TOWARDS ACTIVE AGEING THE MALAYSIAN EXPERIENCE 3rd ASEAN-Japan Active Ageing Regional Conference 26-27 June 2017
Malaysia will be an aged nation by 2030 with people enjoying longer life Number (Male & Female) 4,000 3,500 3,000 2,500 2,000 1,500 1,000 500 [VALUE] 2,903 (9.2%) 3,749 (11.1%) 5,819 (15.3%) 6,957 (17.4%) 8,231 (19.8%) 7,000 6,000 5,000 4,000 3,000 2,000 1,000 Number (Total) Life expectancy 1991 2016 e (estimate) M F M F 69.2 73.4 72.6 77.2 Fertility rate 2012 2013 2014 2015 0 2010 2015 2020 2030 2035 2040 2010 Data: Malaysian Population and Housing Census 2010 2015 2014 Data : Forecasted Source: Department of Statistics Malaysia Male Female Total 0 2.2 2.0 2.0 2.0 e: Estimate Source: Department of Statistics Malaysia 2
Increasing burden for working adults to support older persons 2030 = 28.3% 2030 = 16.6% 2010 2020 2030 2010 = 40.4% 2010 = 7.4% 14 10 7 Youth dependency ratio Old-age dependency ratio Source: MyAgeing, 2017 3
Morbidities Among Malaysian Elderly Study by MOH (2 nd NHMS1995) 81.4% suffered from at least from one chronic medical illness 12.7% had 3 or more chronic diseases The commonest medical illness Joint pain 50.1% Eyesight problem 40.0% Hearing problem 21.0% Hypertension 26.0% Heart diseases 16.3% Diabetes 11.6% Study by MOH (3rd NHMS 2011) Prevalence 95% CI (%) Lower Upper Hypertension 73.7 72.3 75.1 Hypercholesterolemia 37.9 36.3 39.5 Diabetes Mellitus 23.6 22.3 24.8 Asthma Adult 6.2 5.5 6.9 Physical Disability 2.4 2.0 2.9 Nutritional Status - BMI - Underweight 11.0 10.1 12.0 - Normal 48.4 46.9 49.9 - Overweight 29.8 28.4 31.2 - Obese 10.8 9.9 11.7 4
Anchoring growth on people With 2020 now just five years away, the Eleventh Plan is the next critical step in our journey to become an advanced nation that is inclusive and sustainable The Eleventh Malaysia Plan will disproportionately focus on the people the rakyat will be the centre piece of all development efforts Dato Sri Mohd Najib bin Tun Haji Abdul Razak Prime Minister of Malaysia 11 th Malaysian Plan Document 5
Including ageing agenda into national policies SEARO Strategic Element 1 Madrid International Plan of Action on Ageing (2002) Priorities Older Persons & Development Advancing Health & Well-Being into Old Age Ensuring Enabling & Supportive Environment National Policy and Plan of Action for Older Persons (1995, 2011) Strategies Lifelong Learning Promotion & Advocacy Security & Protection Governance & Shared Responsibilities Participation & Unity Across Generations Research & Development National Health Policy & Plan of Action for Older Persons (2008) Strategies Health Promotion Comprehensive health care services HR development Information system Collaboration R&D Legislation 6
National Advisory and Consultative Council for the Older Persons Chairperson: Minister of Women, Family and Community Development Strategic Element 1 Integrated multi-dimensional national approach Technical Committee State Action Council District/Local Authority Action Council Chairperson: Secretary-General, Ministry of Women, Family and Community Development No SUB-COMMITTEES MINISTRY/ AGENCY 1 Health Min. of Health 2 Social & Recreational Dept. of Social Welfare 3 Education & Spirituality Min. of Education 4 Housing & Environment Min. of Housing & Local Government 5 Economy Economic Planning Unit 6 Employment Min. of Human Resource 7 Research & Development Min. of Science, Technology And Innovation Committee for Development of Older Persons Committee for Development of Older Persons STATE NATIONAL Community & NGOs Private 7
Adapting the care & health systems to meet the health needs of the ageing population SEARO Strategic Element 2 Government hospitals/ clinics Elderly Homes Day Centres Public Private hospitals/ clinics Old folk s homes Nursing homes Mobile nursing Private Faith/charity-based centre NGO Activity Centres for older persons (PAWE) Elderly health club 1Malaysia Family Care Domiciliary & palliative healthcare services Respite care Financial aid/ assistance New Public Retirement villages Life apartments Senior clubs/resorts New Private Home-help programme Mobile care services Community-run activity centres Financial aid/ assistance New NGO 8
Provisions of long-term care for the elderly Institutional Services 9 Homes (Rumah Seri Kenangan) - financed by the Government 2 Homes for chronically ill (Rumah Ehsan) 244 centres by NGOs & private registered under the Care Centres Act 1993 21 nursing homes registered under the Private Healthcare Facilities and Services Act 1998 SEARO Strategic Element 3 9
Human resources development to meet the health needs of older persons SEARO Strategic Element 4 All 10 1 23 11 4 5 healthcare service for the older persons (government s primary healthcare facilities) Government hospitals with dedicated geriatric unit Dedicated Rehabilitation Hospital Geriatricians Psychogeriatricians Family medicine specialist with further studies in community geriatric Medical gerontologist 10
Adopting a life-course approach to promote healthy ageing SEARO Strategic Element 5 National Plan of Action for Nutrition of Malaysia III, 2016-2025 National Strategic Plan for Active Living, 2016-2025 11
Multisectoral approach & partnerships SEARO Strategic Element 6 1 Malaysia Family Care: Ministry of Health & Ministry of Women, Family & Community Development (2012) Elderly - Outreach services : Institution and at home Persons with Disabilities Single parent (female) - Building resilience : mental health interventions - Maintaining health : settings approach Objective: Providing holistic health & social support to elderly, disabled & single mothers Strategy: Interagency Networking Sharing Resources Encourage Volunteerism Empower families & communities 12
Challenges Regional differences in development Gender gap Speed of Ageing Human resource, facilities & infrastructure Consolidation of data & analysis 13
Way Forward Financial Health Social Institution Comprehensive social protection Increase financial security of older persons Promote lifecourse action: healthy & active lifestyle Increase availability, accessibility and quality of care facilities and services for older persons Empower volunteerism and broaden the reach of communitybased programme Change perception towards older persons Strengthen collaboration between ministries/ agencies Strengthen legislation & regulation Quality data 14
Jointly prepared by: Dr Ho Bee Kiau, Consultant Family Specialist (sub-specialised in Community Geriatrics), Ministry of Health, Malaysia Ms How Sin Meun, Assistant Secretary, Ministry of Women, Family and Community Development, Malaysia