Download Health of Elders

1
HEALTH SERVICES DELIVERY
1.5
PROGRAMME FOR VULNERABLE POPULATIONS
1.5.2
Health of Elders
A Focal Point
B Implementing Agencies
C Target Areas & Beneficiaries
DDG (PHS)
Director YEDD , HEB, NCD, NIHS, of the Ministry of
Health, PDHSs and the DPDHSs and other sectors
Elders and their family members and the community
Project Summary:
With Sri Lanka entering into the final stage of the Demographic Transition, the proportion of
elderly is increasing as never before, By year 2010 it is expected that there will be about 10 %
of elderly population in the country while this will increase to about 20 % by the year 2020.
Higher proportions of elderly create several challenges for a health system in terns of increased
inputs. It is believed that the increasing incidences and prevalences of several
non-communicable diseases are the results of the population ageing.
However although the elderly are looked after by the routine health care delivery system it is
important to make the system more amenable to the delivery of services for the specific target
group. It is proposed that the system will be fine-tuned to address the most pressing needs of the
elderly in the years to come. This project is designed with the objective of improving the quality
of life of elderly through health promotion, prevention treatment and rehabilitation.
1.
Justification:
At present the elderly population (over sixty years) in Sri Lanka to nearly two million or 10%
of the total population. Among them a large number suffer from physical and social health
problems. Most elders in our society lack adequate knowledge regarding the type of illnesses
they are likely to suffer during old age.
Most hospitals in our country do not have a system for giving preferences to elders at the
OPD or dispensary; which means they have to wait in the same long queue as others. For the
elders who usually seem to take several kinds of medicine for the number of illnesses they
suffer from, it is unlikely that they would be taking the drugs properly if the Pharmacist does
not spend enough time in explaining.
Within the Preventive Health Care Programme screening clinics are not held for elderly to
diagnose the common illnesses early. As such the complications would set in due to delay in
taking treatment. A patient with undetected high blood pressure with hardly any symptom will
suddenly end up in the hospital with a stroke or die before admission.
For most of the elders who suffer from chronic illnesses they need life long treatment. As a
result the number of patients attending the specialist clinics to get the monthly quota of drugs
keeps on increasing in spite of the fact at there are separate clinics held for High blood
pressure, diabetes, heart disease, joint pains, cancer, mental illness etc in most major hospitals.
Some of the patients travel a long distance bypassing a number of hospitals to attend these
clinics (sometimes only to get the blood pressure checked and collect the monthly medicine)
2.
Important Assumptions/Risks/Conditions:
The Provinces will fall in line with the policies of the Ministry of Health
3.
Project Objective:
Objective
Indicators
To improve the quality of life of  Quality of life
elderly through provision of indicators
supportive
environment,
improvement of the facilities for
health
promotion,
disease
prevention & rehabilitation
4.
Project Output/Product:
Outputs
National plan of action
developed based on national
health policy for improving
preventive, curative and
rehabilitative health services
facilities made available for
health promotion of elders
Indicators
 Development of a
national plan of action
Means of Verification
 The availability of the
national plan of action
Number of facilities
undertaking health
promotion of elders
 Number of curricula
supplemented with the
elderly care module

Reports from facilities

Reports

Reports from facilities

Care for elderly included in the
pre service curricula medical,
nursing and paramedical
curricula
The community and health made  Number of facilities
aware of problems related to carryout special
elderly care
rehabilitation programmes
for elders
5.
Means of Verification
Quarterly return (509)/
 New MIS
 Special surveys
(qualitative, quantities)

Related Projects:
Project No.
SRL DPR 002
SRL DPR 001
Project Title
Integrated health care for the elders
Promotion of health and prevention of disability among older
persons
6.
Relevant Agencies to be Coordinated:
Line and provincial Ministries of Health, Director YEDD/HEB / FHB/ NIHS/ Population
Division/ STD AIDS Campaign, MOHs and Medical Institutions, Ministry and Department of
Social Services, Ministry of youth Affairs and Sports, NYSC, Ministry and Department of
Education, HelpAge Sri Lanka and other NGO, department of Labour, Women’s Bureau,
Ministry of Justice, Ministry of media and Information, Universities and development Partners.
7.
8.
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Monitoring & Evaluation:
1.
Who?
Secretary, Ministry of Health, DGHS, DDG/PHS
2.
When?
3.
What actions to be taken based on results of monitoring & evaluation?
Improved planning and provision of services based on the identified gaps.
The activities will be modified based on the findings of the evaluation.
Quarterly, Annually
Activities:
Activities
Expected Results
Conduct a Needs Assessment among
elders and among institutions that can
be utilized for the programme
Health needs of
elders and facilities
identified in MOH
areas
The National Policy
Action Plan
formulated
The cadres necessary
are identified
Formulate the National Policy and
Action Plan on older persons
Identify and create cadres for all
levels based on the policies and
standards
Carryout research to fill in the
knowledge gaps
Develop a forum to collaborate with
other government and
non-government organizations
Conduct a series of advocacy/
awareness programmes among
political leaders, policy makers,
administrators, health staff and
community on health of elderly
Develop a module for training and
education of medical, nursing and
para-medical personal on care of
elderly and introduce into the
curriculum
Research carried out
on priority areas
Inter-sectoral
coordination for care
of elderly by MOH
areas strengthened
awareness created
among field health &
institutional health
staff and community
on health of elderly
A training module
included in the
curricula of medical,
nursing and
para-medical
personal
Process Indicators
Identify the assessment
team
Develop TOR
Identify a core group
Develop the TOR
Develop norms and
standards
Identify required cadre
Identify research
priorities
Identify researchers
Identify stakeholders
Develop the TOR
Identify needs for
awareness
Develop the programme
Identify target audiences
Identify training needs
Develop the modules
Negotiate with
Heads/Deans of training
schools
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Provide screening facilities for
selected diseases for elders in selected
levels of hospitals
common health
problems among
elderly are identified
early
Develop guidelines specifying quality
curative care for elders in state
hospitals
Facilitate the training of carers for
increasing elderly population
Guidelines
developed
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Establish facilities in the community
for health of elderly including day
centres, long stay hospitals
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Establish a mechanism to assist
elderly and disabled to continue
rehabilitation at the time of discharge
from hospitals/institutions
Strengthen the unit of D/YEDD
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Establish a Management
Information system in relation to
elderly health
Select the screening
facilities to be expanded
Select the level of
hospitals
Assess the necessary
equipment/funds
Release circulars
Appoint a working group
Develop the TOR
The number of carers Identify the need
increased
Identify how MoH can
assist in this area
Community facilities Identify what facilities
established
are needed
Identify location of
facilities
The elderly and
Design the method
disabled discharged
Develop forms an
from hospitals are
formats
further rehabilitated
D/YEDD unit
Identify areas for
strengthened
strengthening
Develop a proposal
Management
Identify data fields,
Information system
Develop the mechanism
in relation to elderly Pilot the mechanism
health established