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Health Services


To develop an elderly health service system the Indonesian government through the Ministry of Health has developed a policy that supports improvement of elderly health status through several approaches
The main objective of the elderly health program is to improve elderly health conditions and quality of life through promotion of a health lifestyle. Complementary health services for impoverished elderly to be given through established procedures.

Policies and procedures for healthcare for the elderly are outlined in
Chapter III (Summary of Policy and Program on Elderly) of the
National Plan of Action.



Social Services

 Moving from Welfare approach to Development Approach



Minister for Social Affairs
of the Republic of Indonesia

H.E. Bachtiar Chamsyah
at the
Second World Assembly on Ageing

Madrid, Spain
9th April 2002


 At the outset, allow me to extend my heartfelt congratulations to the Government of Spain for hosting this important World Assembly on Ageing and for assuming the presidency of these proceedings. I am confident that under your able leadership, Mr. President, our deliberation will lead to fruitful outcomes for the promotion of the status of older persons. Let me also extend my congratulations to the other members of the Bureau of the Assembly on their respective elections and for their contribution to a successful meeting. 

Mr. President, 
 The Vienna International Plan of Action, adopted at the First World Assembly, correctly noted that the progressive ageing of our societies is neither an unexpected, unforeseeable event nor a random result of national and international development a effort. Advances in science, medicine and technology, in the past half-century, and particularly of the past decade, greatly increased the average of life expectancy, not only for the rich and privileged few, but also for the vast multitudes throughout the world. The ageing of our societies is a reflection of our successes in many other fields. 

Today, it is estimated that ten percent of all people in the world are aged 60 years or older. While this figure will have doubled in twenty percent within the next 50 years, a there are also major demographic differences that exist between developed and a developing countries in rural areas is higher than in urban areas and in developing countries most older persons live in multigerational households. These situations imply that policy actions will be different in developing and developed countries. 

For developing countries in particular, where a majority of the world's older persons already live, the implications for future sustainable development are acute. It is therefore important to fully implement the outcome of all major United Nations conferences and summits, including the outcome of the Millennium Summit and millennium development goals, and the recently convened International Conference on Financing for Development. In doing so, we will enable older persons to contribute fully and to benefit equally from development.
These conferences aim, among others, to eradicate poverty, to create employment opportunities for young and old alike and to strengthen the social integration of all countries. 

Therefore, it is important to integrate the evolving process of global ageing within the larger process of development and that the new international plan should reflect and projected demographic shifts. The advancing of health, social welfare and supportive environment for older persons are priority areas for the promotion on the status of ageing. Given the complexity of the issue and the multiple factors existing within each of our respective societies, including demographic differences, traditions and culture, implementation of the Plan will need to be flexible and adaptive. 

Mr. President,

Turning to my country, in Indonesia the older persons contribute to 7.4 percent of the total population of 203,456,000 people or around 15 million. It is predicted that by 2010 population of ageing will increase to 9.58 percent, and it will make up to 11.20 percent in 2020.
Although the segment of the elderly population is relatively small, with the larger group being young people, Indonesia has to cope with many traditional and new challenges related to the increasing number of older persons. The Government of Indonesia has been endeavoring its utmost to perfectly plan for social security for the elderly while also grapping the immediate needs of the younger generation. 

Additional particular social burden, which should be coped with related to the elderly in Indonesia, were the lower level of education and social welfare of older persons, decreasing job productivity due to various chronic and degenerative illness, poverty, neglected older persons and disability of the elderly. The changes of social value, in particular pertaining to changing vision of the society from extended family to nucleus family, has brought about the need to review policy towards securing the social life of older persons in their community. 

Since the adoption of International Plan of Action in Ageing, the Government of Indonesia since 1980's had taken initiatives in the field of health services and social welfare for the elderly by empowering community participation on the promotion of older persons. The first provision was established through formulating Coordinating Minister for People's Welfare Decree No: 15/1993, which ordered Minister for Social Affairs to promote the status of older persons. Indonesia also supported UN-Resolution No. 045/026 in 1991 on declaration that October lst to be the International Day for the Elderly, and followed up by declaring May 29`" as National Day for the Elderly. 

Indeed, the Government of Indonesia has reiterated its commitments to ensure that the elderly should benefit equally from our national development. The National Guidelines of State Policy stipulates that older persons be accorded a high degree of respect and their long-life of experiences can contribute to their own community and to national development. In order to ensure the implementation on the promotion of the status of older persons, the Government has also enacted Law No. 13/ 1998 on Welfare for the Elderly. Under that Law, various national programmes have been conducted which are consisted of areas on social welfare, health services, social assistance and social security. Such measures were aimed to prolong the life expectancy and reproduction period, to promote the independency and social welfare of the elderly, as well as to preserve cultural value of "three generation in one roof". 

In order to enhance the socio economic welfare for the elderly, the implemented programs be conducted by cross sections government activities'to promote health, social condition, infrastructure and facilities, and job opportunities for the elderly. The Government of Indonesia is commitced to promote the role of civil society and nongovernmental organization to actively involve on programmes for the elderly. The existing participatory role of civil society has in particular been exercised on effort to strengthening the social agencies, family and community based services. Meanwhile specific health programs for the elderly have been implemented, among others by     establishing integrated geriatric services in hospitals and Community Health Services (PUSKESMAS). In addition, the recent National Conference on Gerontology in February 2002 recommends the need to enhance the healthy ageing Program for the poor. The Government of Indonesia has also formulated provisions on social assistance and social security especially for the neglected older persons by developing specific Social Security Gotong Royong, through empowering the potential traditional values of the community in promoting and  protecting the status of the elderly. 

At this opportunity, I would like to share with you, Mr. President, that the economic crisis that beset Indonesia in 1997 severely restricts our ability to implement national policies and programs on the promotion of the status of the elderly in Indonesia. Nevertheless, the Government of Indonesia formulated National Plan of Action for Elderly Welfare in 2000, which constitutes the need of unifying vision and mission among the stakeholders including the elderly, in this daunting task to enhance the well being of older persons. Our challenge is also related to the implementation of regional autonomy, whereby the government should work harder to advocate the provincial and local administration in order to sustain the programs. 

Mr. President, 
 I will say that we remain committed to pursue effective policies and programmes for older persons that are consistent with a society for all ages and within the framework of the new plan of action. In our culture older persons have always been accorded a high degree of respects and deference. Our challenge is therefore to also ensure that cultural attitudes do not become threatened by the vagaries of macroeconomics or the negative impact of globalization, while moving further along in ensuring that older persons fully enjoy independence, participation, care, self-fulfillment and dignity. That can only be achieve if we are able to put adequate structures and foundation in place early, while at the same time integrating our ageing programs into the overall process of our national development. At the same spirit, international financial institutions and regional development banks can contribute by recognizing all the persons as a development resource, as well as vulnerable group needing support. 

To conclude, Mr. President, let me again underline the dilemma faced by developing countries, lacking in social insurance and security systems, relying heavily on family support structures, and having to implement programs within limited means. The developing countries need to draw support from a friendly global environment, as exhibited by a fulfillment of commitments made at various international development conferences. This includes increased international cooperation such as technical assistance to build national capacity, the provision of financial assistance and international trust fund. Let there be no doubt that we are committed to the notion that older persons are not merely a vulnerable group that must be protected. They are a vital resource possessing a life-long wealth of knowledge and life-long experiences that can contribute to their own and to national development. We require collective approach to meeting the need of older persons and addressing the ageing of global population, and therefore the International Plan of Action adopted in this Assembly should explicitly address commitments to assist developing countries.