{"title":"Long-term care in India: Capacity, need and future","authors":"Arunika Agarwal, David E. Bloom","doi":"10.1111/issr.12312","DOIUrl":"10.1111/issr.12312","url":null,"abstract":"<p>The family is the dominant player in India’s current long-term care (LTC) system. Yet informal family-based arrangements will be insufficient to accommodate India’s growing need for LTC due to increasing longevity and geographic mobility, the prevalence of chronic disease and disability among the elderly, and the decline of extended family living arrangements. Addressing the growing need for LTC will require a robust expansion of the current LTC system, especially its non-familial components. This overhaul will require investments in infrastructure, human resources and legal and regulatory environments. The objectives of this study are to i) provide a descriptive summary and analysis of the LTC system in India, with attention to cross-state heterogeneity and to the financial, social and cultural factors that impede the operation of India’s LTC system; ii) estimate and assess the current and future need for LTC and its critical financial and human inputs; and iii) critically analyse and discuss the institutions and policies, technologies and behaviours needed to bring capacity comfortably into conformance with the need for LTC.</p><p>Actuellement, la famille est l’actrice principale du système de soins de longue durée en Inde. Néanmoins, les dispositifs familiaux informels ne suffiront pas à répondre aux besoins croissants en Inde en matière de soins de longue durée, en raison de la longévité croissante et de la mobilité géographique de la population, de la prévalence des maladies chroniques et du handicap chez les personnes âgées, sans compter que la famille élargie vit de moins en moins ensemble. Répondre au besoin croissant en soins de longue durée nécessitera une expansion vigoureuse du système actuel, en particulier en ce qui concerne ses composantes non familiales. Cette réforme nécessitera des investissements dans les infrastructures, les ressources humaines ainsi que le cadre légal et réglementaire. Les objectifs de cette étude sont les suivants: i) fournir un résumé descriptif et une analyse du système de soins de longue durée en Inde, en prêtant attention à l’hétérogénéité entre les états ainsi qu’aux facteurs financiers, sociaux et culturels qui entravent le bon fonctionnement du système; ii) estimer et évaluer les besoins actuels et futurs en la matière, ainsi que leurs contributions humaines et financières essentielles; mais aussi iii) mener une analyse et une discussion critiques sur les institutions et les politiques, les technologies et les comportements nécessaires pour que les capacités soient largement conformes aux besoins en soins de longue durée.</p><p>Actualmente, la familia ocupa un lugar central en el actual sistema de cuidados de larga duración de la India. Sin embargo, los arreglos familiares informales no serán suficientes para dar respuesta a las necesidades cada vez mayores de la India en materia de cuidados de larga duración debido al aumento de la longevidad y la movilidad geográfica, la prevalencia de las enferm","PeriodicalId":44996,"journal":{"name":"International Social Security Review","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2022-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46076832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Corrigendum: Universal Health Coverage and Social Health Protection: Policy relevance to health system financing reforms","authors":"","doi":"10.1111/issr.12302","DOIUrl":"https://doi.org/10.1111/issr.12302","url":null,"abstract":"<p>In Bayarsaikhan et al., 2022, the affiliation 1 and correspondence address were published incorrectly and should read as follows:</p><p>Dorjsuren Bayarsaikhan*, Lou Tessier** and Aviva Ron***</p><p>*P4H, Geneva, Switzerland; **International Labour Office, Geneva, Switzerland;</p><p>***Independent consultant, Israel</p><p>Addresses for correspondence: Dorjsuren Bayarsaikhan, Global Network for Social Health Protection and Health Financing (P4H), avenue Appia 20, 1211 Geneva, Switzerland; email: <span>[email protected]</span>.</p><p>Moreover, the name of “Joe Kurtzin” was incorrectly mentioned in the acknowledgement section, hence, it was removed and should read as:</p><p>Christina Behrendt and Justine Hsu are acknowledged for having motivated the authors to write this article. Appreciation is expressed to Aurore Iradukunda for having provided valuable technical input.</p><p>The online has been corrected.