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Elderly Adult Profile Perú – Intra Ii 2004

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Elderly Adult Profile Perú – Intra Ii 2004 EEELLLDDDEEERRRLLLYYY AAADDDUUULLLTTT PPPRRROOOFFFIIILLLEEE PPPEEERRRÚÚÚ ––– IIINNNTTTRRRAAA IIIIII 222000000444 DEVELOPING INTEGRATED RESPONSES OF HEALTH CARE SYSTEMS TO RAPID POPULATION AGING INTRA II – PERÚ General Coordinator Dr. Luis Varela Pinedo Coordinator Team Dr. Helver Chávez Jimeno Dr. Antonio Herrera Morales Dr. Francisco Méndez Silva Dr. Miguel Gálvez Cano MULTIDISCIPLINARY TEAM Dr. Luis Varela Pinedo General Coordinator INTRA II-Peru Project Director, Gerontology Institute Universidad Peruana Cayetano Heredia Dr. Helver Chávez Jimeno Titular member, Gerontology Institute, Universidad Peruana Cayetano Heredia Dr. Antonio Herrera Morales Correspondent member, Gerontology Institute, Universidad Peruana Cayetano Heredia Dr. Fernando Portocarrero Salazar Medical Director, Military Geriatric Hospital Dr. Carlos Sandoval Cáceres Resident Tutor in Geriatrics, Medicine Faculty, Universidad Nacional Mayor de San Marcos Dr. Elizabeth Sánchez Yturrizaga Executive coordinator, Consorcio Perú Envejecimiento y Desarrollo (NGO) Dr. José Francisco Parodi García Geriatric Physician, San Martin de Porres University Dr. Pedro Vera Vílchez Elderly Adult Social Program responsible, Hospital Nacional Cayetano Heredia Dr. Juan del Canto y Dorador Elderly adult program responsible Health Ministry (MINSA) Dr. Carmen del Pilar Estela Benavides Elderly adult general direction Woman and Social development Ministry (MIMDES) Dr. Francisco Méndez Silva Correspondent member, Gerontology Institute, Universidad Peruana Cayetano Heredia Dr. Miguel Gálvez Cano Resident Geriatric Physician, Universidad Peruana Cayetano Heredia Dr. Luis Álvarez Cóndor Physician, Geriatrics Service, Geriatric Institute Peruvian Aerial Force (FAP) Dr. River R., Cersso Bendezú Coordinator SBS, Elderly Adult Pilot Program, DISA II, Cañete-Yauyos, South Lima Dr. Diana Rodríguez Hurtado Scientific investigator office and technological development chief, Arzobispo Loayza Hospital Dr. María del Pilar Gamarra Elderly Adult Attention National Commission President, Social Security (EsSalud) Dra. Isabel Benate Gálvez Elderly Adult Affairs Responsible Primary Health Care, EsSalud Dra. Blanca Deacon Castillo Association Pro-Vida Peru President (NGO) Dr. Felipe Aguirre Salinas Executive Director, Association Pro-Vida Peru (NGO) INTRODUCTION During the last 50 years a decrease of the world's population natality and mortality had been leading to the world's population aging. In the Latin American countries (Peru among them) the population's aging is also a demographic characteristic. This has a great importance, because it implies economic and social consequences; as well as changes in work, housing, recreation, and education areas, and mainly in the health necessities that will take place. According to census and estimates, in 1970 the elderly adult population in Peru constituted 5.54% of the national total. According to 1993 census, it was of 6.34%; that means that in a 23 year period the elder adult population grew in less than 1% of the total population. A real growth took place in the last 11 years, since for the end of 2004, it is calculated that this population will arrive to 7.55% and for the 2025 will represent 13.27%; this means that in next 20 years the proportion of elder adult population will be almost duplicated. We are witness of a process of a quick demographic transition, so is our duty to be prepared to confront these changes and their consequences. The expectation of the Peruvian population's life has also changed in the last years. In 1970 this was 53 years, for the 2004 is of 70 years, and is considered that it will reach 75 years for the 2025. 1. GENERAL CHARACTERISTICS 1.1 GEOGRAPHY Peru is in the western and central region of South America, it limits for the west with the Pacific Ocean, for the East with the countries of Brazil and Bolivia, for the North with Ecuador and Colombia; and for the South with Chile. It presents a surface of 1 285 215 km², being the third country in territorial extension of South America after Brazil and Argentina. Located in a tropical region, the typical climate would be expected. However, due to a great number of geographical peculiarities, as the Peruvian current that affects the temperature of the adjacent sea and the Andes mountains that crosses the country from north to south; Peru presents a wide climatic and ecological variety. Traditionally are considered three geographical regions: The Coast: to the west, next to the Pacific Ocean, is constituted by a narrow desertic fringe that concentrates most of the Peruvian population (52%). The Sierra: Central mountainous region that constitutes around 30% of the national territory. It is conformed by mountain ranges and an extensive plateau. This configuration implies that around 30% of the national territory it is located between the 2000 and the 4000 meters over sea level. 