Population and Development Report Issue No. 9
Building Forward Better for Older Persons in the Arab Region
Executive Summary
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Introduction
Most Arab countries will have an ageing population or will have become aged in the next 30 years.
This statement would have been unimaginable a
few decades ago, when the region was witnessing
a massive population boom. Today, several Arab countries have already started the ageing transition and most countries will follow suit in the next 15 years. As a result, the number of older persons (aged 65 and above) is projected to increase from around 21 million today to exceed 71 million in 2050. Their percentage of the population will also increase from around
5 per cent today to more than 6 per cent in 2030 and nearly 11 per cent in 2050.
The fast-paced demographic changes, coupled with the alarming situation of older persons today and the projected situation of future cohorts of older persons, are advancing ageing as a priority policy item across the region. The COVID-19 pandemic and its devastating effect on older persons only served to highlight the existing vulnerabilities of older persons and the need to take prompt action to protect them and guarantee their rights. It has proven once again that business as usual and the fragmented policies of yesterday are no longer adequate. A paradigm shift is needed to change the bleak prospects of ageing in the Arab region.
In this context and building on ESCWA’s earlier knowledge produced on ageing in the Arab region, as well as the insights gained from its ongoing work with member States, the ninth issue of the Population and Development Report (PDR9) focuses on the care ecosystem for older persons as an entry point to address older persons’ priorities and ensure that all people can age with dignity in the region.
The model of the care ecosystem (figure 1) presented in this report is comprised of two distinct yet closely related elements: social protection and the long-term care (LTC) economy. Social protection is defined as a set of public policies and programmes intended to ensure an adequate standard of living and access to health care throughout the life cycle. Social protection benefits can be provided in cash or in kind through universal or targeted non-contributory schemes, contributory schemes such as pensions and complementary measures. Long-term care is defined as the need for and supply of long-term care support including formal and informal care and services to assist older persons and support their independence. It could include services provided in the community and at home, as well as institutional care.
Figure 1. The care ecosystem for older persons
1. Snapshot of ageing and older persons in the Arab region
The Arab region is ageing at a fast pace. The number of older persons is projected to increase from 20.8 million in 2020 to 71.5 million by 2050. Their percentage of the population will also increase from 4.8 per cent today to 6.2 per cent in 2030, and 10.6 per cent in 2050.
Countries in the Arab region are not ageing at the same pace, but most Arab countries will begin their ageing transition in the next two decades.
Lack of data disaggregated by age, sex, social status, living arrangements among other indicators is a significant limitation hindering countries’ ability to produce evidence-based policies that are responsive to older persons.
National development plans and strategies of Arab countries should consider the changing demographic trends to better prepare for future generations.
Overview
Although the Arab region is characterized by a youthful population by global standards, the region needs to brace for a historic demographic transition. The proportion of older persons is set to more than double in the next 30 years, from around 5 per cent to nearly 11 per cent of the total population. The quickening pace of aging can be explained by a combination of declining childbearing and increasing longevity. Despite the unique demographic dynamics in each country, there are common socioeconomic implications of ageing that need to be considered across the Arab region.
Definitions, methodology and limitations
This report defines older persons as the population over the age of 65. This is a departure from previous PDR reports and this change was made for the following reasons:
- The ageing transition is demographically defined as those above the age of 65.
- The retirement age in most Arab countries is closer to 65.
- The global trend in the region and beyond is to push the brackets of who is defined as an older person given that people today are leading longer and healthier lives.
Demographic trends, patterns and prospects of ageing in the Arab region
1. The Arab region is ageing at an increasing pace
The number of older persons in the Arab region increased considerably in the last 50 years, from 4.5 million in 1970 to 20.8 million in 2020. This trend is set to continue with the number of older persons projected to triple to 71.5 million by 2050.
Age pyramids for the Arab region (1970, 2020, 2030 and 2050)
Source: ESCWA calculations based on data from DESA, 2019a.
The Arab region is relatively young, as there are approximately more than ten times as many young people in the region than older persons today. But by 2050, this reality will change significantly as the number of older persons could make up around a quarter of the number of young people.
