Provision of care for older persons- Example from HelpAge International Africa region 2nd IAGG Conference, Nairobi/ 6-8 Dec 2016 Prafulla Mishra, Regional Director

Who older caregivers care for Past and current engagements Service delivery- Ethiopia, Zimbabwe, Sudan- working with day centres, HBC, ‘Food on Foot’, SaG RaG HIV pandemic- focus also shifted to supporting older ‘care givers’ responsible for OVCs and others Advocacy and policy development as well as technical support to MoHs Current work- 2015 survey on care work (7 countries + 2 regional nodes) Targets of Care Who older caregivers care for Quality and accessible health care has been a focus of HelpAge and network since founding HelpAge’s core health agenda is based on our belief in the right to health throughout life, not the capacity to contribute Health, care giving and care receiving needs and contributions of older people are closely intertwined It emphasizes the importance not only of the physical but also the psychological, social and spiritual dimensions of health. This is the strength of the care aspect of the agenda until the end of life, when health care and social support work hand-in-hand With HIV, older persons started providing care for OVCs, their children who were now HIV positive as well as other older persons in the family and community

Type of care provided HBC provide a range of care   HBC provide a range of care Training manuals developed on home based care providers as well as Many a times the training content is also geared towards

Future trends and focus of work Family focused- care for the care provider Scaling up of care work- diversity of care needs Integration- health care and social care sectors working together Stronger links to MoH formal systems Measurement and data- eg. Health Outcomes Tool/ Citizen data Citizen participation processes around quality of services & accountability Health care workers….need for numbers 13.5 million LTC workers needed Importance of integrating health and care work across different themes, for example, health financing is a important need if we expect older persons receive care Building on wider understanding of health, which goes beyond the provision of services and takes in the overall circumstances in which people live as they grow older. Access to nutrition, water, sanitation and safe, appropriate housing, as well as a community life where older people are treated with respect and included in social, political and economic life are also critical to health and well-being in old age. Diversity of care needs across age cohorts, conditions and socio-economic factors

Right to health throughout life, not only the capacity to contribute Older life consists of different phases of being well, ill and then eventually frail and dying, older people do not fit a conventional health pattern that emphasises cure and a return to full physical vitality

Challenges/ Opportunities Availability Accessibility Affordability Understanding and focus on ageing largely lacking Lack of formal systems. Current engagements operating at NGO/ private sector- issues of sustainability. Whose responsibility is it? Funding not available- affordability of care Opportunities Countries including ageing and LTC issues in formal health care systems WHO’s work on healthy ageing AU Protocol for Older Persons SDG 3- remarkable opportunity, needs resources and focus ILO Social Protection Floors LTC needs and deficiencies in care systems largely hidden and most countries do not allocate any funding to this Older life consists of different phases of being well, ill and then eventually frail and dying, older people do not fit a conventional health pattern that emphasises cure and a return to full physical vitality Probably a need to work towards using common terminologies. In HelpAge’s survey, teams used mainly terms such as home based care, community based care. May be using Long Term Care will help shift mind set towards longer term thinking? Important to Focus on interventions that support the older person’s household- than focus on older people direct health interventions bring greater health benefits - caring for carers who are looking after frail and sick individuals within their household Opportunities – SDGs, Agenda 2063 and WHO Ageing and Health framework all promoting people centred approach, Universal health coverage for all ages and leave no one behind; current UN Convention discussions and AU protocol ratification, AU PWD and SP protocol development Ensure inclusion of older people in new approaches to health financing  with emphasis of access to affordable essential treatment to older people but in conjunction with social protection and livelihoods [community risk management for health care costs and insurance are likely to feature within this agenda]