Empty cradles and ageing population

by K. Jayasinghe

Two to three generations ago, most of the middle and upper class families of Sri Lanka had an item that was passed from generation to generation - a cradle made of hard wood. For grandparents of that era, it was a pleasure to see their grandchildren fall into sleep in these cradles, invariably in those they themselves slept as infants. But today, in most situations these cradles are either collecting dust in attics in the few remaining spacious ancestral houses or discarded long time ago as a useless item.

Increasing number of empty cradles indicates that lesser newborns are getting added to the population. This is not a phenomenon that is common to developing countries like Sri Lanka. In fact, Sri Lanka stands out in this respect and almost falls in line with the developed world.

Total Fertility Rate, which is the average number of children a woman would have in her reproductive life span stands now at 1.9 for Sri Lanka. This is less than the rate required for replacement, which is 2.1. In Europe, the fertility rate is 1.4. Among the Asian countries, Japan records the lowest fertility; 1.3 children per woman.

Other industrialized nations of Asia namely South Korea, Hong Kong, Taiwan and Singapore indicate sub-replacement fertility rates. However the fertility rates of our neighbours; Pakistan, Bangladesh and India are high.

Despite being a developing country, Sri Lanka was able to bring down its fertility to below replacement level due to several factors. Among them are; the introduction of family planning methods to the country by non-governmental organisations in early 1980s that was efficiently and effectively supported by the Government, the high rate of literacy specifically among women and increased labour force participation of women.

Similar social benefits and significant contribution towards healthcare by successive Governments that helped to reduce maternal morality and deaths due to diseases prevalent among the adults and the elderly elevated the life expectancy for males to 72 and that for females to 78 years.

Reduction of fertility and the increase of life expectancy brought about the inevitable demographic transition, which is the ageing of population. This is a phenomenon experienced generally by the developed world. In this respect, Sri Lanka is again venturing into the group of developed countries but without the wealth and economic development these countries possess.

According to the Census of Population of Sri Lanka conducted in 2001, the proportion of the persons 60 years and above defined in general terms as the elderly is about 9.2 per cent and the total number of such persons was estimated to be around 1.7 million.

Sri Lanka has not only the almost highest proportion of elderly among the developing countries, but it is also among the fastest ageing countries in the whole world. Demographic projections indicate that while the other developing countries in Asia lag behind, Sri Lankan population will age rapidly such that by 2010 the proportion of elders would be 12 per cent, by 2020 17 per cent and by 2030 one of every 5 persons in the country would be an older person (20%).

Population ageing brings about several constraints both in economic as well as social terms. Those available for work in the country will be reduced on two scenarios. On the one hand increasing number of elders will not be economically active and thus those available for labour will be less and on the other, there will be increased labour force migration to developed countries due to increased demand for labour, mainly due to the first scenario they themselves face.

What is hurting the economy of Sri Lanka most is that those who emigrate would be the skilled and the lack of skilled labour will slow down the economic growth. The child and old age dependency, which are respectively the ratios of children and elders to the economically active population change in the opposite directions. While the current child dependency is around 42 per cent and decreasing over time, the old age dependency is 9 per cent and increasing. By the year 2030 they will be almost equal at 26 per cent and 24 per cent respectively.

Another constraint to the economy of the country, imposed by an ageing population is the demand from the healthcare system. Health services for the diseases and ailments of the elderly are costly and prolonging. Who will pay for this large and increasing Medicare bill? There will be a heavy burden on the younger labour-force in an ageing population.

On top of the healthcare needs there will be other social requirements for the older people. It is certain that the younger generation will have to shoulder the burden of their elders. Some analysts think that China, which is a fast developing economy, would grow older even before becoming richer due to its one child policy.

Some others think that when population shrink, the overall GDP may drop but not the per capita income. But the contribution of the GDP needed to sustain the needs of the ageing population is high. Thus the question will be how could the too few young look after and/or work for the too many older people.

Increasing number of elders will also be affected by the decrease of younger persons in terms of care needed as the children; their traditional caregivers would not be available for many. Even most of those available children would be involved in income generating activities in urban areas or abroad where the demand is high. Lack of their children among them affects the elders in yet another way, which is termed as 'the empty nest syndrome'. This is more or less a psychological condition.

In the eastern culture, children are considered as precious assets to the family. Parents invest on children, spending on their education and caring for their health and other needs and even traditionally present some wealth when they marry and move away.

Basically, parents when growing old expect their children to be around, not only to care for them but also to give a family atmosphere with loving grandchildren. In the absence of younger generation within the family, older parents increasingly feel unwanted and especially those who do not get involved in some purposeful activities feel very lonely and miserable.

