National Program for Health Care of Elderly NPHCE

National Program for Health Care of Elderly (NPHCE) NHM & Tertiary Component Ministry of Health & Family Welfare

Rising Population of Elderly • 2011 census: – Elderly Population - 10. 38 Crore – Percentage of elderly - 8. 6% • 2050 Projections: – Elderly Population - 32. 43 crore – Percentage of elderly - 20. 6% • Elderly population growth much faster - Population growth rate (2001 -2011) = + 18% - Elderly population growth rate (2001 -2011) = + 36%

Burden of Disease in Elderly • Morbidity profile • 75% of the elderly are suffering from more than one chronic disease • Approximately 50% have two at-least two chronic diseases • 25 % elderly have 3 or more chronic disessses • Disability profile • 25 % elderly suffer from visual disabilities • 13% of elderly suffer from Hearing disabilities • 10 % of elderly suffers from Locomotors disability Source of Data: NSSO Mo. SPI

National Programme for Health Care of Elderly (NPHCE) Launched in 2010 -11, to address various health related problems of elderly people. Objective • To provide accessible, affordable, and high-quality long-term, comprehensive and dedicated care services to an Ageing population; • Creating a new "architecture" for Ageing; • To build a framework to create an enabling environment for "a Society for all Ages"; • To promote the concept of Active and Healthy Ageing; • Convergence with National Health Mission, AYUSH and other line departments like Ministry of Social Justice and Empowerment. 2/23/2021

Program components i. Dedicated geriatric care facilities through primary health care system of service delivery ii. Tertiary level geriatric care through • Regional Geriatric Centres • National Centre for Aging 2/23/2021

Package of services : Primary & Secondary Care • Sub Centre: – Health Education related to healthy ageing, environmental modifications, nutritional requirements, life styles and behavioral changes. – Special attention to home bound / bedridden elderly persons and provide training to the family health care providers in looking after the disabled elderly persons. • Primary Health Centre: – A weekly geriatric clinic at PHC level by trained Medical Officer, Conducting Health assessment of the elderly persons and simple investigation including blood sugar, etc. • Community Health Centre – Biweekly geriatric Clinic and Rehabilitation services to be arranged by trained staff and rehabilitation worker at CHCs. – Domiciliary visits by the rehabilitation worker will be undertaken for bed-ridden elderly and counseling to family members for care such patients. • District Hospitals: – Dedicated Geriatric OPD services, In-door admissions through 10 bedded geriatric ward, laboratory investigations and rehabilitation services. – Provide services for the elderly patients referred by the CHCs/PHCs etc and refer severe cases to tertiary level hospitals 2/23/2021

Package of services at tertiary level • Regional Geriatric Centers: – Provide tertiary level services for complicated/serious Geriatric Cases referred from Medical Colleges, District Hospitals and below. – Conduct post graduate courses in Geriatric Medicine. Each RGC to produce 2 post graduates (MD geriatrics) every year. – Providing training to the trainers of identified District hospitals and medical colleges – Developing/and updating Training modules, guidelines and IEC materials. – Research on specific elderly diseases. • National center for Ageing: – High level tertiary care with multidisciplinary clinical services involving medical and surgical disciplines. – specialised OPD care in various clinical disciplines. Special clinics like memory clinic, fall and syncope clinic, frail elderly clinic, aids and appliances clinic, implants and cosmetic clinic. – Day care centre for : Investigations, rehabilitation, respite care, dementia care , continence care – In patient care for: Intensive care, acute rehabilitation, diagnostic and therapeutic services, long term rehabilitation service. – Human resources development in all sub-specialties of Geriatric Medicine – Developing evidence based treatment protocols for Geriatric diseases prevalent in the country. – Special focus on care for 75+ aged population 2/23/2021