</p>","PeriodicalId":44996,"journal":{"name":"International Social Security Review","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2022-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/issr.12302","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137560935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The role of health and social care workers in long-term care for elders in Poland, Czechia, Hungary and Slovakia: The transition from institutional to community care","authors":"Zofia Szweda-Lewandowska","doi":"10.1111/issr.12311","DOIUrl":"10.1111/issr.12311","url":null,"abstract":"<p>Care for the elderly is one of the most important socioeconomic issues arising from the ageing of the population. Given the declining workforce in the care and health sectors in many countries, difficulties exist already in fully meeting care needs. Moreover, deinstitutionalization, which involves a transition from institutional to community-based care, requires an increase in human resources in the care and health sectors. The article addresses long-term care systems for the elderly and the conditions affecting the possibility for the Visegrád countries (Czechia, Hungary, Poland and Slovakia) to transition from a post-socialist model (familialism by default/unsupported familialization) to a European care model based on deinstitutionalization. A further aim of the article is to show some differences in the provision of long-term care for the elderly that are observed in Central Europe, and to underline that their specific characteristics should be taken into account when planning and designing public policies and guidelines for social policy at the European Union level.</p><p>Les soins aux personnes âgées sont l’un des problèmes socioéconomiques les plus importants liés au vieillissement de la population. La main-d’œuvre dans les secteurs du soin et de la santé étant en baisse, des difficultés se font déjà sentir pour répondre pleinement aux besoins médicaux. Par ailleurs, la désinstitutionnalisation, qui implique une transition des soins institutionnels aux soins communautaires, nécessite d’augmenter les ressources humaines dans les secteurs du soin et de la santé. L’article traite des systèmes de soins de longue durée destinés aux personnes âgées et des conditions régissant la possibilité pour les pays du groupe de Visegrád (Tchéquie, Hongrie, Pologne et Slovaquie) de passer d’un modèle postsocialiste (familialisme par défaut/familialisation sans accompagnement) à un modèle de soins européen basé sur la désinstitutionnalisation. L’objectif de cet article est également de montrer certaines différences dans la prestation de soins de longue durée pour les personnes âgées en Europe centrale et de souligner que leurs caractéristiques spécifiques devraient être prises en compte dans la planification et la conception de politiques publiques et de lignes directrices sur les politiques sociales au niveau de l’Union européenne.</p><p>Los cuidados de las personas de edad avanzada constituyen uno de los problemas socioeconómicos más importantes que se derivan del envejecimiento de la población. Debido a la disminución de la mano de obra en los sectores de los cuidados y de la salud, ya se observan dificultades a la hora de satisfacer plenamente las necesidades de atención. Asimismo, la desinstitucionalización, que implica una transición de la atención institucional a la atención comunitaria, precisa que se dediquen más recursos humanos a los sectores de los cuidados y de la salud. El artículo aborda los sistemas de cuidados de larga duración a disposici","PeriodicalId":44996,"journal":{"name":"International Social Security Review","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2022-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45572255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Providing long-term care: Options for a better workforce","authors":"Ana Llena-Nozal, Eileen Rocard, Paola Sillitti","doi":"10.1111/issr.12310","DOIUrl":"10.1111/issr.12310","url":null,"abstract":"<p>Older people and their care workers have been disproportionately affected by the COVID-19 pandemic. Many OECD Member countries have taken measures to contain the spread of the infection and improve the care workforce. Yet the health crisis is highlighting and exacerbating pre-existing structural problems in the long-term care (LTC) sector. In many OECD Member countries, recruiting enough workers in LTC remains a challenge and care workers experience difficult working conditions. Skills mismatch and poor integration with the rest of health care lie at the root of preventable hospital admissions even in normal times. Such challenges are likely to become ever more acute if no further action is taken given the speed of population ageing. Policies to improve recruitment and which also address retention through training, improvements in coordination and productivity, leveraging the effect of digital technologies, are needed.