Older women’s health and well-being in Asia and the Pacific region: Focus on violence against older women

October 1, 2020 Older women’s health and well-being in asia and the pacific region: focus on violence against older women

This virtual statement was presented by ARROW’s Sai Racherla during the 45th Session of the Human Rights Council Interactive dialogue with the Independent Expert on the Human Rights of Older Persons. To watch the full intervention, click HERE.

In 2019, an estimated that 60.1 per cent of 702.9 million world’s older people (65 years or over) resided in the Asia-Pacific region. Women constituted 52.9 per cent of the persons within this equation.

Declines in fertility and mortality in the region have resulted in these fundamental changes in age structures of population in the region. It is important to recognize- older persons are not a homogenous group, and come from diverse socio- economic backgrounds, immigrant and ethnic minorities, living in poverty and with disability, living in emergencies, sexual and gender minorities, indigenous persons, persons living with HIV and sex workers, widows and single women.

Discrimination based on age is combined with gender and the above diversities, negatively affects the enjoyment of full range of human rights and dignity of older persons.

Key trends in the region point to an increase in the proportion of older persons.  In 2016, approximately 12.4 per cent of the population in the region was 60 years or older, and this is projected to increase to more than a quarter — or 1.3 billion— people by 2050. A rapid increase in the pace of ageing is also observed and even in countries with low proportion of older persons, the absolute numbers of older persons can be quite significant. The ageing demographic shifts have implications related to health, health care systems, health workforce, health care technologies, social protection, employment, quality of life and long-term care of individuals including humanitarian and disaster response.

In terms of gender dimensions, while in the Asia and Pacific region, women outlive men by at least four years on average. This difference is as high as 13.2 years in Republic of Korea and 12.7 years in the Russian Federation. Women’s longer life expectancies and the consequent larger proportion of older women living alone throws challenges on a number of issues, as older women have lesser income security, and are often discriminated against due to limited access to resources and opportunities including health care, adequate housing, social protection and legal justice.

Older women face greater risk of physical and psychological abuse due to discriminatory societal attitudes and the non-realisation of the human rights of women. Some harmful traditional and customary practices result in abuse and violence directed at older women, often exacerbated by poverty and lack of access to legal protection.

Women’s poverty is directly related to the absence of economic opportunities and autonomy, lack of access to economic resources, including credit, land ownership and inheritance, lack of access to education and support services and their minimal participation in the decision-making process.  Poverty can also force women into situations in which they are vulnerable to violence and discrimination including sexual exploitation.

Although living longer, evidence points to prevalence of poor health conditions and morbidity among older women such as urinary incontinence, vaginal fistula, pelvic infections, cancers of reproductive systems, mental health issues including depression, dementia, cardiovascular diseases. Which have impact on dignity and well-being of women, but also many of these conditions are results of lifelong gender discrimination faced by women.

Further to this, estimates note one in six older persons experience some form of abuse worldwide. This is a gross human rights abuse.  An understanding the prevalence and a situational analysis is the first step towards developing a public health, and community approach. Data among women beyond the reproductive age (15-49) is neglected, DHS for example, and this is a huge barrier to inform progress/ lack of progress on older person issues.

The other gap is also a lack of consensus in defining and measuring elder abuse and its major subtypes (psychological, physical, sexual, and financial abuse and neglect), as a result there are variations in prevalence reporting. Pension funds in the region often only provide coverage for public sector, in some instances, formal private sector, but not informal sector.

The coverage of women by the labor based social protection schemes is significantly less in comparison to men. It is understood that all Member States report some form of non-contributory pension scheme for older persons, however it is understood that the coverage of these pension schemes, size and frequency do not provide for minimum subsistence level income.

The current inattention to older women in the gender-based violence (GBV) field has minimized the experiences of older women survivors at great detriment to their health and rights. For example, health providers seldom ask older women about their sexual activity and relationships, a neglect that leads to older women being excluded from necessary HIV testing and care as well as support services for abuse. This oversight is increasingly worrisome given the rise in new HIV infections among adults age 50 and older in recent years, with the majority of transmissions stemming from individuals unaware of their HIV-positive status.  Approaches are required in public health interventions for Gender Based Violence and HIV that acknowledges older women – their sexuality, sexual agency, and activity – so that health providers and advocates acknowledge and serve older survivors.

Recommendations:

  • Reclaim the framework suggested by the International Conference on Population and Development and the Beijing Platform for Action, it is important to relook at the global health policies to incorporate a life course approach to women’s health as a matter of human rights.
  • A concerted research effort is needed to provide a basis for developing policy guidance and for pinpointing essential indicators and establishing necessary data systems to enable a routine tracking of progress and strengthen the capacity to mainstream gender, age and age-related disability analysis
  • Strengthen the development and implementation of comprehensive and integrated policy frameworks that address and mainstream population ageing into national development strategies and plans, heath and gender equality plans in line with the Madrid International Plan of Action on Ageing;
  • Ensure that no older persons are left behind, including, in particular, older persons living in rural and urban areas, indigenous and ethnic minority older persons, older migrants and older women and vulnerable older persons in general;
  • Ensure the inclusion of older persons, and their specific requirements, vulnerabilities and capacities, in policymaking processes, including in humanitarian contexts and in particular in disaster risk reduction policies, strategies and practices and in emergency response;
  • Align disease prevention and health systems and to advance universal health coverage, as appropriate, as a platform for bringing together various health and development efforts, so that all older persons have access to quality health services locally without suffering the financial hardship associated with paying for care;
  • Develop health and social long-term care systems, including palliative care, that can deliver high-quality integrated care, while recognizing and enhancing the capacity of formal and informal caregivers and volunteers;
  • Health services for older persons need to ensure mental as well as physical health, address violence, neglect and abuse of older persons, promote positive images of ageing, prevent ageism and age-related discrimination at the workplace.
  • Currently data for persons beyond the reproductive years is not available, and data on population ageing and age-disaggregated statistics as key elements in formulating evidence-based policies and of supporting monitoring and evaluation of programme delivery to assure their efficiency and effectiveness
  • Human rights and gender equality are central to address the issue of ageing in Asia Pacific, and policies to take into account a lifecycle approach

Reference: ARROW, Reclaiming and Redefining Rights. ICPD+25: Status of SRHR in Asia and the Pacific, Older Women’s Health and Well-being in Asia and the Pacific region. Retrieved from https://arrow.org.my/publication/older-womens-health-and-well-being-in-asia-and-the-pacific-region/

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