Challenges

Countries in southern Europe are going through demographic changes characterized by low fertility, emigration, especially among young people, and population aging. With greying populations, countries are looking for ways to address the special needs of older persons, including health care, because of their unique vulnerabilities and lack of access to basic services. In the former North Macedonia, studies have shown that over 50 percent of people over 65 years had difficulty accessing primary health care services. In Bosnia and Herzegovina, the social isolation and prevalence of chronic non-communicable diseases among the elderly were a big challenge. In both countries, there were concerted efforts to enhance the quality of life of older people, including making health care ‘age friendly.’ Moreover, the older persons themselves recognized that harnessing their contributions would not only improve their own lives but also the wider community. 

Toward a Solution

Bosnia and Herzegovina and North Macedonia launched a South-South Cooperation initiative to exchange experiences, lessons learned and good prac- tices in addressing the health needs of older persons. Stakeholders from both countries agreed that it would be beneficial to share the success of Bosnia and Herzegovina in establishing healthy aging centres with North Macedonia. The ini- tiative was conducted with United Nations Population Fund (UNFPA) support and in cooperation with the NGO Partnership for Public Health. The Center for Healthy Aging worked towards improving the quality of life of older persons, especially their mental health, and enabling them to be actively engaged in and to make valuable contributions to their community.

With support from the United Nations Population Fund (UNFPA), two centres for healthy aging were established in North Macedonia in the municipalities of Vinica and Caska serving the needs of older persons, including those who could not afford health care. A learning visit to the Centers for Healthy Aging in Sarajevo was conducted in 2017 , includ- ing participants at the ministerial level, to see first-hand the operation of the centres and good practices that could be transferred as appropriate.

Capacity building activities have been organized in both countries to better understand the consequences of rapid demographic changes and how capacities of older persons can be tapped. Furthermore, NGOs working in population aging were mobilized to promote active and healthy aging among older persons.

To improve the quality of life of older persons it is necessary to foster their physical activity, healthy nutrition and maintain their active and contrib- utory role in the society. Older persons, leading an active lifestyle, are independent and do not represent an unnecessary burden on their fam- ilies and public health system.

To promote healthy aging, it is important to have regular communi- cation among various stakeholders. Such communication enables all stakeholders to understand the root causes of development problems and learn from each other different approaches to resolving issues. Older persons must be included in the programme leadership and the sector must be continually consulted and surveyed.

The practice described here could be easily replicated (and adjusted, if need be) in any country that has an aging population. Services provided in each of the centres are multi-sectoral in essence and depend on local capacities to provide those services, as well as the needs of the local pop- ulation or their willingness to engage in such services.