Recommendations from a meeting on
Health of the elderly and policy implications in ghana

Organized by the Ghana Public Health Association




EXECUTIVE SUMMARY

The Ghana Public Health Association organized a scientific seminar to examine the health of the elderly and the policy implications for Ghana. The seminar was driven by the growing proportion of the elderly in Ghana and what this poses to the burden of disease and cost to individuals, families, communities, health system and the government. Key health problems of the elderly identified cover both disease specific and health systems issues. Implementation of a draft ageing policy developed in 2010 to,
among others, address the health concerns of the elderly was found to be inadequate due to absence of a legal framework to back the policy, among others. The seminar identified specific intervention options for the way forward, including establishing a National Council for the elderly, sensitizing the general public on health needs of the elderly, and making health services ‘elderly-friendly’.

Context

1. There has been an increasing trend in ageing in all regions of the world. Older adult population has increased in all six regions of the world with the highest population in Europe where the proportion of older people is estimated to reach 36.6% by 2050. Between 2010 and 2050, the number of older people in less developed countries is projected to increase more than 250% , compared with a 71% increase in developed countries

2. In Ghana, the population aged 60+ was 6,726 at independence in 1957. In 2010, it was estimated that the Ghanaian population aged 60+ years was nearly 1.5 million, representing 6% of the total population, an increase of over 220% since independence. This age group is
expected to grow to nearly 2.5 million by 2025, and to almost 6 million by 2050, representing 14
% of the total population.

3. The growing elderly population poses increasing burden of disease and cost to individuals, families, communities, health system and the government. There is therefore an urgent need to assess the ageing situation in Ghana and outline policy and intervention options for the future.

4. It is under this context that the Ghana Public Health Association (GPHA) organized a public scientific lecture on the health of the elderly and policy implications on 25 June 2014 to understand the scope of the issue and discuss its public health implications to inform policy. GPHA is an apolitical, non-governmental professional association of all interested professionals who have a contribution to make to improve public health in Ghana.

Key Issues and Conclusions

1. The key health problems of the elderly identified are disease specific and health systems issues.
2. The most common disease conditions cited were:
a. Non-communicable Diseases, especially undiagnosed and untreated hypertension, b. Mental illness (such as depression, dementia),
c. High level of sensory impairment (hearing loss and visual impairment due to cataract,
glaucoma and refractory errors) which are undetected and/or unmanaged d. Dental diseases, and
e. Musculoskeletal problems leading to limitation of movement affecting social
participation and quality of life/frailty.
3. Health systems issues identified include:
a. Poor utilisation of health care services and inadequate access to specialized health services
b. Poor attitude of health staff to the elderly,
c. Inadequate education on nutritional needs of the elderly
d. Inadequate preparedness and capacity of the health workforce to care for older people, e. Health facilities not “elderly friendly”,
f. National Health Insurance benefits package not covering a number of health conditions
of the elderly such as male cancers (only breast and cervical cancers are covered), biopsy and histology.
g. Absence of an Ageing Council and legislative backup has affected implementation of the
Ageing policy drafted in 2010.
h. Poor communication and lack of awareness about health issues of elderly, and i. Breakdown of traditional social and family support systems.

4. Implementation of the draft Ageing Policy of 2010, which was approved by Cabinet with its Action Plan in November, 2010, and launched in 2011 has been adversely affected due to absence of a proposed Ageing Council and legislative backup. Ministries, Metropolitan, and District Assemblies (MMDAs) were supposed to have integrated the draft implementation plan

into their own programmes but this has not happened. The MOH/GHS is the institution expected to implement the health and nutrition component of the Ageing policy but it does not have its own Ageing policy implementation plan.

Recommendations for Way Forward

The key ministries responsible for ageing are Ministry for Gender, Children and Social Protection, and Ministry of Health/Ghana Health Service. The following Intervention options are proposed for their guidance to address the issues affecting the elderly in the country.

Ministry for Gender, Children and Social Protection

1. Undertake a nationwide community sensitization, advocacy, information and education on the health of the elderly targeting the public, carers, community leaders, religious organizations etc.
2. Initiate moves to establish a National Council on the Elderly backed by legislation with a clear
mandate to promote alleviation of the social, health and economic challenges of the elderly.

3. Appoint High level Champions for the elderly in Ghana.
4. Develop social networks for community-based support of older people with active participation
of District Assemblies, both as recipients and providers of care.
5. Create Ageing Desks at all Ministries, Departments and Agencies.

Ministry of Health and Ghana Health Service


1. Develop health implementation plan of the Ageing policy (GHS) and integrate ageing and health in the Community Health Planning and Services programme.
2. Build health workforce capacity at all levels of the health system, among all categories of professionals through: professional development of existing staff, in service development for existing staff, and pre service training
3. Create age-friendly health facilities, and triaging in favour of the elderly in all health facilities.
4. Broaden the health insurance package and coverage to take care of special needs of
the elderly.
5. Establish mechanisms to make assisted devices for hearing and visual impairment available to people in need.


Signed

Dr Amofah George
0244322843
General Secretary
Ghana Public Health Association