2017年-世界发展银行全球_A_Human-Rights_Based_Approach_to_the_Economic_Security_of_Older_People_in_Moldova_124页_4mb

Summary of "A Human Rights-Based Approach to the Economic Security of Older People in Moldova"

Core Content

This report examines the economic security and well-being of older people in Moldova through a human rights-based approach, highlighting the challenges and opportunities related to aging in the context of the country's demographic and socioeconomic conditions. The study focuses on three key aspects of economic security: health, labor market engagement, and access to social protection.

Main Viewpoints

• Demographic Trends: Moldova is experiencing rapid aging due to low fertility, high net emigration, and low life expectancy. The population is projected to shrink by 29% by 2060, while the proportion of older people (aged 65+) is expected to triple.

• Economic Security: The economic security of the elderly is under threat due to a combination of health, labor market, and social protection challenges. Older people in rural areas are particularly vulnerable to poverty and have limited access to basic services.

• Human Rights Framework: The report emphasizes the importance of the right to health, the right to work, and the right to social security for older people. It calls for policies that ensure these rights are respected, protected, and fulfilled.

• Health Challenges: Moldova has one of the lowest life expectancies in the region. The elderly suffer from high morbidity and face significant barriers to accessing quality healthcare and medicines. The current health financing model is inefficient, with high out-of-pocket expenses and limited financial protection.

• Labor Market Issues: Older people are increasingly excluded from the labor market, with many working in low-productivity sectors such as agriculture. There is a need to promote employment among the elderly through education, skill development, and reform of social protection systems.

• Social Protection System: While most elderly are covered by the social protection system, the pension system is under strain due to a declining workforce and increasing dependency ratio. The system lacks sustainability and adequate financial support for the elderly.

Key Information

Demographic Patterns and Well-being of the Elderly

• Rapid Aging: Moldova's average age has increased significantly since the 1990s, with a faster rate than neighboring countries. By 2060, Moldova is expected to be as old as Belarus and the Russian Federation.

• Low Fertility: The total fertility rate in Moldova has dropped below the replacement level, with estimates suggesting it is among the lowest in the region. This has led to a shrinking population and a growing elderly population.

• High Emigration: Net emigration has played a significant role in the population decline. Young people, especially those of working age, are migrating abroad for employment, which exacerbates the aging process.

• Low Life Expectancy: Moldova has one of the lowest life expectancies in the region. This contributes to the challenges of maintaining an adequate standard of living for the elderly.

• Poverty Among the Elderly: Moldova is one of the few countries in the region where the elderly are poorer than the general population. Rural elderly are at higher risk of poverty and have less access to essential services.

Human Rights Perspective

• Right to Health: The elderly face significant health challenges, including chronic diseases. Access to healthcare is limited, and the current system does not provide adequate financial protection or timely care.

• Right to Work: The labor market is not supportive of older workers. There is a need for policies that promote employment and lifelong learning, as well as reforms to reduce disincentives to work.

• Right to Social Security: The social protection system is under strain, with a rising dependency ratio. Reforms are necessary to ensure the sustainability of the pension system and to provide adequate support for those not in the contributory system.

Healthy Aging

• Health Outcomes: Life expectancy for those aged 60 is significantly lower than the regional average. Chronic diseases are becoming more prevalent, and the health system is inefficient, with high out-of-pocket costs and limited access to quality services.

• Healthcare Access: The elderly have limited access to medicines and quality health services. This is compounded by low health awareness and poor service delivery.

• Health Financing: The current health financing model is inefficient, with high informal and formal out-of-pocket expenditures. This limits the financial protection available to the elderly.

Productive Aging

• Employment Trends: The share of older people in the labor market is declining. Many older workers are employed in low-productivity sectors, such as agriculture, while the economy is growing in more productive areas.

• Labor Market Barriers: There are significant barriers to employment for the elderly, including lack of relevant education and skills, social protection disincentives, and negative social attitudes.

• Policy Recommendations: To promote productive aging, the report suggests investing in lifelong learning, improving access to formal care facilities, and reducing disincentives to formal employment through policy reforms.

Secure Aging

• Social Protection Coverage: Most elderly are covered by the social protection system, but the system is under financial strain. Pensions are a primary income source, but the dependency ratio is rising.

• Pension System Challenges: The pension system is unsustainable without reform. It is essential to create a fiscally and socially sustainable pay-as-you-go system and to develop alternative support mechanisms for those not in the contributory system.

• Social Services: The delivery of in-kind services is inefficient. There is a need to improve the quality and accessibility of these services to support the elderly effectively.

Policy Implications

• Healthy Aging: Policies should focus on improving access to affordable and quality healthcare, increasing reimbursement rates for essential medicines, and promoting health awareness from an early age.

• Productive Aging: Encouraging older workers to remain in the labor market requires investment in education and skills, as well as reforms to reduce barriers to employment and promote formal participation.

• Secure Aging: Reforms to the social protection system, particularly the pension system, are necessary. It is also important to develop alternative support mechanisms for the elderly not covered by the contributory system.

• Cross-cutting Policies: There is a need for improved data collection, monitoring, and awareness campaigns to ensure the rights of the elderly are respected and protected.

Conclusion

The aging challenge in Moldova is severe and requires a comprehensive human rights-based approach to ensure economic security and well-being for older people. The report calls for policies that address the interlinked challenges of health, employment, and social protection to support the elderly in the current and future context of an aging population.