2. This ageing trend is the combined result of declining fertility and rising life expectancy
The average number of children per woman dropped from 7 in 1970 to 3.3 in 2020 and is projected to further decrease to 2.5 by 2050.6 At the same time, the average number of years a 65-year-old man in the Arab region could expect to live increased from 11.5 years in 1970 to 14.3 years in 2020. Arab women’s life expectancy at age 65 grew even more significantly from 12.8 years in 1970 to 16 years in 2020.
3. Migration is a major determinant of population ageing
Migration is a major determinant of population ageing, particularly in the Arab region that continues to host increasing numbers of migrants and refugees.
In 2020, Arab countries hosted around 41 million migrants and refugees, 15 per cent of the global total. Migration is particularly important in GCC countries, where migrants make up as much as 53 per cent of the population.
Most migrants tend to be of working age and seldom remain beyond retirement age (figure 6). Therefore, their presence is stalling the ageing transition, which is expected to start in most GCC countries in the next 10 to 15 years.
The increasing efforts to reduce dependency on migrant workers and nationalize the GCC labour force could therefore accelerate the pace of the transition.
Age structure of migrants in GCC countries (2020)
Source: ESCWA calculations based on data from DESA, 2020.
Countries in the Arab region are not ageing at the same pace, but most Arab countries will begin their ageing transition in the next two decades.
The ‘ageing transition’ is calculated based on the proportion of persons in a population aged 65 and above, which is in line with demographic research methodologies on population projections. A population is defined as ‘ageing’ when the share of persons aged 65 and above is between 7 per cent. The Arab region is ageing much faster than regions that experienced this phenomenon before. For example, the ageing transition in European countries lasted between 50 to 150 years while the average for the Arab region is estimated at 36 years
Ageing transitions in Arab countries (2000-2100)
Source: ESCWA calculations based on data from DESA, 2019a
Note: The estimated duration of the ageing transition is shown in brackets. The starting year of the ageing transition is the year the proportion
of older persons reaches 7.0 per cent, rounded to one decimal place. If the share is above this (i.e. 7.05 or above), the preceding year is used
as the starting date.
The socioeconomic situation of older persons in the Arab region
Population ageing carries important economic and social implications for Arab countries and societies. Social protection, adequate housing, quality and accessible health care and education are all important prerequisites for ageing with dignity, however significant gaps exist in Arab countries in these areas.
1. Non-inclusive social protection puts older persons at risk of being left behind
The right of older persons to income security is enshrined in human rights charters and international labour standards as well as international agreements such as MIPAA. The COVID-19 pandemic has highlighted the inadequacies of current social protection systems and reiterated the case for serious structural reform. One way to guarantee income security is through an adequate pension, yet this right is still unfulfilled in the Arab countries. In most Arab countries for which data is available, only military personnel and workers in the public sector and the formal private sector are entitled to social security benefits. On average, only 38 per cent of older persons above retirement age received a pension in the Arab region in 2020. Even among those who are covered, they may not receive an adequate income to guarantee them a dignified life.
2. The trend of population ageing in the Arab region coincides with an important shift in the living arrangements of older persons
Over the last 30 years, the percentage of older persons who live with a child or a young person (below 20) has fallen sharply in several Arab countries. At the same time, the percentage of older persons living alone or only with a spouse has risen considerably.
3. Old age is generally correlated with a higher prevalence of disability
The figure below shows the disability prevalence rate by age group at the regional level. In the Arab region, the disability prevalence rate among the population aged 0-64 is below 5 per cent in every country where data is available, while it is consistently significantly higher in the 65+ age group, reaching up to 31 per cent.
Disability prevalence by age group in the Arab region (2018)
Source: ESCWA, Disability in the Arab Region 2018.
4. Non-communicable diseases are the leading cause of death among older persons in the Arab region
The main causes of death vary considerably across the lifecycle as figure 9 shows. Non-communicable diseases (NCDs) are increasingly the leading cause of death as people age, with a marked jump from 52 per cent in the 15-49 age group to 85 per cent in the 50-59 age group.
