U n i v e r s a l h e a l t h c o v e r a g e a n d h e a l t h y a g e i n g Third, countries must reorient their health systems to respond better to the needs of older people – a large and complex agenda. Many older people require health and social support services due to reduced mobility, increased frailty or other physical or mental health conditions. At present, health systems and services are largely oriented and resourced to treat acute episodes of ill health, whereas older people typically require services such as secondary prevention, screening and early diagnosis, as well as ongoing management of chronic health conditions, and cognitive and functional decline. The health needs of older people must be incorporated into national health plans and policies, including policy frameworks and strategies focusing on UHC. The continuum of care Integrated, people-centred models of service delivery are needed to ensure the continuum of care, from promotion and prevention to primary and specialist care, rehabilitation, palliation and end-of-life care. Effective care of older people will require teamwork and effective co-ordination between health and social care services; between families, communities, health facilities and social support agencies; between insurance and financing mechanisms; and, crucially, between general and specialised health professionals. Population ageing is likely to increase the demand for health workers, both specialists in gerontology and geriatrics as well as generalists equipped with the skills and competencies to meet the needs of older people. Hospitals can become more age-friendly through changes to the physical environment, for example, in access to wards and other facilities, and through changes to service delivery that address the preferences of older people and enable their rehabilitation, participation and independence. Transitional care options, including step-down care, will be needed to facilitate older people’s movement along the care continuum. Increased demands for health services by older people will place a strain on health financing and social security systems. Like the system as a whole, financing mechanisms must be refocused and their coverage expanded to meet these health costs. Technology, including innovations in e-health and m-health, holds promise in potentially helping increase efficiency, while improving access among vulnerable groups of older people. Lastly, to better guide action on ageing and health, the evidence base on ageing must be strengthened. Reliable information drives sound policy-making. More and better information is needed in many countries on issues such as the health status and needs of older people, their access to services, and the quality of the care they receive. Research and analysis on ageing should break down and analyse information by factors such as age, sex, income and rural or urban location in order to understand the health needs of everyone. Appropriate information must be available to policymakers to facilitate evidence-informed policy dialogue and decision-making. The WHO has undertaken policy-focused analysis to inform technical collaboration on ageing and health in countries of the Western Pacific region. The way forward Moving forward will require political commitment, advocacy and strengthened partnerships. Ageing and health is a complex and challenging field. There is no magic remedy, however, societies and governments have shown a growing awareness and willingness to take action. Member states showed such interest when they endorsed the WHO Regional framework for action on ageing and health in the Western Pacific (2014–19), which has provided a strong basis to catalyse action. The regional framework endorses the four broad areas of action described in this article, recognising the importance for older people of retaining their health and living in environments that promote their active participation. In this way, their experience, skills and wisdom will continue to be great resources in their communities. Partnerships for public policies will be essential, including through mechanisms that recognise the contributions of older people themselves. The WHO is committed to using our convening power to bring together various partners on ageing and health, and work on strengthening the health systems response to ageing in the context of UHC. References WHO-WPRO (World Health Organization Regional Office for the Western Pacific), 2014a. Regional Framework for Action on Ageing and Health in the Western Pacific Region (2014–19). Manila: WHO-WPRO. WHO-WPRO (World Health Organization Regional Office for the Western Pacific), 2014b. The Health of Older People in Selected Countries of the Western Pacific Region. Manila: WHO-WPRO. 34 Commonwealth Health Partnerships 2015 DR SHIN YOUNG-SOO took up the position of the World Health Organization’s regional director for the Western Pacific on 1 February 2009 and was nominated for a second five-year term in 2014. He was the first regional director for the Western Pacific to be appointed from outside the WHO. Shin has longstanding connections with the WHO, having undertaken more than 30 assignments with the organisation as an adviser and consultant, and having on a number of occasions served on its Executive Board as the representative of the Republic of Korea. Before joining the WHO, Shin was professor of health policy and management at the College of Medicine, Seoul National University, where he graduated magna cum laude in 1969.
Commonwealth Health Partnerships 2015
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