Islamset - Support for the elderly in Sri Lanka

Dr Darnton- Hill has highlighted the importance of aging as a global health issue. His emphasis on quality of life and the determinants of healthy aging will be of particular interest to industrialized countries already trying to meet the needs of this age group. The immediate priority for many of the developing countries, however, is to draw attention to this phenomenon and the new demands it will place on the health care system. Only then can a programme be designed to meet these demands within the narrow limits of the resources available.

Sri Lanka's per capita gross national product is US$ 510. In 1993 average life expectancy was estimated at 69.5 years for men and 74.2 years for women. The proportion of the population over 60 years of age was 6.6% in 1993 and is expected to be 15.8% by 2025. A recent community-based survey on the health status of the elderly carried out in the Western. Province of Sri Lanka produced the following information (1).

Only 49% of the men and 37% of the women questioned considered their condition to be "healthy". Health problems named were as follows:
- eyesight (59% );
- hearing (22% );
- mastication (30% );
- mobility (7% ).
43% had used some source of health care during the previous month.
32% thought they needed more medical care than they had access to.

In addition, the need for assistance to obtain various aids was frequently mentioned. It should also be noted that the Western Province, which includes the capital, Colombo, is better equipped with health and other services than the rest of the country.

In Sri Lanka the government is the main provider of health care, and per capita expenditure on health in 1993 was only US$ 8 (2). As in many other developing countries, the main priority for health programmes is maternal and child health. It is only recently that the growing elderly population has been recognized as a health issue, calling for an appropriate programme which takes into account the psychological and social needs of this age group.

As in many other societies, the family is the main source of support for the elderly in Sri Lanka. The economic and social changes taking place in many families are likely to affect this support base in the coming years. Since the support available for the elderly outside the family is very limited, this trend must be given careful consideration in planning for the future.

As in many other developing countries, the main priority for health programmes is maternal and child health.

In this connection, Dr Darnton-Hill is right to stress the importance of factors which have a positive influence on health in later life. The data available on Sri Lanka show that health status is positively influenced by more contact with family, better financial status, being employed, and being satisfied with the physical environment.

In many countries undergoing rapid change with the aim of achieving "development", care of the elderly is becoming a major challenge that cannot be brushed aside. Programmes which take into account the many different kinds of input needed "to keep them healthy" must be planned and implemented.

Andrews GR, ed. Aging in South East Asia: a five country study. New Delhi, World Health Organization Regional Office for South-East Asia, 1993.
Annual health bulletin. Colombo, Ministry of Health, 1993.