Cause of death as a percentage of all deaths, both sexes, in the Arab region (2019)
Sources: ESCWA calculations based on data from WHO, 2020. Global Health Estimates 2019: Deaths by Cause, Age, Sex, by Country and by
Region, 2000-2019.
Note: Data on the State of Palestine was not available.
5. The vulnerability and the risk of poverty of older persons is increased significantly by a lack of formal education
SDG 4 includes a call for lifelong learning opportunities for all, yet the Arab region is lagging in meeting the educational needs of older persons. Indeed, illiteracy among older persons above 65 is widespread in the Arab region. Figure 11 shows the illiteracy rates of older persons across 14 Arab countries. Among the 14 Arab countries for which data is present from 2017 onwards, at least two in every three older persons are illiterate in six Arab countries: The Comoros, Mauritania, the Sudan, Egypt, Algeria and Morocco
Illiteracy rates among older persons in selected Arab countries (2020 or latest year available)
Sources: UNESCO, 2021a.
Note: The data is taken from 2017 for Egypt, Mauritania and Qatar; 2018 for Algeria, the Comoros, Jordan, Lebanon, Morocco, Oman and the Sudan; 2019 for the United Arab Emirates; 2020 for Kuwait, the State of Palestine and Saudi Arabia.
6. Older persons’ contributions are often overlooked, and they are subject to ageism
Older persons enrich their families, economies, and societies but their contributions are often overlooked or underappreciated. Despite the strong tradition in the region for families to care for older persons, there also continue to be negative stereotypes portraying them as dependents and without lack agency and capacity.
2. Social protection for older persons in the Arab region
The ongoing demographic transition in the Arab region and the recent COVID-19 pandemic have accentuated the need for inclusive persons social protection systems that cover the entire life cycle.
Older women are more excluded: the male pension coverage rate can be five times higher than the female coverage rate in some countries.
In many Arab countries, the sustainability of contributory pension schemes is imperilled as the proportion of beneficiaries increases relative to the population.
There is considerable inequality among older persons receiving contributory pensions, with a large number receiving very small amounts.
The value of cash transfers in many countries is low and has been further eroded by inflation.
Older persons are in many countries legally covered by contributory or non-contributory health care regimes. However, legal coverage often fails to translate into effective coverage.
Introduction
As the previous chapter showed, the Arab region faces a demographic transition as the population ages. Consequently, provision of social protection to older persons is becoming increasingly critical. In some contexts, this is further accentuated by changing household compositions – since a larger proportion of older persons now live on their own rather than with their children or grandchildren – and by the partial disappearance of traditional and more informal solidarity structures. Smaller families also mean that there are less children to support their ageing parents. The COVID-19 crisis has further underlined the importance of comprehensive social protection systems covering the entire life cycle.
TARGET 1.3
Implement nationally appropriate social protection systems and measures for all, including floors, and by 2030 achieve substantial coverage of the poor and the vulnerable
Overall social protection coverage
Before delving into the discussion on estimating overall social protection coverage it is important to be mindful of some of the limitations that impact the ability to accurately assess social protection coverage. Some of the limitations include:
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Difference between legal and effective coverage:
When discussing social protection coverage, whether for older persons or for any other group, it is essential to distinguish between legal coverage and effective coverage. Legal coverage refers to the part of the population who should be covered by social protection according to the legal framework in place. Effective coverage refers to the proportion of the population who are in fact covered. For instance, if legal coverage measures the population eligible to receive cash benefits, effective coverage measures the population that receive such benefits. For this chapter, coverage should unless otherwise stated be understood as meaning effective coverage.
-
Diversity of contributory as well as non-contributory schemes in one country:
There are often separate pension schemes for private and public sector workers as well as for the military. Countries generally have several social assistance programmes providing cash transfers and other benefits. While beneficiary data may be available for one or a few of the social protection schemes in a country, it can rarely be found for all of them, which complicates the task of calculating overall coverage rates. Even if beneficiary data were available for all social protection schemes in a country, accurately inducing the overall coverage rate would require knowing the extent of overlap between the schemes. Thus, simply adding together the number of beneficiaries from each separate social protection scheme would generate an inflated overall coverage rate.
