Challenges

Extended life expectancy at birth and low fertility have contributed to steady population ageing. This is considered by far the greatest achievement of human development. It is expected that, on a global level, the number of persons over 60 will triple from 600 million to almost 2 billion by mid-century, and the proportion of persons over 60 will double from 10 percent to 21 percent in the population. Many older persons live in dire conditions, with low pensions and insufficient healthcare services, as well as in inadequate housing, especially in rural areas. Furthermore, mental health issues are becoming increasingly widespread due to lack of socialization of older persons, lack of inter-generational support and long-term migration of younger family members.

There are concerns about the capacities of societies to address the challenges of an ageing population and the need to recognize the potential that an ageing society can bring.  This programme addresses those concerns.

Toward a Solution

An effective method to address the needs of the ageing population is a programme called Healthy Ageing Centres, which was first developed in 2009 by the non-governmental organization (NGO) Partnership for Public Health in Bosnia and Herzegovina.  It was built on strong societal and cultural values in support of older persons.  It aimed at promoting physical and mental health, and preventing older persons’ mental health illnesses associated with loneliness, as well as increasing voluntary engagement of older persons in community development initiatives and generating inter-generational collaboration and support.

The United Nations Population Fund (UNFPA) country office in Bosnia and Herzegovina closely collaborated with the Partnership for Public Health in policy and advocacy work in the country. As a result of this collaboration, the network of Healthy Ageing Centres was expanded from its initial location to another 11 locations in Bosnia and Herzegovina over a period of 11 years; many more local communities have expressed interest in opening these centres. UNFPA also provided technical support to relevant authorities in Bosnia and Herzegovina in developing strategies on ageing, where Healthy Ageing Centres have an important role by improving the position of older persons in society.

This innovative programme developed in Bosnia and Herzegovina has proven to be a highly successful model. It is successful for many reasons. First, older persons have strong capabilities that are not recognized in society and that only need to be stimulated for the greater good. Second, active participation in society brings a dual benefit – to society, through voluntarism, and to the individual old person through improved health and wellbeing. Third, the initiative contributes to gender equality. In the past, community associations and groups were mostly led by men, whereas the Healthy Ageing Centres offer the same opportunities for all older persons. Finally, older persons learn to use modern technologies that enable them to communicate with their children and family who often have migrated within the country or abroad. These skills come very handy at the time of crisis such as the COVID-19 pandemic, where older persons are being prevented from appearing in public to protect their own health and where communication is of outmost importance.

The network of Healthy Ageing Centres is cost-effective and fully sustainable. Operating costs are low (under the assumption that premises are available and can be easily equipped). At present, the monthly operating costs of each centre per older person is approximately EUR 4, or 1 percent of an average net monthly salary in the country. Considering the costs of pharmaceuticals for treatment of many non-communicable (including mental) illnesses, the operating costs are very low and affordable to local authorities. The methodology for establishing the network of Healthy Ageing Centres is very simple, and only initial management capacity building is required. The ensuing work is largely based on voluntarism and requires little investment. Indeed, the added value of the centres is very high.

This programme was presented at the Ministerial Conference on Ageing in Lisbon in 2017.  As a result, delegations from other countries in the region showed keen interest in replicating the initiative in their countries. Several countries in Eastern Europe and the Caucasus (including their government institutions and NGOs) expressed interest in learning more about the principles and operational modality of the Healthy Ageing Centres and in opening their own networks.

In response, UNFPA facilitated an inter-country cooperation to enable a direct exchange of knowledge, experience and lessons learned. The initial transfer of knowledge and experiences was organized between Bosnia and Herzegovina and the Government of North Macedonia in 2018. Furthermore, in 2019, a workshop on healthy ageing was organized in cooperation with UNFPA Eastern Europe and Central Asia Regional Office and UNFPA Georgia for government and non-government representatives from nine countries of Eastern Europe and the Caucasus.