Strengthened health workforce a prerequisite for ageing populations

World Health Day in 2012 focused on the vision of “Good health adds life to years” as the World Health Organisation attempts to draw global attention to ageing and health, and to highlight ageing as a rapidly emerging priority. On the occasion of World Health Day 2012, the Global Health Workforce Alliance emphasised the critical role that health workers have in caring for ageing populations and in the delivery of essential health care services.

According to the WHO, in the next few years, for the first time, there will be more people aged over 60 than children aged less than five. By 2050, 80% of the world’s older people will be living in low- and middle-income countries. Currently, the main health challenges for older people are non-communicable diseases. Health systems, particularly in low- and middle-income countries, are poorly designed to meet the chronic care needs that arise from this complex burden of disease.

The new emerging demands being placed on health care system does not only imply a serious need for greater numbers of health workers, but also requires an evaluation of the competencies and necessitates changes in the way services are provided to older adults.

The Global Health Workforce Alliance is calling for the provision of accessible, reliable and affordable health care for all and pledges its support to health personnel across the world. Clearly, without a committed, motivated and skilled health workforce, it will be impossible to make meaningful strides in improving global health outcomes. The Alliance urges increased investment in training, recruitment, retention and support of health workers, at all levels, ensuring a committed and motivated health workforce to better serve our ageing communities now and for the future.

On another front, ageing parents assume their kids will look after them when they’re older. Those without kids assume they can pay for care with all the money they’re saving. However new studies on the aging population in the developed world suggest that both groups could be setting themselves up for disappointment.

While the number of elderly people requiring assistance is expected to double in the next 30 years, researchers say a shortage of adult children and health-care workers could mean the baby boomers won’t get the care they need.The Institute for Research on Public Policy (IRPP) describes the outlook as “a major cause of concern,” noting a critical need for policy-makers to reconsider their approach to voluntary, for-profit and public homecare.

A caregiver is defined as a member of the immediate or extended family, or a friend or neighbour, who provides support and assistance without pay. At present, as much 80% of care given to older adults comes from such individuals.The problem is that baby boomers, on average, didn’t have as many children as their parents, and thus won’t have the same in-family resources as they age.According to the IRPP report, by 2031, roughly one in four women aged 65 and older will have no surviving children — up from 16% in 2001. That proportion climbs to 30% in 2051.

Even older people who do have adult children can’t necessarily count on them to be around. While our homecare and community-care system is premised on this idea that there’s family available to provide care, nowadays, they may exist, but they’re not available as they don’t live in the same community, or they have work and other responsibilities.

In the absence of such caregivers, there will be a greater need than ever for formal homecare providers. However, the population of homecare providers is shrinking at the same time the number of people requiring assistance is growing.It is already difficult for homecare agencies to attract workers to the sector because they’re not paid as well as other careers. There is the concern about whether in the future there will be paid workers available to provide care for those who need it, given the challenge that people have accessing that profession.

The Institute for Research on Public Policy says there is no “one-size-fits-all” policy solution, but that a range of supports that would make caregiving more appealing at the voluntary, for-profit and public levels are necessary.Revisiting rules around income security programs, for instance, could help ensure that adult children who drop out of the labour force to care for their parents aren’t penalized in terms of pension. The IRPP also calls for improved access to formal homecare services, as well as better financial incentives to those providing voluntary care, so they don’t end up poor as a result of their activity.