-
Adequacy of the coverage:
Estimating effective social protection coverage is complicated by the more fundamental question of what “being covered” actually means to start with. For instance, some benefits provided through pensions or social assistance schemes may be set at such low a level that they do not come close to ensure an adequate standard of living. It is doubtful whether recipients of such benefits are in fact “covered” in any meaningful way. Thus, the question of coverage is interrelated with the one of adequacy.
Despite the above limitations, there have been significant efforts in recent years to calculate social protection coverage, including the proportion of older persons who receive a pension,33 as part of efforts to measure progress on achieving the SDGs. The proportion of older persons (60 and above) receiving a pension in the region is the second lowest in the world, at a mere 38 per cent or half the world average (78 per cent). It is considerably lower than in the Americas (88 per cent), Asia and the Pacific (74 per cent) and Europe and Central Asia (97 per cent), and only higher than in Sub-Saharan Africa (20 per cent) In only one Arab country does the coverage rate exceed the world average, with 85 per cent of older persons in Tunisia receiving a pension. Meanwhile, 70 per cent of older persons do not receive a pension in 10 Arab countries, namely Yemen, the Sudan, Lebanon, Mauritania, the Syrian Arab Republic, Iraq, Qatar, the United Arab Emirates, Morocco and Kuwait
Proportion of older persons receiving a pension by region (Latest year available)
Sources: ESCWA Data Portal; ILO, 2021a; DESA, n.d.
Note: The average for the Arab region is an estimate – see the technical annex 1 for more information.
Given the limitations of the data on overall social protection coverage of older persons presented above, this section zooms in on the inclusion of older persons in specific social protection schemes and programmes. While the administrative data used in this section generally cannot be used to draw conclusions about the proportion of older persons covered by contributory or non-contributory social protection, it often has the advantage of being detailed, allowing for more in-depth analysis. Since it is often published on a regular basis, such data also makes it possible to study developments over time.
Arab countries (excluding GCC) by proportion of older persons receiving a pension and GDP per capita (Latest year available)
Sources: ESCWA Data Portal; ILO, 2021b
Today, the vast majority of older women are excluded from the coverage of social protection systems, largely due to their low participation in the labour market for the past several decades, as well as their likelihood to work in the informal economy in some countries.
Male pension coverage rate can be five times higher than female coverage rate in some countries
The lack of data on overall coverage disaggregated by gender in the Arab region continues to be a significant limitation for a deeper understanding of the exclusion of older women from social protection coverage.
However, there is a noticeable change underway. Although the proportion of women among older persons covered by pension schemes is very small, this proportion is steadily increasing and is expected to continue to grow in the coming years.
This trend is largely a consequence of the increasing level of female labour market participation in the last five decades or so, and in some cases the transition of women from the informal to the formal economy during this period.
While the above discussion has focused on old-age pensions, it may be noted that many older women in Arab countries receive survivor benefits – in other words, benefits given to the widows, orphans or other relatives of deceased beneficiaries.
Countries often offer social assistance programmes as part of their social protection systems. These programmes provide monetary and in-kind benefits to vulnerable population groups. This section will look briefly into the inclusion of older persons in social assistance programmes in selected Arab countries where data is available: Algeria, Tunisia, Egypt and Jordan.
The Algerian social assistance scheme Allocation Forfaitaire de Solidarité (AFS), set up in 1994, is targeted at vulnerable older persons, persons with disabilities, families of children with disabilities and female heads of household. As of 2018, the programme had 962,710 beneficiaries, of whom 315,145 (171,958 women and 143,187 men) were older persons . Notably, the number of older persons covered by the programme has hardly increased since 2004 – when it was 309,725 (167,358 women and 142,367 men) – even though the total number of older persons in the country has almost doubled. Consequently, the proportion of older persons receiving AFS transfers decreased from 13.8 per cent in 2014 (14.3 per cent among women and 13.2 per cent among men) to 7.9 per cent in 2018 (8.5 per cent among older women and 7.2 per cent among older men).
