Transcript LONG TERM CARE POLICY FOR ELDERLY IN THAILAND

LONG TEM CARE POLICY FOR
ELDERLY IN THAILAND
the United Nations/Royal Thai Government
(UN/RTG) joint team on social protection
LONG TERM CARE POLICY FOR ELDERLY IN THAILAND
WORK SHOP 23/01/2013
LONG TERM CARE POLICY FOR ELDERLY IN THAILAND
I: DESCRIPTION OF THE CURENT SITUATION
II: SITUATIONAL ANALYSIS – SWOT
III: MAIN ISSUES IN THE LTC MODELS
LONG TERM CARE POLICY FOR ELDERLY IN THAILAND
I: DESCRIPTION OF THE CURENT SITUATION
THANKS TO ALL OF OR PARTNERS, specially
Dr Nantasak THAMANAVAT,
Director of institute of geriatric medecine ,
Ministry of Health
LONG TERM CARE POLICY FOR ELDERLY IN THAILAND
Total number of older : 7million (11.5%) in 2010
• Rapid population ageing
The share of older population doubles in 25 years
time - from 10.1% in 2000 to 21.5% in 2025 and
triples in 50 years – 29.8% in 2050)
• Second fastest ageing country in South East Asia
(3.7% per year),
• Rapid declines in fertility due to successful family
Planning from 6+children per woman in 60s to 1.5 in
10
• Increased life expectancy – due to improved public
health care & services (2010; M= 67.8 yrs; F=72,8)
LONG TERM CARE POLICY FOR ELDERLY IN THAILAND
National Plan on Older Persons
-1st National Plan for Older Persons (1982-2001);
-2nd National Plan for Older Persons (2002-2021);
which was revised in 2010
Enactment of regulations to promote elderly well-being
-Declaration on Thailand’d Older Persons (1999)
-National Commission on the Elderly (2003) chaired P M
-Act on Older Persons (2003)
-The 10th National Economic and Social Dvpment Plan
(2007-2011)
-National Framework on the Preparation for Ageing
Society (2007-2011 – being monitored by NESDB)
LONG TERM CARE POLICY FOR ELDERLY IN THAILAND
Universal free health care for older persons has been in effect since
early 1990s
• Section 52 of the Constitution (1997) states that “ All Thai people have
an equal right to access thequality health services…”
• Universal Health Coverage (UHC) reforms introduced in 2001 with
small co-payment at Baht 30 (equivalent to 1 USD)
Elderly Health Care & Services
• Community-based Care by NGOs & CBO & the Local Administrative
Organizations s e.g.
• Home visit by health personnel and volunteers (total volunteers in
2009 =1,007,274)
• Health Volunteers i.e. home visits, data collection, basic health
assessment (under supervision of Community Health Centres)
• Temples and Elders Clubs are actively engaged in health promotion
through selfcare and physical exercises and education prevention,
LONG TERM CARE POLICY FOR ELDERLY IN THAILAND
LONG TERM CARE POLICY FOR ELDERLY IN THAILAND
LONG TERM CARE POLICY FOR ELDERLY IN THAILAND
LONG TERM CARE POLICY FOR ELDERLY IN THAILAND
LONG TERM CARE POLICY FOR ELDERLY IN THAILAND
LONG TERM CARE POLICY FOR ELDERLY IN THAILAND
LONG TERM CARE POLICY FOR ELDERLY IN THAILAND
LONG TERM CARE POLICY FOR ELDERLY IN THAILAND
Policy Advocacy on Social Protection
LONG TERM CARE POLICY FOR ELDERLY IN THAILAND
LONG TERM CARE POLICY FOR ELDERLY IN THAILAND
LONG TERM CARE POLICY FOR ELDERLY IN THAILAND
II. SITUATIONAL ANALYSIS
SWOT
LONG TERM CARE POLICY FOR ELDERLY IN THAILAND
LONG TERM CARE POLICY FOR ELDERLY IN THAILAND
LONG TERM CARE POLICY FOR ELDERLY IN THAILAND
LONG TERM CARE POLICY FOR ELDERLY IN THAILAND
STRENGTHS
Laws and regulations for universal social protection,
The stakeholders high understanding of the threats,
The field network of ONG, Clubs, Volunteers and Care Givers,
The cultural tradition to support elderly, family and neighbours
The place of communities
Economical growth ….
WEAKNESSES
Lake of interaction between the different levels of health care
Lake of available or professionalized human resources
Sustainability of local and national funding
Overlaping between actors (volunteers care givers and structures)
Lake of visibility for social welfare organisations ….
LONG TERM CARE POLICY FOR ELDERLY IN THAILAND
OPPORTUNITIES
Implementation of the Universal coverage,
Many implemented pilots to be the references of best practices,
The interministérial structure crosscuting the different chapters of
LTC policy and to coordonate the definition of the foreseen policy,
The Political will,
…
THREATS
 Demographic urgency
Urbanisation and family model
The growth of the heavy dependancy
 To use an external model non suitable for Thailand to implement
urgently the designed policy
 To ignore or reduce the role and the input of the informal aid
 To design a bagpipe policy, ...
LONG TERM CARE POLICY FOR ELDERLY IN THAILAND
MODEL FOR THE PROPOSED STRATEGY
W-T
Will imply reducing the weakness that can make threats have a
real impact
Suggestions:
• Choose a bottom up definition of the policy and implementation
•Avoid to define a LTC policy for elderly but a holistic, pragmatic
plan
•Choose a bottom up definition of the policy and implementation
• Enhance the informal organisation and intergenerational,
•Priority for local initiatives through existing organisations,
LONG TERM CARE POLICY FOR ELDERLY IN THAILAND
III - Main Issues in the different models for
LTC policy
LONG TERM CARE POLICY FOR ELDERLY IN THAILAND
Governance: What is the suitable level and the role of each,
Objectives: Non-definition or uncertainity of the aims
Conceptual: LTC social or health as it is in Thailande facing the
need of competency from one to the other to realise a suitable
support (volunteers/care givers – nursing home/ health care
institutions),
Organisation: Centralised, decentralised, professionalised,
association, are all facing the lack of coordination with overlaping
between systems and multiplication of people who are in charge
to help the elderly. Professionalisation enhance the risk of
decreasing the place of informal and family help,
Fundation: funded, private insurance, public systems,
copayment, taxe fundation or social funds are all facing the rapid
growth of the expenditures through the solvabisation of needs,
rules to allocates the means,
LONG TERM CARE POLICY FOR ELDERLY IN THAILAND
Human resources:The harrassement of care givers (work injuries
and psychological problems ,
Need of a strong training engieniery to support HR
Evaluation process: Which ratio to appreciate the results?
Standards and quality to deliver services
Help the caregivers, prevention of autonomy lost, improvement
of housing, enhancement of social relation and cognitive
entertainement,
LTC in the comprehensive organisation for care
LONG TERM CARE POLICY FOR ELDERLY IN THAILAND