The unprecedented increase in human longevity in 20th century has resulted in the phenomenon of population ageing all over the world. According to 2001 census, there were 75.93 million Indians above the age of sixty years;
As per the NPOP, Ministry of Health & Family Welfare was entrusted with the following agenda to attend to the health care needs of the elderly:
- Establishing Geriatric ward for elderly patients at all district level hospitals.
- Expansion of treatment facilities for chronic, terminal and degenerative diseases.
- Providing Improved medical facilities to those not able to attend medical centers – strengthening of CHCs / PHCs / Mobile Clinics.
- Inclusion of geriatric care in the syllabus of medical courses including courses for nurses
- Reservation of beds for elderly in public hospitals
- Training of Geriatric Care Givers
- Setting up research institutes for chronic elderly diseases such as Dementia & Alzheimer.
The Vision of the NPHCE is:
- To provide accessible, affordable, and high-quality long-term, comprehensive and dedicated care services to an Ageing population;
- Creating a new “architecture” for Ageing;
- To build a framework to create an enabling environment for “a Society for all Ages”;
- To promote the concept of Active and Healthy Ageing;
Specific Objectives of NPHCE are:
- To provide an easy access to promotional, preventive, curative and rehabilitative services to the elderly through community based primary health care approach
- To identify health problems in the elderly and provide appropriate health interventions in the community with a strong referral backup support.
- To build capacity of the medical and paramedical professionals as well as the care-takers within the family for providing health care to the elderly.
- To provide referral services to the elderly patients through district hospitals, regional medical institutions
- Convergence with National Rural Health Mission, AYUSH and other line departments like Ministry of Social Justice and Empowerment.
Core Strategies to achieve the Objectives of the programme are:
- Community based primary health care approach including domiciliary visits by trained health care workers.
- Dedicated services at PHC/CHC level including provision of machinery, equipment, training, additional human resources (CHC), IEC, etc.
- Dedicated facilities at District Hospital with 10 bedded wards, additional human resources, machinery & equipment, consumables & drugs, training and IEC.
- Strengthening of 8 Regional Medical Institutes to provide dedicated tertiary level medical facilities for the Elderly, introducing PG courses in Geriatric Medicine, and in-service training of health personnel at all levels.
- Information, Education & Communication (IEC) using mass media, folk media and other communication channels to reach out to the target community.
- Continuous monitoring and independent evaluation of the Programme and research in Geriatrics and implementation of NPHCE. 1.2.4 Supplementary Strategies include:
- Promotion of public private partnerships in Geriatric Health Care.
- Mainstreaming AYUSH – revitalizing local health traditions, and convergence with programmes of Ministry of Social Justice and Empowerment in the field of geriatrics.
- Reorienting medical education to support geriatric issues.
Expected Outcomes of NPHCE
- Regional Geriatric Centres (RGC) in 8 Regional Medical Institutions by setting up Regional Geriatric Centres with a dedicated Geriatric OPD and 30-bedded Geriatric ward for management of specific diseases of the elderly, training of health personnel in geriatric health care and conducting research;
- Post-graduates in Geriatric Medicine (16) from the 8 regional medical institutions;
- Video Conferencing Units in the 8 Regional Medical Institutions to be utilized for capacity building and mentoring;
- District Geriatric Units with dedicated Geriatric OPD and 10-bedded Geriatric ward in 80-100 District Hospitals;
- Geriatric Clinics/Rehabilitation units set up for domiciliary visits in Community/Primary Health Centres in the selected districts;
- Sub-centres provided with equipment for community outreach services;
- Training of Human Resources in the Public Health Care System in Geriatric
Package of Services
In the programme, it is envisaged providing promotional, preventive, curative and rehabilitative services in an integrated manner for the Elderly in various Government health facilities. The package of services would depend on the level of health facility and may vary from facility to facility. The range of services will include health promotion,preventive services, diagnosis and management of geriatric medical problems (out and in-patient), day care services, rehabilitative services and home based care as needed. Districts will be linked to Regional Geriatric Centres for providing tertiary level care. The services under the programme would be integrated below district level and will be integral part of existing primary health care delivery system and vertical at district and above as more specialized health care are needed for the elderly.