Promoting and protecting the rights of older persons in Pakistan
Earlier this week, on June 25th, British Council Islamabad launched the report ‘Moving from the Margins: Promoting and protecting the rights of older persons in Pakistan’, drawn from the project commissioned by their Research, Evaluation, Monitoring Unit (REMU) in 2016. This project was conducted with the support of HelpAge International in Pakistan and the REMU staff.
The project evidences those human rights for the older population which are neglected in Pakistan and sets out policies and programmes required to protect and promote these rights. Most importantly, it contributes to generating data on the lives of older people in Pakistan, an essential requirement in monitoring progress in meeting the pledge ‘Leave no one behind’ of the 2030 Agenda of Sustainable Development.
The acceleration of population ageing has profound consequences on a broad range of economic, political and social processes in a low-and-middle-income country like Pakistan. The structural mismatch between advances in longevity and a lag in the evolution of national policies to address the resulting issues is an impediment common to the responses of policymakers in developing countries worldwide.
Pakistan is currently the sixth most populous in the world. In 2017 its older age population was approximately 12.5 million, almost 7 per cent of total population – by no means an insignificant segment of the population (only 15 countries worldwide have older age population more than 10 million older people). By 2050 the number of older persons in Pakistan is estimated to reach a staggering 40 million.
British Council Pakistan identified the problems faced by older persons as a matter of urgency, partly in view of the findings of the Global AgeWatch Index for Pakistan. A review of the ageing-related evidence and policies for older people is deemed an urgent requirement, in particular to address the problems of ageism and unequal opportunities for older people in Pakistan.
The data for research undertaken in the project included a nationwide survey on Pakistan’s older people, which is a unique survey in collecting data on human rights of older persons. In addition to the quantitative analysis of the survey, qualitative analysis of personal interviews and focus group discussions with older persons and other stakeholders, and reviews of national and provincial level legislations, policies and programmes, have also been undertaken.
The analytical framework is derived from the 1991 UN General Assembly’s principles for the advancement and protection of older persons’ human rights, based on the Universal Declaration of Human Rights, organised under the five dimensions: 1) Independence; 2) Participation; 3) Care; 4) Self-fulfilment and 5) Dignity.
Key findings
- Independence (and secure living): Adequate access to food and other basic needs including water, shelter and clothing is restricted for 20 per cent of older persons interviewed, particularly women. Many older people say that they face obstacles in generating income due to the age-related discrimination they encounter in accessing work and employment. Only a few older people reported having access to government allowances and only 2 per cent of them receive a pension.
- Participation (and inclusion): Opportunities for older people to participate in the public sphere are limited. Older women, especially in rural areas, have very limited access to public life except for participating in religious activities and family ceremonies.
- Care (and access to health): Only half of the older population interviewed are satisfied with the care received with various aspects of their daily living. Older women and older people living in rural areas are amongst the most dissatisfied with the care they received. Older people also reported significant barriers to accessing health services including lack of transport; low availability of services; low quality of health services in government hospitals; lack of medications; excessive bureaucracy; and no age friendly services provision. The financial contribution required to access many health services in Pakistan is a major burden for older people. Overall 25 per cent of older persons struggle with basic needs for healthcare and medicine. Women do worse than men in this respect. Close to 50 per cent believe that younger members of the family have a greater ability to pay for the costs of their health care.
- Self-fulfilment: Most older people interviewed are satisfied with the freedom to choose what to do with their life. However, two-thirds of them report that there are not enough education and training opportunities for them.
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Dignity: Older people, especially in the urban area, report having been denied their fair share of household money, inheritance or properties. Fifteen percent of older people reported that others caused them emotional or psychological distress. One out of ten older persons believe that they have been looked down upon or treated in humiliating, shameful or degrading way because of their age.
Policy situation
As of today, the government of Pakistan has developed three national level policies and legislative instruments: 1) the 1999 National Policy for the promotion of better health of the Elderly; 2) the 2004 National Policy of Older People; and 3) the 2007 Senior Citizens Bill. Unfortunately, none of these national instruments have been approved by the parliament. Older persons have now been identified as a vulnerable group by the Federal Ministry of Human Rights of Pakistan and there is a new Bill currently being drafted. It is not clear how the newly formed Ministry of Social Welfare plays a role, especially in view of the fact that the new Ministry has the remit of ensuring the social safety net for all.
Only patchy progress has been made at the provincial level with the “Senior Citizen Bill” approved by the Khyber Pakhtunkhwa Parliament in 2014; the “Senior Citizen Welfare Bill” approved by the Sindh assembly in 2016 and the “Senior Citizens Bill” by the provincial assembly of Baluchistan in 2017. Punjab, the largest province, has yet to ratify any such senior citizens bill, although they started the drafting process sooner than any other province.
The three provincial bills have many aspects in common: they envisage that the interests of older citizens are guarded by special councils headed by the provincial social welfare ministers. They propose providing better care for senior citizens at hospitals and establishing homes for older people. A unique feature of the Sindh law is a provision that those who abandon older family members and spouses can be punished with three months’ imprisonment or fines.
It is not possible to assess how these legislations have resulted in an improvement in the lives of older persons in these provinces. For example, the KP government established the Social Welfare Council, but has not been able to hold its quarterly meetings. Close to one million senior citizens in Khyber Pakhtunkhwa have applied for the Senior Citizens Card, which will give them access to free treatment and medicines as well as free entry to public places, but it could not be issued to them to date. Many believe that these legislations were not implemented due to lack of budgetary resources.
Recommendations
Pakistan’s older population will double by 2030, reaching close to 25 million. It is therefore imperative that the country responds urgently to the most critical needs of its older population. At the same time, the policies need to promote more profound societal changes which creates positive age-friendly and enabling environments for future generations of older Pakistanis.
Supporting older people and particularly older women to have a secure income through universal social pensions should be a top priority in Pakistan. Ensuring that health services are aligned to the health needs of the older population especially at the primary health care level is essential to assist older people to remain active and engaged in their communities. Finally, eliminating all forms of age discrimination and providing an environment in which older people are protected from violence and abuse will help them exercise their choices and contribute to society.
About the Author
Professor Asghar Zaidi is a Senior Research Fellow at the Oxford Institute of Population Ageing. Asghar is Professor of Gerontology at Seoul National University, Korea and Visiting Professor at London School of Economics and Political Science, London.
Comments Welcome
We welcome your comments on this or any of the Institute's blog posts. Please feel free to email comments to be posted on your behalf to administrator@ageing.ox.ac.uk or use the Disqus facility linked below. Her dissertation focuses on demographic change, intergenerational justice and participation.
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Comments Welcome: We welcome your comments on this or any of the Institute's blog posts. Please feel free to email comments to be posted on your behalf to administrator@ageing.ox.ac.uk or use the Disqus facility linked below.