The Tunisian social assistance scheme Programme Nationale d’Assistance aux Familles Nécessiteux (PNAFN), set up in 1986, targets beneficiaries on the basis of various factors including self-reported revenue and incapacity to work. As of 2020 around 260,000 households were covered by the PNAFN. Although the programme is not explicitly targeted at older persons, they are strongly overrepresented among beneficiaries: As of 2016, the PNAFN coverage rate was
The Takaful and Karama programme in Egypt, set up in 2015, consists of two sub-programmes: Takaful, targeted at households with children, and Karama, targeted at vulnerable older persons and persons with disabilities. As of 2021, the Karama component had around 1.3 million beneficiaries of whom approximately a quarter (more than 300,000) were older persons. It is worth noting that there is a high possibility of overlap between persons with disability and older persons, given that people are more prone to disability as they age.
Almost a quarter of the 105,642 families benefitting from the monthly cash transfers provided by the National Aid Fund during 2020 were headed by older persons. On the other hand, older persons are strongly underrepresented among beneficiaries of the NAF programme Takaful, which was launched in 2019.
Adequacy of social protection systems for older persons
The coverage of social protection measures providing monetary benefits – whether it be a contributory pension scheme or a non-contributory cash transfer programme – is meaningful only in so far as it guarantees an adequate standard of living. A key factor to take into account when evaluating the adequacy of pensions or cash transfers is whether they are increased in line with inflation.
Within each country and pension scheme for which data are available, considerable inequality exist among pensioners, making the average levels somewhat deceptive to use as a measure of overall adequacy. The available data suggest that a relatively small number of older persons covered by the schemes receive very large pensions (far above the average), while a large majority receive rather low ones (below the average). Thus, the median old-age pension is much lower than the average pension.47 Differences in pension levels can be discerned along various lines, including age, gender, region and sector of employment.
Average monthly pension (PPP) in Tunisia and Bahrain (Latest year available)
Sources: Tunisia, Caisse Nationale de Sécurité Sociale (Annuaire Statistique 2017); Bahrain (Social Insurance Organization, 2021).
With regard to the adequacy of non-contributory cash transfer programmes targeting older persons, the picture is also somewhat mixed. In Egypt, Karama benefits were set to 350 EGP at the launch of Takaful and Karama in 2015. At that time this corresponded to $162, though strong inflation during the following years caused the real value to fall considerably. In 2017, the level of benefits was raised to 450 EGP, though this hardly sufficed to compensate for the rapid price increases that year, and the real value had fallen to $100 by 2020.
Health coverage
Health coverage can be provided either on a contributory or non-contributory basis. The groups covered by contributory health insurance tend largely speaking to be the same as those covered by contributory pension schemes – in other words, formal workers and their households. This means that in those countries where a relatively large proportion of older persons receive a pension from the social insurance system, a similarly large proportion are covered by contributory health insurance.
Tunisia, for instance, have a contributory health insurance regime, CNAM, covering both the public and private sectors. There is a non-contributory health coverage regime called Assistance Médicale Gratuite I (AMGI), which provides free health coverage to the households covered by the cash transfer programme PNAFN. In addition, AMGII provides subsidized health coverage to households deemed vulnerable but not sufficiently poor to qualify for the PNAFN.
Tunisia: Estimated health coverage for total population and persons aged 62 or above (2016)
Source: Centre de Recherches et d’Etudes Sociales, 2019.
However, it is critical to bear in mind that legal health coverage does not always translate into effective coverage. In other words, even when older persons are covered by health insurance or when they are entitled to benefit free of charge from publicly provided services, they may not in practice be able to access the health care they need when they need it without incurring financial hardship.
Costing expanding social protection to include larger proportions of older persons
While there is widespread agreement on the importance of extending social protection to all older persons, it is more challenging to say how this should be done. A key question concerns whether coverage ought to be achieved by means of contributory or non-contributory mechanisms, or by some combination of the two. In all cases, it ought to be remembered that attaining higher coverage rates is meaningful only in so far as benefits and services are at an adequate level. Therefore, ensuring the political as well as financial sustainability of social protection is essential.