</p>","PeriodicalId":44996,"journal":{"name":"International Social Security Review","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2022-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/issr.12310","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45686562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Introduction: Making the case to formally revise the international social security standards to include long-term care for the elderly","authors":"Roddy McKinnon","doi":"10.1111/issr.12305","DOIUrl":"10.1111/issr.12305","url":null,"abstract":"<p>First published in April 1948 as the <i>Bulletin of the International Social Security Association</i>, this year marks the 75th anniversary of what, since January 1967, we have all come to know as the <i>International Social Security Review</i>. To mark this important anniversary, this special double issue, “The human right to long-term care for the elderly: Extending the role of social security programmes”, talks to current debates on social security coverage extension in a context of population ageing. There is a case to be made for revising the international social security standards to formally recognize long-term care for the elderly, possibly as a distinct branch of social security. At the heart of this discussion, the questions to be addressed by all countries are the roles that social security systems can and should play in helping to meet the long-term medical and social care needs of elders.</p><p>Publiée pour la première fois en avril 1948 sous le nom de <i>Bulletin de l’Association internationale de la sécurité sociale</i>, la revue <i>International Social Security Review</i> (ISSR) que nous connaissons tous sous ce nom depuis janvier 1967 célèbre cette année son 75<sup>e</sup> anniversaire. À l’occasion de cet anniversaire clé, ce double numéro spécial intitulé «Droit humain aux soins de longue durée pour les personnes âgées: étendre le rôle des programmes de sécurité sociale» aborde les débats actuels sur l’extension de la couverture de la sécurité sociale dans un contexte de vieillissement de la population. Il y a lieu de réviser les normes internationales de sécurité sociale pour une reconnaissance officielle des soins de longue durée pour les personnes âgées, éventuellement en tant que branche distincte de la sécurité sociale. Au cœur de cette discussion, les questions auxquelles tous les pays doivent répondre concernent les rôles que les systèmes de sécurité sociale peuvent et doivent jouer pour aider à répondre aux besoins des personnes âgées en matière de soins médicaux et d'aide sociale à long terme.</p><p>Este año se conmemora el 75º aniversario de la que, desde enero de 1967, se conoce como <i>International Social Security Review</i> (Revista Internacional de la Seguridad Social), publicada por primera vez en abril de 1948 bajo el título <i>Bulletin of the International Social Security Association</i> (Boletín de la Asociación Internacional de la Seguridad Social). Con motivo de esta importante efeméride, se presenta este número especial doble titulado “El derecho humano de las personas de edad avanzada a los cuidados de larga duración: Ampliación de la función de los programas de seguridad social”, en el que se recogen los debates actuales sobre la extensión de la cobertura de seguridad social en un contexto de envejecimiento de la población. Existen motivos de peso para revisar las normas internacionales de seguridad social a fin de que los cuidados de larga duración de las personas de edad avanzada gocen de reconocimi","PeriodicalId":44996,"journal":{"name":"International Social Security Review","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2022-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45399524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Universal Health Coverage and Social Health Protection: Policy relevance to health system financing reforms","authors":"Dorjsuren Bayarsaikhan, Lou Tessier, Aviva Ron","doi":"10.1111/issr.12295","DOIUrl":"10.1111/issr.12295","url":null,"abstract":"<p>Universal Health Coverage (UHC) and Social Health Protection (SHP) are key policy foci that cut across all dimensions of the 2030 Sustainable Development Goals agenda. Understanding of these two concepts, their fundamentals and relations would improve health policy development and implementation to attain UHC and effectively protect the health of people and save lives and livelihoods. The COVID-19 pandemic has provided useful lessons to improve multi-sector activities to strengthen and finance health and social protection systems. The aim of this article is to provide conceptual clarity on the contribution of the global frameworks on SHP to the policy goal of UHC. In doing so, the article contributes to health financing and social security related policy discussions and advocates for much needed integrated policy actions at global as well as country levels. It discusses the origins of the two concepts and the relevance of SHP to health systems financing for UHC. Although country situations differ, the main findings, especially for low- and middle-income countries, are highlighted and summarized.