Progress in Operationalization of the Programme activities 2019 -20 As on date 713 districts have been sanctioned for geriatric care services of dedicated OPD, 10 bedded geriatric ward, Physiotherapy and laboratory services. Operational S. No Institutions Sanctioned OPD Indoor wards Physiother Laboratory apy services 16 492 - 14 438 974 - 1 2 3 4 RGCs District hospitals CHCs PHCs 19 713 4451 18362 18 578 2704 10168 5 SCs providing home based care 89862 11330 (Based on the Annual Progress Report 2019 -20 ) 14 524 2032 -

Paradigm of elderly care services provided in 2019 -20 S. N 1 2 3 4 5 6 7 8 9 Services RGCs OPD care services 133545 9992 In-door admissions 34637 Physiotherapy care 230749 Lab Tests No of Elderly Screened & given Health card No of Elderly Provided Home care services No of Elderly Provided supportive devices Cases referred Cases died in hospitals DHs CHCs PHCs SCs Total 7567744 688966 754186 4215883 7016670 269286 744964 2348922 9032922 2843211 2, 65, 94, 092 9, 68, 244 15, 33, 787 90, 71, 154 599908 719021 526754 273850 21, 19, 533 11157 92657 68674 68783 2, 41, 271 4820 18006 7256 17502 47, 584 32017 59202 65057 64119 2, 20, 395 17026 2156 384 2275600 19, 566 Overall 2. 65 crore elderly have been provided OPD care, while 9. 68 lakhs indoor admissions, 15. 33 lakhs sessions and 90. 71 lakhs laboratory test have been undertaken for elderly patients under NPHCE. 2/23/2021 (Based on the Annual Progress Report 2019 -20)

Issues & Future Plans To operationalise all district hospitals of the country for provision of geriatric care services. • Dedicated geriatric services delivery at CHCs and PHCs • Home based care services through peripheral staff • To operationalise all 19 Regional Geriatric Centers for provision of specialized geriatric services, training, research and initiate 2 seats of MD Geriatrics per RGC. has been identified as decade of HEALTHY AGING. Programme • 2020 -2030 Capacity building of elderly care service needs to develop a multisectoral Implementation Framework for this providers in the states through respective RGCs. decade. • 2/23/2021

Thank You

GIA Released and Expenditure Reported under NPHCE since 2010 -11 S. No. Implementing Agency GIA Released (Rs. In Lakhs) Expenditure Reported (Rs. In lakhs) Balance (Rs. In Lakhs) 1 Regional Geriatric Centres (RGCs) - 19 9118. 89 3036. 34 6082. 55 2 National Centre of Ageings (NCAs) - 2 19919. 00 16944. 00 2975. 00 3 IIPS for LASI 2920. 00 2581. 96 338. 04 Total 31957. 89 22562. 30 9395. 59 2/23/2021

Allocation & Releases under NCD Flexible Pool under NHM and Expenditure under NPHCE programme since F. Y. 2015 -16 Rs. In Crore Financial Year 2015 -16 2016 -17 2017 -18 2018 -19 2019 -20 2020 -21 Total Central Allocation (BE) 527. 33 527. 36 925. 00 972. 80 670. 92 702. 89 4, 326. 30 Central Release 379. 00 481. 00 904. 31 540. 14 670. 86 50. 69 3, 026. 00 Expenditure under NPHCE 28. 16 35. 47 32. 99 49. 84 24. 04 2. 32 172. 82 1. The Programme(NPHCE) has been covered under NCD Flexible Pool including 4 other programmes i. e. NPCB, NPCDCS, NMHP & Tabacco. The allocation and releases is shown under NCD Flexible Pool and expenditure under National Programme for Health Care of the Elderly (NPHCE) 2. Release for the F. Y. 2020 -21 is updated upto 15. 10. 2020 and is provisional. 3. Expenditure includes expenditure against Central Release, State release & unspent balances at the beginning of the year. Expenditure for the F. Y. 2020 -21 (upto 30. 06. 2020 as per FMR) are provisional. 2/23/2021