Cost of providing a social pension of $10/day at PPP to older persons above 65 and above 75 years as a percentage of GDP in selected Arab countries (Available years)
Source: ESCWA calculations based on DESA, 2019a.
3. Ageing and the long-term care economy in the Arab region
The dynamics of increased life expectancy coupled with changing social norms create escalating demands on establishing accessible and equitable long-term care (LTC) services.
In addition to the ongoing socio-demographic changes in the region, the COVID-19 pandemic has significantly affected the LTC market.
With culturally sensitive and high-quality LTC services in place, the burden on the family is shared and reduced, and older persons are better able to ‘age in place’.
There is considerable potential for LTC markets to create new job opportunities.
With the Arab regional context, the home-based LTC market appears to be the most preferred way of supporting older people while allowing them to continue living as independently as possible within their homes, families and communities. However, residential and nursing care might be a more suitable alternative for a smaller group of people with advanced and complex needs.
Background
The population is ageing very quickly across the Arab region. Chapter 1 details the processes of population ageing and provides evidence of its speed, raising attention to the need for swift responses at the policy and practice levels. Many countries in the region have already entered the demographic transition or are set to begin them during the next few decades. However, unlike historical experiences in Europe and North America, the ageing transition process in the Arab region will occur in a relatively short period.
While longevity provides much to celebrate, it is essential to realize that not all additional years gained through longevity are healthy life years. These dynamics of increased life expectancy associated with slower increases in healthy life expectancy, and coupled with changing social norms and trends, create escalating demands for accessible and equitable long-term care (LTC) services.
The long-term care economy
Social policy related to LTC has moved beyond providing safety nets, such as social protection mechanisms, to become a key instrument working in tandem with economic policies to ensure socially sustainable development that is equitable for everyone. With culturally sensitive and high-quality LTC services in place, the burden on the family is shared and reduced, and significant labour power is released and utilized for the benefit of individuals and the broader economy.
Emerging LTC markets in the Arab region
In the Arab region, LTC is almost entirely provided through informal support by families, neighbours and friends.81 Current evidence suggests that older persons in the Arab region have a clear preference for maintaining their independence and remaining in their own homes. Home care is also perceived as a more cost-effective option of care while at the same time improving older people’s well-being and continued contribution to their families, communities and the broader society.83 However at the same time, specialist LTC facilities, including residential nursing care homes, are an integral part of the broader LTC market to meet the needs of the small proportion of older people with complex needs that cannot be supported at home or whose circumstances and preferences might be different.
Job opportunities in LTC markets
Changing demographics, including population ageing and high unemployment rates, especially among youth and women, bring opportunities for emerging LTC markets since LTC is reliant on human interactions and relationships. It is thus one of the few sectors that will continue its reliance on human input despite technological advances that have replaced many jobs with machines and robotics. Assistive technology is also assuming increasing importance in LTC services, but the human touch remains essential. Older people themselves prefer personal interaction and have voiced concerns about over-reliance on digital technology in delivering health and LTC services.
The interactive role of the LTC workforce with others within the LTC economy
Source: Prepared by ESCWA.
Conclusion
This chapter highlights some of the challenges and opportunities associated with the rapid ageing transition underway in the Arab region. The aims and analysis focused on the pressing need to establish well-regulated and high-quality LTC markets to meet the growing needs of older people, reduce the burden of care on informal caregivers and create job opportunities. For these markets to be effective they need to be guided by rights-based and person-centred approaches, with older persons as active agents. The proposed framework defines the LTC markets through a holistic lens where LTC services go beyond meeting medical needs associated with ill health and co-morbidity to provide means for older people to continue participating in the social, economic, and public spheres.
4. Building forward better for older persons
Arab countries and relevant organizations should make available updated, reliable and accessible data disaggregated by age, sex, and location to help inform context-appropriate policy development.
Governments should not only work towards improving the lives of current older persons but can adopt a life-course approach to policymaking.
Social protection schemes should be more inclusive and responsive to older persons.