</p><p>La couverture santé universelle (CSU) et la protection sociale de la santé (PSS) sont deux axes politiques essentiels qui recoupent l’ensemble des dimensions du programme des objectifs de développement durable à l’horizon 2030. La compréhension de ces deux concepts, de leurs fondements et de leurs relations permettrait d’améliorer l’élaboration et la mise en œuvre des politiques de santé afin d’atteindre la CSU, de protéger efficacement la santé et les revenus des personnes, et de sauver des vies. La pandémie de COVID-19 a permis de tirer des enseignements utiles pour améliorer les activités multisectorielles visant à renforcer et à financer les systèmes de santé et de protection sociale. Cet article vise à clarifier la contribution des cadres conceptuels mondiaux sur la PSS à l’objectif stratégique de la CMU. Ce faisant, l’article contribue au débat sur le financement de la santé et la sécurité sociale, et plaide en faveur d’actions politiques intégrées, indispensables tant au niveau mondial que national. Il examine les origines des deux concepts et la pertinence de la PSS pour le financement des systèmes de santé en vue d’atteindre une couverture universelle. Bien que les situations diffèrent d’un pays à l’autre, les principales conclusions de cette analyse, en particulier pour les pays à revenu faible ou intermédiaire, sont mises en évidence et synthétisées.</p><p>La cobertura sanitaria universal y la protección social de la salud son objetivos de política fundamentales que abarcan todos los aspectos de la Agenda 2030 para el Desarrollo Sostenible. Comprender estos dos conceptos, sus principios básicos y su interrelación mejoraría la formulación y la aplicación de las políticas en materia de salud y ayudaría a conseguir la cobertura sanitaria universal, proteger eficazmente la salud y los medios de subsistencia de las personas y salvar vidas. ","PeriodicalId":44996,"journal":{"name":"International Social Security Review","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2022-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46893168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The financial sustainability of public pensions in Cuba: The impact of ageing, structural reforms and the economic crisis","authors":"Carmelo Mesa-Lago, Carla Moreno, Stephen J. Kay","doi":"10.1111/issr.12293","DOIUrl":"10.1111/issr.12293","url":null,"abstract":"<p>This article analyses Cuba’s pension system from 2006–2021 with respect to its financial and actuarial sustainability and impact on the population. It includes discussion of the ageing population; the sharp cut in social expenditures since 2009; the deficit in pension financing and the impact of the 2008 parametric reform; the devaluation of pensions; structural reforms and the expansion of poverty and the curtailing of social assistance; the impact of the current economic crisis on pensions; and projections of the future financial sustainability of pensions.</p><p>Cet article analyse le système de pensions cubain de 2006 à 2021, sous l’angle de sa viabilité financière et actuarielle, et de son impact sur la population. Il traite notamment du vieillissement de la population, de la forte réduction des dépenses sociales depuis 2009, du déficit du financement des pensions et de l’impact de la réforme paramétrique de 2008 ; il aborde également les questions de la dévaluation des pensions, des réformes structurelles, de l’expansion de la pauvreté parallèlement à la réduction de l’aide sociale, de l’impact de la crise économique actuelle sur les pensions ainsi que des projections de la viabilité financière future des pensions.</p><p>En este artículo se analiza el sistema de pensiones de Cuba de 2006 a 2021 desde la perspectiva de su sostenibilidad financiera y actuarial, y de las repercusiones que tiene en la población. Se aborda el envejecimiento de la población, los drásticos recortes del gasto social que se han realizado desde 2009, el déficit de financiación de las pensiones y las repercusiones de la reforma paramétrica de 2008, la devaluación de las pensiones, las reformas estructurales, la expansión de la pobreza y las restricciones en materia de asistencia social, los efectos de la crisis económica actual en las pensiones y las proyecciones sobre la futura sostenibilidad financiera de las pensiones.