1. the United Nations/Royal Thai Government (UN/RTG) joint team on social protection LONG TEM CARE POLICY FOR ELDERLY IN THAILAND

2. LONG TERM CARE POLICY FOR ELDERLY IN THAILAND WORK SHOP 23/01/2013

3. LONG TERM CARE POLICY FOR ELDERLY IN THAILAND I: DESCRIPTION OF THE CURENT SITUATION II: SITUATIONAL ANALYSIS – SWOT III: MAIN ISSUES IN THE LTC MODELS

4. LONG TERM CARE POLICY FOR ELDERLY IN THAILAND I: DESCRIPTION OF THE CURENT SITUATION THANKS TO ALL OF OR PARTNERS, specially Dr Nantasak THAMANAVAT, Director of institute of geriatric medecine, Ministry of Health

5. LONG TERM CARE POLICY FOR ELDERLY IN THAILAND Total number of older : 7million (11.5%) in 2010 Rapid population ageing The share of older population doubles in 25 years time - from 10.1% in 2000 to 21.5% in 2025 and triples in 50 years – 29.8% in 2050) Second fastest ageing country in South East Asia (3.7% per year), Rapid declines in fertility due to successful family Planning from 6+children per woman in 60s to 1.5 in 10 Increased life expectancy – due to improved public health care & services (2010; M= 67.8 yrs; F=72,8)

6. LONG TERM CARE POLICY FOR ELDERLY IN THAILAND National Plan on Older Persons -1st National Plan for Older Persons (1982-2001); -2nd National Plan for Older Persons (2002-2021); which was revised in 2010 Enactment of regulations to promote elderly well-being -Declaration on Thailand’d Older Persons (1999) -National Commission on the Elderly (2003) chaired P M -Act on Older Persons (2003) -The 10th National Economic and Social Dvpment Plan (2007-2011) -National Framework on the Preparation for Ageing Society (2007-2011 – being monitored by NESDB)

7. LONG TERM CARE POLICY FOR ELDERLY IN THAILAND Universal free health care for older persons has been in effect since early 1990s Section 52 of the Constitution (1997) states that “ All Thai people have an equal right to access thequality health services…” Universal Health Coverage (UHC) reforms introduced in 2001 with small co-payment at Baht 30 (equivalent to 1 USD) Elderly Health Care & Services Community-based Care by NGOs & CBO & the Local Administrative Organizations s e.g. Home visit by health personnel and volunteers (total volunteers in 2009 =1,007,274) Health Volunteers i.e. home visits, data collection, basic health assessment (under supervision of Community Health Centres) Temples and Elders Clubs are actively engaged in health promotion through selfcare and physical exercises and education prevention,

8. LONG TERM CARE POLICY FOR ELDERLY IN THAILAND

15. Policy Advocacy on Social Protection

16. LONG TERM CARE POLICY FOR ELDERLY IN THAILAND

18. II. SITUATIONAL ANALYSIS SWOT

19. LONG TERM CARE POLICY FOR ELDERLY IN THAILAND

22. STRENGTHS  Laws and regulations for universal social protection,  The stakeholders high understanding of the threats,  The field network of ONG, Clubs, Volunteers and Care Givers,  The cultural tradition to support elderly, family and neighbours  The place of communities  Economical growth …. WEAKNESSES  Lake of interaction between the different levels of health care  Lake of available or professionalized human resources  Sustainability of local and national funding  Overlaping between actors (volunteers care givers and structures)  Lake of visibility for social welfare organisations ….

23. LONG TERM CARE POLICY FOR ELDERLY IN THAILAND OPPORTUNITIES  Implementation of the Universal coverage,  Many implemented pilots to be the references of best practices,  The interministérial structure crosscuting the different chapters of LTC policy and to coordonate the definition of the foreseen policy,  The Political will,  … THREATS  Demographic urgency  Urbanisation and family model  The growth of the heavy dependancy  To use an external model non suitable for Thailand to implement urgently the designed policy  To ignore or reduce the role and the input of the informal aid  To design a bagpipe policy,...

24. LONG TERM CARE POLICY FOR ELDERLY IN THAILAND MODEL FOR THE PROPOSED STRATEGY W-T Will imply reducing the weakness that can make threats have a real impact Suggestions: Choose a bottom up definition of the policy and implementation Avoid to define a LTC policy for elderly but a holistic, pragmatic plan Choose a bottom up definition of the policy and implementation Enhance the informal organisation and intergenerational, Priority for local initiatives through existing organisations,

25. LONG TERM CARE POLICY FOR ELDERLY IN THAILAND III - Main Issues in the different models for LTC policy

26. LONG TERM CARE POLICY FOR ELDERLY IN THAILAND  Governance: What is the suitable level and the role of each,  Objectives: Non-definition or uncertainity of the aims  Conceptual: LTC social or health as it is in Thailande facing the need of competency from one to the other to realise a suitable support (volunteers/care givers – nursing home/ health care institutions),  Organisation: Centralised, decentralised, professionalised, association, are all facing the lack of coordination with overlaping between systems and multiplication of people who are in charge to help the elderly. Professionalisation enhance the risk of decreasing the place of informal and family help,  Fundation: funded, private insurance, public systems, copayment, taxe fundation or social funds are all facing the rapid growth of the expenditures through the solvabisation of needs, rules to allocates the means,

27. LONG TERM CARE POLICY FOR ELDERLY IN THAILAND  Human resources:The harrassement of care givers (work injuries and psychological problems, Need of a strong training engieniery to support HR  Evaluation process: Which ratio to appreciate the results?  Standards and quality to deliver services  Help the caregivers, prevention of autonomy lost, improvement of housing, enhancement of social relation and cognitive entertainement,  LTC in the comprehensive organisation for care

28. LONG TERM CARE POLICY FOR ELDERLY IN THAILAND