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Geriatric Care, Issues and Challenges Before Homoeopaths

Dr. Eswara Das

What are the present demographical trends of population in our country and what is the present infrastructure available to us to tackle with the increasing elderly population? Dr. Eswara Das writes about the present scenario of the elderly population, their common problems and the infrastructure available to tackle them.


Demography is the mathematical and statistical study of size, composition and spatial distribution of human population and of changes over line in these aspects through operation of the five processes of fertility, mortality, marriage, migration and social mobility.

Introduction
There is an uneven demographic pattern across the world. One of the biggest concerns of the developing countries is the high birth rate and infant & maternal mortality rates. These counties pool their resources to reduce such mortalities and birth rate. The trend in many developed countries is an alarmingly high proportion of higher age group amongst the total population. Certain counties show a negative population growth. Some countries have stated even encouraging a positive birth rate and providing incentives to eligible couples.

India is trying to stabilize its population growth. In middle of the twentieth century we dad a higher population of lower age group. Present demographic pattern shows a higher percentage of lower age groups as well a moderately higher proportion of higher age group - A real population explosion. This is due to effective MCH activities, which reduced the infant and child mortality as also due to fecundity of eligible couples. Improvement in medico-social sector contributed longevity.

When our population is plotted graphically based on the age group, it would give a typical pyramidal structure with the base of the pyramid forming the infant group, gradually ascending with higher age groups to its vertex with the old age population. In many of the developed countries the present population structure is in the form of an inverted pyramid with its vertex at the bottom representing the infants and base at the top representing the population of higher age group. These patterns have a direct bearing on the health sector especially in planning the health policies and strategies.

Present Indian Scenario
India is supporting about 16% of the total world population. The total landmass compared to world landmass is only 2.4%. We had the one-billionth baby on May 11th 2000. Our annual population growth rate is 15.5 million. According to the Demographers, if the present trend continues, India would become the most populous country in the world by 2045.

We have unique diversity on socio-cultural status, educational levels, geographical distribution, and climatic variation. Such state of affairs with unabated population growth and limit resources makes our health care system more complex.

Over the last five decades, due to persistent persuasion of policies, India could achieve phenomenal progress in crude Death Rate from 25 in 1951 to 9 in 1996. The life expectancy has enhanced from 32 years in 1947 to 61.6 years. Though these indices are commendable, India remain at 138th Rank amongst 174 countries in term of Human Resource Development Index (Health is one of the indices in deciding the Human Development index). In this context we have to clearly find the goals to be achieved and lay down a definite action plan.

Homoeopathic Infrastructure
We have about 156 undergraduate and 15 post-graduate colleges both in the Government and private sector, there are about 9000 dispensaries and around 300 hospitals. The human resources by way of trained manpower is about 1.05 lakh (Also about 1 lakhs non-institutionally qualified, but registered practitioners)

Impact of Higher Age Group Population on the Society
Improved survival means that a larger proportion of life is now spent in old age. If we examine the implications of the higher age group population on the society. We could see this larger percentage of population becoming unproductive, become burden on the social security system and take away the major chunk of state revenue as pensionary benefits. They also become burden on the family with their offspring finding difficult to take care of their parents. Urbanization, small dwelling units in cities, larger working hours, increase in medical care cost etc. shall add the miseries to the wards in taking care of their parents. This affects physical, emotional and behavioural pattern of the aged.

Implications on the Health Care Sector
Health sector has been focusing on primary health care, mostly curative health. Recently emphasis on preventive care especially on the communicable diseases is given. Infant, child and maternal care have been receiving more focused attention. Attention on these has drastically improved the health status of women and children. Infectious diseases are not a serious issue to the health planners. Many of the tuberculosis sanitariums have been converted to regular hospitals. Leprosy is not as untouchable as it used to be. Cholera death is very rare. Typhoid. Plague, diarrhoeal disease are well contained through advances in medical science and improvement in sanitation.

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