recommendations

 Improve awareness and knowledge of managers, policy-planners as well as the community on challenges of population ageing and older persons’ life. Create favourable conditions and community movements to involve in health care for the elderly.  Improving elderly’s knowledge and skills to take care of themselves; strengthening the primary health care and health care system for the elderly through capacity building of commune health stations, geriatric wards in provincial hospitals, and other hospitals providing health care for the elderly; pay attention to detection and treatment of chronic diseases; ensure access to health care for disadvantaged elderly.  Develop and maintain long-term care models for older persons.  Improve social security to ensure income for the elderly. Revise and extend different insurance schemes appropriate to older persons’ contribution and affordability; Create opportunities for older persons to participate in economic activities, especially those with high qualifications, older persons with priority, rural elderly and older women.  Enhance roles of civil societies in developing, advocating and implementing policies on ageing and for older persons.

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