Policy Mapping on Ageing in Asia and the Pacific Analytical Report Author: Camilla Williamson HelpAge International East Asia/Pacific Regional Office July 2015 Copyright © 2015 HelpAge International Registered charity no. 288180 HelpAge International East Asia/Pacific Regional Office 6, Soi 17 Nimmanhemin Road Suthep, Muang Chiang Mai 50200, Thailand Tel: +66 (0)53 225 440 Fax: +66 (0)53 225 441 [email protected] www.helpage.org www.ageingasia.org Written by: Camilla Williamson, Consultant: Ageing and Older, Policy, Practice and Advocacy Any part of this report may be reproduced for non-profit purposes unless indicated otherwise. Please clearly credit HelpAge International and send us a copy of the reprinted article or web link. Disclaimer: Funding for this work was provided by the United Nations Population Fund (UNFPA). The findings, interpretations and conclusions presented in this document are those of the author and of HelpAge, not necessarily those of UNFPA. Publication ID: EAPRDC0022 TABLE OF CONTENTS FOREWORD i EXECUTIVE SUMMARY ii 1. INTRODUCTION 1 1.1 About the Study 1 1.2 Methodology 2 1.3 How the findings are presented 4 1.4 Limitations 4 2. OVERALL FINDINGS 6 2.1 Overview 6 2.2 Focal points and institutional arrangements 11 2.3 National plans on ageing vs policy mainstreaming 12 2.4 Policy development by level of income and demographic trends 13 3. FINDINGS BY MIPAA PILLAR 14 3.1 Older Persons and Development 14 3.2 Advancing Health and Well-being into Old Age 16 3.3 Ensuring Enabling and Supportive Environments 21 4. CROSS-CUTTING ISSUES 26 4.1 Older women 26 4.2 Oldest old 27 4.3 Older people in rural areas 27 References 29 Annex 30 FOREWORD Demographic trends in the Asia and Pacific region are expanding interest in addressing challenges and capturing opportunities related to population ageing. Most countries in the region are already experiencing rapid ageing, and that will only accelerate in the coming decades. Partly in response to the Madrid International Plan of Action on Ageing (MIPAA) in 2002, most countries in the region began the process of developing policies and legislation on ageing and integrating older people’s concerns into broad policy- making. Progress has been uneven across the region, with some countries already enacting laws on ageing and others having only basic decrees in place. Some approved policies are not yet being translated into practice. With UNFPA’s support, HelpAge International commissioned a mapping of policy and legislation on ageing and older people in 26 countries across the region. This document presents the findings of the review. An analysis of the implementation or impact of these policies was beyond the scope of the review. The existence of policy within any country included in this study, even where implementation arrangements and mechanisms are detailed, does not mean that this policy has been implemented to any extent. Additional work is needed to review the implementation and impact of policy on ageing across the region. HelpAge and UNFPA would like to thank their respective Country Offices and country associates from across the Asia and Pacific region for their support in providing information and giving advice on the policy mapping project. Policy Mapping on Ageing in Asia and the Pacific i EXECUTIVE SUMMARY This report outlines the findings of mapping research that documents the policy, legislation and action plans on ageing and older people in 26 countries across the Asia and Pacific Region. These countries are Afghanistan, Bangladesh, Bhutan, Cambodia, China, Cook Islands, Democratic People’s Republic of Korea, Fiji, India, Indonesia, Iran, Lao People’s Democratic Republic, Malaysia, the Maldives, Mongolia, Myanmar, Nepal, Pakistan, Palau, the Philippines, Solomon Islands, Sri Lanka, Thailand, Tonga, Tuvalu, and Viet Nam. In addition to policy, legislation and action plans focussed solely on ageing and older people, the review also included references to older people in a number of mainstream national policy documents. These were reviewed in order to capture government action on ageing beyond the policy documents focussed solely on older people. An annex to this report presents the full data collected during the review, by country. National policy, legislation, and/or action plans focussed solely on ageing and older people were found in 18 of the 26 countries reviewed and are in progress in two others. Just under half of these countries (8 of 18) have only one type of document (a policy, legislation or an action plan), while a combination of these mechanisms are found in the other countries. When mainstream national policies covering the entire population are also considered, all the 26 countries reviewed have at least some policy explicitly