</p><p>Dieser Artikel analysiert das Rentensystem Kubas in den Jahren 2006 bis 2021 in Bezug auf seine finanzielle und versicherungsmathematische Tragfähigkeit und seine Auswirkungen auf die Bevölkerung. Er befasst sich mit der Bevölkerungsalterung, der massiven Senkung der Sozialausgaben seit 2009, dem Rentenfinanzierungsdefizit und den Auswirkungen der parametrischen Reform von 2008; des Weiteren mit dem Wertzerfall der Renten, den strukturellen Reformen, der Ausbreitung der Armut und den Sozialhilfekürzungen, den Auswirkungen der Wirtschaftskrise auf die Renten sowie Prognosen für die künftige Rententragfähigkeit.</p><p>В статье анализируется пенсионная система Кубы 2006-2021 годов с точки зрения её финансовой и актуарной устойчивости и воздействия на население. В статье обсуждаются следующие вопросы: старение населения, резкое сокращение социальных расходов с 2009 года, дефицит финансирования пенсий и последствия параметрической реформы 2008 года, девальвация пенсий, структурные реформы и увеличение масштабов нищеты, а также сокращение социальн","PeriodicalId":44996,"journal":{"name":"International Social Security Review","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2022-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45832814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Income protection for self-employed and non-standard workers during the COVID-19 pandemic","authors":"Slavina Spasova, Pietro Regazzoni","doi":"10.1111/issr.12292","DOIUrl":"10.1111/issr.12292","url":null,"abstract":"<p>Based on original evidence from the European Social Policy Network (ESPN), the article investigates the extent to which self-employed and non-standard workers, who are less protected by “ordinary” social protection, were included in “extraordinary” income protection and job retention schemes during the COVID-19 pandemic in the European Union (EU) and the United Kingdom. When the crisis hit, countries quickly introduced unprecedented emergency income replacement measures for the self-employed. Nevertheless, most of these schemes provided only basic support through lump sums and were, in some cases, subject to a variety of eligibility conditions. Non-standard workers were in general included in job retention schemes, but substantial gaps remained in some countries. The article discusses how such gaps were addressed in five EU Member States. The article concludes by highlighting some policy pointers for better and more adequate “extraordinary” income protection for the self-employed and non-standard workers in times of crisis.</p>","PeriodicalId":44996,"journal":{"name":"International Social Security Review","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2022-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9349796/pdf/ISSR-75-3.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40681141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Valéry Ridde, Mouhamadou Faly Ba, Marion Guyot, Babacar Kane, Ndeye Bineta Mbow, Ibrahima Senghor, Adama Faye
{"title":"Factors that foster and challenge the sustainability of departmental health insurance units in Senegal","authors":"Valéry Ridde, Mouhamadou Faly Ba, Marion Guyot, Babacar Kane, Ndeye Bineta Mbow, Ibrahima Senghor, Adama Faye","doi":"10.1111/issr.12300","DOIUrl":"10.1111/issr.12300","url":null,"abstract":"<p>In an effort to establish universal health coverage (UHC), Senegal set up two departmental health insurance units (UDAM) to scale-up health insurance to rural communities. Part of this innovation meant that health insurance was no longer managed by volunteers, but by professionals. Several years after the conclusion of the project in 2017 that supported their initial development, both UDAMs still operate successfully. This mixed methods research aims to understand the factors that have contributed to the sustainability of both UDAMs, as well as discuss the remaining challenges. The factors deemed favourable to sustainability are actions undertaken to ensure financial stability and organizational risk taking. However, the mobilization of the population, relationships with health professionals and the role of the State have been more difficult to organize. Challenges concern the payment of subsidies and the supply of medicines by the State and partnership with the health care system, the maintenance of contributions, the digitalization of administration, as well as fraud and abuse.</p>","PeriodicalId":44996,"journal":{"name":"International Social Security Review","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2022-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/issr.12300","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41609179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}