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Ghana Case Study on Ageing Final.Pdf 1 Table of Contents Page CHAPTER ONE 2 INTRODUCTION 2 1.1 Background 2 1.2 Objectives 4 1.3 Global Trends in Ageing Populations 4 1.4 Madrid International Plan of Action 5 1.5 Global Strategy and Action Plan on Ageing and Health 5 1.6 Ghana’s Position on the Global Strategy 6 1.7 Review of Policies on Ageing 7 1.8 Review of Ghana’s National Policy on Ageing 7 1.9 National Social Protection Policies for Older People 8 1.10 Understanding Ageing-Related Issues 9 1.11 Methodology for the Case Study 9 CHAPTER TWO 11 EVIDENCE OF EXISTING DATA 11 2.0 Introduction 11 2.1 Study on Global Ageing and Adult Health (SAGE) 11 2.2 Ghana Health Service Data 17 2.3 Social Security and National Insurance Trust Data 19 2.4 National Health Insurance Authority Data 20 2.5 Livelihood Empowerment Against Poverty (LEAP) Programme 22 2.6 Ghana Living Standard Survey 24 2.7 2010 Population and Housing Census Data 26 CHAPTER THREE 30 ASSESSMENT OF EXISTING DATA 30 Introduction 30 CHAPTER FOUR 32 IMPROVING THE USE OF EXISTING DATA 32 4.0 Introduction 32 4.1 Illustration of the Use of SAGE Data: 32 2 4.2 Illustration of the Use of NHIA Data 33 4.3 Illustration of the Use of SSNIT Data 33 4.4 Illustration of the Use of Census and GLSS6 Data 33 CHAPTER FIVE 35 ENCOURAGING THE USE OF DATA – IN THE FUTURE 35 CHAPTER SIX 36 CONCLUSION AND RECOMMENDATIONS 36 6.0 Introduction 36 6.1 Strength of the Data 36 6.2 Recommendation – Strengthening Capacity for Data Collection and Collation 37 Appendix A 39 Contributors to Ghana's Case Study on Ageing 39 Reviewers of Case Study 39 Appendix B 41 Health Insurance Registration Data 42 References 43 3 CHAPTER ONE INTRODUCTION 1.1 Background The population of older adults is increasing in all regions of the world although at a varying pace. The global population of people aged 60 years and older has increased from 382 million in 1980 to 962 million in 2017 (United Nations, 2017). It is projected that the population of older adults (60 years and older) will account for about one-fifth (22%) of the world population by 2050 (World Health Organization, 2018). In the short term, it is estimated that globally the number of older people aged 60 years and older will outnumber the number of children under five by 2020 (World Health Organization, 2018). The absolute and relative increase in the population of older adults has occurred at a varying pace across different regions of the world. Population ageing is more advanced in countries such as Japan (United Nations, 2015). While countries such as France have had nearly 150 years to adjust to changes in the population structure as a result of ageing, developing countries such as India and China will have just about 20 years to make the necessary adjustments (World Health Organization, 2018). The World Health Organization estimates that “in 2050 80 % of older people will be living in low-and middle-income countries”. Although the African region is regarded as a youthful continent, the population of older persons in the region is increasing. The population of older persons in sub-Saharan Africa has doubled between 1990 and 2015, increasing from 23 million to 46 million (United Nations, 2016). It is projected that sub-Saharan Africa will experience a fast growth in the population of older adults (64%) over the next 15 years (United Nations, 2015) with a projected increase to 161 million by 2050 (United Nations, 2016). In spite of the rapid rate of population ageing in the sub-Saharan African region as a whole, the extent of population ageing varies markedly from country to country. While countries such as Mauritius have about 15 % of their population being older adults, in Senegal, older adults constitute about 11 % of the population whereas countries such as Uganda have less than 4 % of the total population being older adults (United Nations, 2016). The population of Ghana, like other African countries has seen an increase in the absolute number of older adults. Data from the 2010 Population and Housing Census indicates that the population of older adults has increased about sevenfold; from 215,258 in 1960 to 1,643,978 in 2010 (National 1 Population Council, 2014). It is projected that the population of older adults in Ghana will increase to 2.3 million in 2025 and 5.6 million by 2050 (Ghana Statistical Service, 2014) as illustrated in Table 1. Table 1: Actual and projected population of older adults (60 years and older) in Ghana, 1960 - 2050 While on the one hand, the success of population ageing at the global, regional and national levels can be attributed to increasing longevity, improvement in health and socio-economic conditions, on the other hand, the increasing number of older adults presents challenges for the health and social wellbeing of older adults especially in the