addressing older people. Higher income countries included within the review do not appear to be more likely than the other countries to have national policy, legislation or action plans on ageing, nor to have greater breadth of policy addressing older people. Countries which are ageing more rapidly are somewhat more likely to have national policy, legislation and/or action plans on ageing and a greater breadth of policy addressing older people. Among the 18 countries with national policy, legislation and/or action plans on ageing, their documents generally cover a wide range of issues related to later life. Policy documents in all those countries include social protection, healthy ageing, equal and universal access to health care, housing and the living environment, care and support for care givers, and images of ageing in society. Nearly all of these countries also mention training for health care workers and neglect; abuse, violence, rights and age discrimination; work and labour; and knowledge, education and training. Most of the countries in the review (23 of 26) have clear focal points on ageing, and many countries have an institution, council, committee or commission focussed on ageing. However, many of the countries do not explicitly state that older people are included directly within these institutions or engaged in related processes. Policy Mapping on Ageing in Asia and the Pacific ii The research used the broad framework of the 2002 Madrid International Plan of Action on Ageing (MIPAA) to capture and analyse the information. This study is framed by MIPAA’s three pillars: Older persons and Development, Advancing Health and Well-being into Old Age, and Ensuring Enabling and Supportive Environments. Key findings related to each pillar are presented below. Older Persons and Development Some policy explicitly addressing older persons and development was found in all countries (26/26). However, the range and depth of this policy varies dramatically across the region. In some cases, mainstream national policies make an explicit mention of effects on older persons. Policy referring to older people in relation to migration was found in on- ly 4/26 countries; policy on emergency response and disaster risk reduction was found in 11/26 countries; policy on knowledge, education and training was found in 18/26 countries; and policy on work and labour policy was found in 20/26 countries. Half of the countries reviewed (13/26) have a social pension (a government provided, non-contributory cash transfer to older persons). Of the countries where national development plans or poverty reduction plans were found, 21/25 include older people within these, though this is often only a limited ref- erence. Advancing Health and Well-being into Old Age Policy explicitly addressing older people and advancing health and well-being was found in 22/26 countries. Health is the sector with the most in-depth policy of the areas considered in the review. Wide variation exists between countries by specific issue under health and well-being. For example, policy addressing HIV/AIDS was found in only 4/26 countries, policy ad- dressing mental health in 12/26 countries, and policy addressing nutrition in 15/26 countries. Many countries address non-communicable diseases (NCDs) in health policy, though age-specific NCDs are not always explicitly targeted. All countries reviewed (26/26) have mainstream national policy that addresses disabil- ities, though older people are often not addressed explicitly within this. Ensuring Enabling and Supportive Environments An enabling and supportive environment includes such considerations as housing, care, abuse, and positive societal and intergenerational relations. Policy explicitly ad- dressing older people and ensuring enabling and supportive environments was found in 25/26 countries, although with significant variation between countries. Most countries have policy addressing care and support for care givers (24/26), hous- ing and the living environment (22/26), images of ageing (20/26), and neglect, violence, abuse, rights and age discrimination (19/26). Few countries have addressed cross-cutting issues, such as gender-specific policy, policy addressing the needs of the oldest old or policy addressing rural ageing populations. Policy Mapping on Ageing in Asia and the Pacific iii The report presents a number of recommendations including these: Countries should ensure that where policy exists, implementation arrangements, mon- itoring and evaluation processes, research and data to inform policy, and details of budgets are included within this. These should be collected in one place and shared publicly to ensure good practice can be shared. Further analysis should be carried out to understand the