Giving Priority To The Health Needs Of Older Persons

The choice of theme for this year's celebrations of World Health Day "High Blood Pressure" is most exciting because Cardiovascular ailments are the major  one causes  of death Globally, they account for about 17 million deaths in the world each year. Complications of high blood pressure, also called hypertension or BP for short account for more than nine million of these deaths including about half of all deaths from heart disease and stroke. 

One in three adults worldwide has high blood pressure.  This proportion increases with age, from one in 10 people in their 20s and 30s to five to ten people in their 50s.;  This makes it imperative that appropriate and accessible preventive healthcare services are put in place to help reduce health risks to this segment of society especially those associated with hypertension.  This is against the background that old age and health are  key challenges  in the yet to be implemented National Ageing Policy.

 Absolute numbers of older people, that is those 60 years and above have been increasing rapidly in recent times due mainly to improved health care which has translated into increasing life expectancy. The greatest beneficiaries being women who now enjoy life expectancy above 60 years.  High blood pressure increases the risk of heart attacks, stroke and kidney failure.  If left uncontrolled, it can also cause blindness, irregularities of the heart  beat and heart failure.  

There is a social cost to this problem too, millions of people forgo seeking care for high blood pressure in the early stages because they cannot afford it.  This results in early deaths, disability, personal and household disruption, loss of income, a diminished work force and high  medical care expenditures. Older people will benefit a lot if appropriate and accessible preventive and curative healthcare measures  are put in place. This will  help reduce health risks including those associated with hypertension, given the fact that old age and health are challenges in the yet to be implemented National Ageing Policy. 

This makes it imperative for the Ministry of Health and appropriate   institutions to intensify health promotion programmes aimed at reducing occurrence of preventable diseases.  One priority area should be  early detection and treatment of high blood pressure along with public polices and primary health care services that educate and support people to prevent them from developing high blood pressure.  Those who have developed the disease must be helped to manage it effectively.  The offices of the National health Insurance Scheme owe it a responsibility to embark on community awareness campaigns to increase the understanding of the rights and entitlements enshrined under the National health Insurance Act, Act 852 its benefits and the process of accessing these.  Particular efforts should be made to package the awareness messages in a form that would be easier for older people especially women to understand. The age of exemption form the payment of premium should be reduced from 70 years to 60 to improve enrolment of non-SSNIT Pensioners on the scheme. 

The fact that majority of older persons are not on a pension scheme means that many older people below age 70 are being partially denied the opportunity to enroll on the National Health Insurance Scheme due to Financial Constraints.  Government should therefore heed   to recommendations in the AU Policy Framework and Plan of Action on Ageing which requires member states to develop and review health budgets to ensure that adequate funding is devoted to the provision of older people taking into account their higher per capita requirement.  It will also be prudent if benefit packages under the scheme are made more relevant to the health care needs of older people. 

The general window opened for the use of the fund under sections of the Act establishing the scheme should be invested in improving the capacity of health professionals to provide geriatric medical services under the scheme.  Section 30 (3) partially  mandates the National Health Insurance Authority to assess benefit packages under the scheme every six months and advice the sector Minister accordingly.  Some diseases to consider in expanding health care services under the NHIS for older people include urine retention, eye care, colon cancer, prostate cancer and Ear-Nose and Throat ailments. 

Health data should be disaggregated by age to include people above sixty years.  This will ensure ready availability of data to at least monitor changes in the health care needs of older people.  We need to use the celebration of World Health Day this year to advance the cause of the aged because they have paid their dues to the motherland. It would therefore be at the height of ingratitude to allow older people to die from preventable ailments like hypertension.

 BY JUSTICE MINGLE,   A JOURNALIST

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