Health care systems and policies for older adults in Nepal: new challenges for a low-middle income country.

Discover public health Pub Date : 2024-01-01 Epub Date: 2024-12-30 DOI:10.1186/s12982-024-00382-9
Usha Dhakal, Emily Briceño, Uttam Sharma, Umesh Bogati, Abha Sharma, Lochana Shrestha, Dirgha Ghimire, Carlos F Mendes de Leon
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Abstract

Background: Nepal, like other low- and middle-income countries, is experiencing a rapid increase in the number of older adults and the rate of aging in the population. This has increased the number of older adults with age-associated chronic illnesses, which in turn will escalate the demand for specialized healthcare and long-term care in Nepal. However, very little is known regarding the current healthcare system and health policies for older adults in Nepal. In this paper, we aimed to advance this understanding.

Methods: We reviewed the existing literature on the health, healthcare system, and policies related to older adults in Nepal.

Results: Our findings revealed that older adults have a high prevalence of chronic conditions such as cardiovascular, musculoskeletal, and chronic kidney diseases, and the number of patients with Alzheimer's disease and related dementias is on the rise. Additionally, there is a decline in historical family caregiving for several reasons such as international migration of offspring, and the country currently lacks a skilled geriatric workforce and formal long-term care support and services (LTSS). Together, this has created a challenge in adequately meeting the health and care needs of the older population. Findings also indicated that several geriatric health policies exist in the country, which ensure primarily free healthcare services for older adults. However, economic constraints limit the financial resources to implement these policies, build appropriate care facilities, and improve access and utilization.

Conclusion: Therefore, the government must develop sustainable financing to adequately provide quality healthcare and LTSS for older adults as the population ages.

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尼泊尔老年人的卫生保健系统和政策:中低收入国家面临的新挑战。
背景:与其他低收入和中等收入国家一样,尼泊尔正在经历老年人数量和人口老龄化速度的快速增长。这增加了患有与年龄有关的慢性疾病的老年人的数量,这反过来又将增加尼泊尔对专业保健和长期护理的需求。然而,很少有人知道关于目前的医疗保健系统和卫生政策的老年人在尼泊尔。在本文中,我们旨在促进这一认识。方法:我们回顾了有关尼泊尔老年人的健康、医疗保健系统和政策的现有文献。结果:我们的研究结果显示,老年人患有心血管、肌肉骨骼和慢性肾脏疾病等慢性疾病的患病率很高,阿尔茨海默病和相关痴呆患者的数量正在上升。此外,由于后代的国际移民等几个原因,历史上的家庭护理有所减少,而且该国目前缺乏熟练的老年劳动力和正式的长期护理支持和服务(LTSS)。总之,这给充分满足老年人口的保健和护理需要带来了挑战。调查结果还表明,该国存在若干老年保健政策,主要确保老年人获得免费保健服务。然而,经济约束限制了实施这些政策、建立适当的护理设施以及改善获取和利用的财政资源。结论:因此,随着人口老龄化,政府必须发展可持续的融资,以充分为老年人提供优质的医疗保健和长期生活保障。
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