What is urgently needed is to examine what could the relevant institutions of the government, non-governmental organisations, the elderly and the society as a whole could do in the present situation. In this regard a fundamental need is to collect information about the elders covering the areas such as the distribution of the elderly population, their demographic, economic, health and social characteristics, special needs, availability of caregivers and prevalent social and psychological situation of the elderly.

The National Secretariat for Elders of Ministry of Women's Empowerment and Social Welfare in 2003 - 2004 conducted a National Survey on Elders covering a total sample of nearly 12,000 elders spread among the 25 districts of the country. The report of this survey is out and it gives some useful information for policy planners, service providers, caregivers of the elderly, elders themselves and those in the threshold of moving into the old age. The survey indicates that the total number of the elders in the country is nearly 1.7 million distributed as 204,000 in the urban areas, 1,400,000 in the rural and 64,000 in the estate sector.

Dependency of elders on their children for income support seems to be high (46%) which may not sustain in the scenario of shrinking younger generation. Those guaranteed with income support through pension and other formal income support systems such as EPF are few (13%). Although there are other pension schemes such as the Farmers' pension scheme and Fishermen's pension scheme, the coverage is very low and it is known that benefits from such schemes are inadequate and do not adjust in relation to inflation.

The Farmers' and Fishermens' pension schemes need contributions from the beneficiaries and the past records indicate that the Government had to subsidise to compensate the defaults.

The older persons should make sure of income security for a comfortable old age. What are the avenues available in this regard for the large majority who do not get formal pensions? One approach is to continue working as long as possible.

At present level, only about 8 per cent of the elders are salaried and another 18 per cent get income either from their property or from self-employment in agricultural activity or in doing some businesses.

The mandatory retirement age was reduced to 55 years in order to pave way for the increasing younger population. Very soon, not only this has to be revoked but incentives also should be given for continuous employment mainly in the self-employment sector. It is also the responsibility of the middle-aged persons to ensure in whatever the avenues available, that they have income security in their old age, as their children would not be around to support them.

It is encouraging to note that at present, majority of elders (71%) reside in houses either owned or rented by them. Dependency on children for living arrangements is also substantial (18%). However if elders are living with their children to fulfill intergenerational transfers such as caring the grandchildren while the elders receive food, shelter and care as valued customary, it is mutually beneficial.

Nevertheless, in such situations it is always safe to make living arrangements somewhat independent so that the chances of conflicts between generations are minimum. Making some physical separations between the living quarters of the two generations could conveniently ensure this independency. What is more beneficial would be, while planning and building houses, to build some units at ground level with wide doors leading to the toilets so that wheelchairs could be rolled in if necessary, for the benefit of the owner's older parents or for themselves when become old.

Healthy old age is very important. Many elders suffer due to complete loss or poor eyesight. The survey reveals that about 65 per cent of all the elders consider their eyesight is poor. This number is over 1 million. Of them, 43 per cent or 460,000 need spectacles but do not have.

Eyesight is a primary need for elderly to do their activities of daily living independently. A pair of spectacles is comparatively inexpensive but would immensely help to improve the quality of life of an elderly person who needs them.

The Government and the NGOs could assist in fulfilling this need. A healthy old age needs adequate long-term planning and practices, which should have been initiated in the middle age. Good practices to avert heart diseases, lung and bone diseases, which are common among elderly are investments for a happy old age.

Another initiative that could be taken in the middle age is to prepare one's abilities and mental condition to be conducive for a happy retirement. Retirement is a different phase of life, especially for males who work on regular hours outside home. It is good for working males to start well ahead some useful activities at home for a housewife not to feel that there is 'a stranger in my home' when the husband is retired.

There are many challenging work in religious and social service sectors for active minds to get involved even when the persons are retired from regular work. Empirical data shows that happy are those elders who prepared for old age.

Another probable answer to the old age crisis would be, just as much as we were able to reduce fertility ahead and faster than our developing neighbours, is to reverse the process even before others plan to do so.

If we take this step, which of course have a long gestation period, could we be rich with a highly literate and skilled labour force whose services would be exported supplying for the demand in developed countries and earn the much needed foreign exchange? This could be seen as a natural cycle or the basic principle of economics; supply and demand.

Some countries in Europe now adopt policies such as granting long leave for pregnant women, other benefits for working mothers, daycare for children, and tax benefits and social benefits for children; which induce increasing birthrates. Such policies, focused to reverse the birth dearth impose long-term social and economic impacts and thus should involve national policy formulating and service providing institutions of the government for consideration.

If implemented, that strategy will make the 'empty cradles' to be filled and keep swinging, once again.

(The writer is former Assistant Director of Census and Statistics Department and a former Executive Director of HelpAge Sri Lanka)