34.48% of the Peruvians habit this region. The Forest: to the east, it constitutes the forest plains of the Amazon basin. This region occupies 60% of the territory, but only 13.52% of the Peruvian population's habits it. Since the year 2004 the country is conformed by 25 regions (the old 24 departments and the constitutional county of Callao) whose first representatives, were elected in November of the 2003. With this current and recent process of decentralization it is expected that the country overcome the strong centralism that has characterized it for five centuries. These regions are divided in counties (188) and these in turn are formed by districts (1595). Peru’s capital is the city of Lima, located in the central coast of the country. This city was founded in 1535, beside Rimac River by the Spanish conqueror Francisco Pizarro. From the beginning of the Spanish colonization until today Lima has been the center of the political and economic power; configuration that has been prejudicial for the development of the rest of the country and that has generated deep social and economic inequalities. According to the 1993 census, Lima city had 5 854 608 inhabitants; the projections of the National Institute of Statistics (INEI) for the year 2004 give it a population of 7 208 794 people that almost represents the fourth part of the national total The second city of the country is Arequipa located at 2360 meters over the sea level, in the Peruvian Andes. With 851 750 inhabitants, and located in the region of the same name, concentrates 2.95% of the Peruvian population's. 1.2 POLITICAL - ECONOMIC SYSTEM 1.2.1 Historical aspects Peru was one of the last countries in South America that reached its independence that was proclaimed in 1821. Almost from the beginning of Peru’s republican life, the government’s system was democracy, based on the division of the powers of the state, government's alternation and congress's renovation by means of elections. Peru has had 13 constitutions, the first one promulgated in 1823, and the last one in 1993. 1.2.2 Political Aspects The Peruvian State is conformed by three autonomous powers: a) Executive Power: The Peru has a presidential government's system. The executive power resides in the President of the Republic who has chief of state functions. It is him who directs the government politics, supported by a political-electoral majority, determined by popular vote. b) Legislative Power: Resides in the Congress that at the moment consists of an unique Camera. The number of congress members is one hundred twenty. The Congress is chosen by a five-year period. Their main functions are to give the laws and permanent inspection, as well as the eventual reformation of the Constitution. c) Judicial Power: Is integrated by jurisdictional organs that administer justice on behalf of the Nation, and for organs that exercise their government and administration. The jurisdictional organs are: the Supreme Court of Justice, the Superior Court, specialized and mixed Tribunals, and Peace Tribunals. The Full Room of the Supreme Court is the maximum organ of deliberation of the Judicial Power. Parallel to these three powers, there are autonomous organisms that are: · Republic General Controllership . National Elections Jury · People Defensory · Public Ministry 1.2.3 Economic process in the last two decades The Peruvian economy in the 80s decade had one of the highest hyperinflations in the world, the reduction of the per capita income, and the increment the foreign debt. Peru was also excluded of the support of the IMF and of the World Bank (ineligible country), due to the incomplete payment of the foreign debt. In the 90s answering to this situation, were applied programs of macroeconomic adjustment, commercial opening and structural reformations that considered among other measures, the privatization of public companies, and modifications in the administrative structure of the public sector. These measures reduced the inflation drastically and created the conditions to recapture the route of the growth and sustained development as well as a progressive reinsertion in the international economic system. This process entered in crisis at the end of the 90s due to the impact of El Niño phenomenon in the agriculture, the financial crisis of Asia, and the political instability due presidential re-election of Alberto Fuijmori and its subsequent renouncement. All of these factors limited the growth among the years 1998 to 2001. In July 2001 Alejandro Toledo assumed the presidency; from then on the Peruvian economy has presented a slow but stable growth. The growth of the National Gross Product for
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