sub-Saharan Africa region. Older adults in sub- Saharan Africa face numerous social, economic and health challenges. For example, older adults in many sub-Saharan African countries do not receive social pensions except in a few countries such as South Africa. Additionally, health insurance coverage specifically for older adults is not available in many African countries except Ghana and Senegal (Parmar et al., 2014; Pham, 2017). Furthermore, Ghana has instituted the livelihood empowerment against poverty cash transfer programme that targets households with older adults as eligible beneficiaries (Pham, 2017). In spite of the implementation of the aforementioned social protection programmes for older adults in Ghana, there has not been a holistic assessment of the situation of older adults in the country. 1.2 Objectives This case study seeks to provide empirical evidence in support of identifying and improving national efforts to build and strengthen local and sub-national data collection systems, establish linkages across sectors, and promote co-production, analysis and use of data by a wide range of stakeholders, including older adults themselves. 2 1.3 Global Trends in Ageing Populations In this current age, most people are expected to live beyond 60 years and by 2050, 1 in 5 people will be 60 years or older (WHO, 2017). Although the growth in the population of older adults is global in nature, it is more prominent in certain regions. Both developed and developing countries populations are ageing, however, the growth is much more evident in developing countries. Between 2000 and 2015, developing countries experienced over 60% growth in the population of older people and the projected growth between 2015 and 2030 stands at 71%. For developed countries, the growth in the population of older adults between 2000 and 2015 stood at 29% and it is expected to grow by 26% between 2015 and 2030. In the sub-Saharan Africa region, the population of older adults 60 years and older doubled between 1990 and 2015 – increasing from 23 million in 1990 to 46 million in 2015 (United Nations, 2016). The population of older adults in sub-Saharan Africa is projected to further increase to 161 million in 2050. The World Health Organization estimates that the projected number of older adults (60 years and older) in Africa in 2050 will constitute about 10% of the population of Africa. 1.4 Madrid International Plan of Action The Madrid International Plan of Action on Ageing (MIPAA) is a United Nation (UN) document on population ageing adopted at the Second World Health Assembly on Ageing in April 2002 to replace the earlier Vienna International Plan of Action on Ageing. The MIPAA was adopted to guide global policies on ageing for the current century. The main feature of the MIPAA was the society for all ages concept and its thematic foundation. The first draft had two parts: the long-term strategy on ageing, as the preamble to the draft Plan of Action; and the main body of the draft revised Plan. The latter identified three priority directions for policy action: (i) sustaining development in an ageing world; (ii) advancing health and well-being into old age; and (iii) ensuring enabling and supportive environments for all ages. The Madrid Action Plan was followed by the development of an African Union Policy framework and Plan of Action on Ageing (AU/HAI, 2003). This is in sharp contrast with the period of the first UN International Plan of Action on Aging. At the time, much of the continent was not aware of the burgeoning demographic revolution (Apt, 2012). 3 In Ghana, there is considerable interest in ageing. The government has responded to the issue with germane policies and programmes to address ageing-related challenges. Firstly, Ghana has an ageing policy dubbed “Ageing with Security and Dignity” that focuses on challenges spanning housing, health, poverty, and gender dynamics of ageing in Ghana (Ministry of Employment and Social Welfare, 2010). Other policies formulated to address the issue include the National Social Protection Strategy (which includes the Livelihood Empowerment against Poverty (LEAP)), Ghana National Disability and National Health Insurance Scheme (NHIS), albeit not solely directed to older adults. Although Ghana has pockets of policies, initiatives and directions on ageing, there is no harmonization of the various policies, strategies or interventions. Consequently, the full potential of these policies and interventions for the health and wellbeing of older adults is not being realized. 1.5 Global Strategy and Action Plan on Ageing and Health Population ageing is a global phenomenon and all countries including low-and-middle income countries are being entreated to ensure that the health and wellbeing of older adults is addressed in national development plans.
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