While the family remains an important caregiver, alternative options need to be explored and expanded, including professional home care and institutional care.
Introduction
This chapter offers practical steps Arab Governments can take to empower and protect older persons. Previous chapters have highlighted key structural barriers to older persons’ pursuit of a dignified life. Anticipating potential vulnerabilities can help inform progressive policies that prepare Arab countries to ensure as smooth a demographic transition as possible. Supporting the elderly is in line with the 2030 vision of ‘leaving no one behind’. Moreover, harnessing the contributions of older persons can be invaluable in ensuring that SDG targets are met. The concrete actions in this chapter are proposed in the pursuit of operationalizing the global frameworks at national levels
The figure below outlines the general policymaking process that underpin the detailed recommendations offered in each intervention area in this chapter.
Source: Prepared by ESCWA.
Data
Data
Build comprehensive, integrated, and inclusive data systems that provide the necessary data to inform evidence-based policy making.
Arab countries and relevant organizations should make available updated, reliable and accessible data disaggregated by age, sex and location. Age-disaggregated data remains limited and where it does exist, it often only offers one age range covering all older persons, which makes it difficult to distinguish between different sub-age groups among the elderly. Each country has its own unique data collection capacity and system, which will need to be assessed and strengthened. The variety in data quality and the lack of unified data standards across the region also make it hard to compare data across the countries.
Life cycle approach
Life cycle
Adopt a life-cycle approach to address needs of older persons today as well as taking proactive measures to address the anticipated needs of future cohorts of older persons.
Governments should not only work to improve the lives of current older persons but can adopt a life course approach to policymaking. Such an approach aims to enhance the lives of current populations from early ages to ensure decent futures for the next generations of older persons. It works on multiple fronts, addressing the short-to medium-term needs of older persons today as well as taking proactive measures to address the anticipated needs of future cohorts of older persons. Adopting such a holistic approach can help facilitate positive contributions from all citizens as they age. Addressing inequalities from an early age is critical given that disadvantages compound and reinforce one another, ultimately materializing in especially pronounced manners in old age.139 Adopting such an approach will help Arab countries as they strive to build sustainable and resilient societies.
Social protection
Social protection
Increase coverage, ensure adequacy, and strengthen sustainability of social protection systems that empower older persons to age with dignity.
While there is widespread agreement on the importance of extending social protection to all older persons, it is more challenging to say how this should be done. There are three central elements that need to be considered.
- First, coverage is the best place to start. Understanding who is currently not being protected by current systems, and why this is the case, is critical before developing appropriate policies to fill the gaps. In this pursuit, Arab countries should consider implementing universal or semi-universal non-contributory pension schemes, bearing in mind that this would considerably reduce the degree of exclusion errors, and that providing non-contributory social protection to a larger section of society could enhance political support for social spending.
- Second, the adequacy of social protection schemes needs to be ensured. This involves ensuring that benefits provided to older persons through contributory as well as non-contributory social protection schemes are regularly adjusted in line with inflation or with wages.
- Third, the complementarity of contributory and non-contributory programmes needs to be strengthened. Arab Governments should abstain from categorically excluding older persons covered by contributory social insurance mechanisms from non-contributory mechanisms such as cash transfer programmes.
Long-term care economy
Long-term care
Develop responsive, diverse, and sustainable LTC services to ensure high-quality, personalised care and support for older persons.
LTC markets are crucially needed in the Arab region, especially given the fast pace of population ageing. Chapter 3 described how existing efforts in this regard are fragmented and require a more holistic approach. Building partnerships, harnessing advances in technology, raising awareness and collating accurate data on demand and preferences are critical success criteria to achieve high-quality LTC markets, based on person-centred and human rights approaches, that benefit all involved.
Building forward better
To realize the promise of ‘leaving no one behind’, Governments need to prioritize older persons. Arab Governments are starting to make progress in this pursuit, but more is needed.
This report provides a one-of-a-kind roadmap to support member States’ efforts. Taken together, these recommendations will help Arab countries build forward better for older persons. Countries need to adopt holistic approaches and mainstream ageing and older persons’ issues across the policy sectors and processes.
