| Table of contents |
Executive Summary .......................................................................................................................................i
1. DEMOGRAPHIC TRENDS, THE PROFILE OF OLD PEOPLE, AND THE EMERGING
ISSUES .........................................................................................................................................................1
A. Demographic trends.........................................................................................................................2
B. Socio-economic characteristics of old people..................................................................................6
C. Emerging issues ...............................................................................................................................9
Annex 1.1: Description of the World Bank 2006 Sri Lanka Aging Survey ...........................................11
2. INFORMAL SUPPORT SYSTEMS.............................................................................................13
A. Living arrangements ......................................................................................................................13
B. Intergenerational transfers (cash and in-kind) ...............................................................................17
C. Respect and authority within household and society .....................................................................23
D. Expectations of future support .......................................................................................................25
E. Formal care for the Elderly ............................................................................................................27
F. Policy Recommendations...............................................................................................................29
Annex 2.1: Tables...................................................................................................................................32
3. INCOME SUPPORT PROGRAMS FOR OLD AGE ...................................................................40
A. Assessment of current system........................................................................................................40
B. An integrated approach to pension policy......................................................................................51
Annex 3.1: Tables...................................................................................................................................64
4. HEALTH STATUS, PUBLIC HEALTH, AND HEALTH CARE OF OLD PEOPLE ................67
A. What are the prospects for healthy aging? .....................................................................................67
B. How accessible and adequate are the healthcare ...........................................................................72
services for the elderly?..........................................................................................................................72
C. What are the prospects for sustainable healthcare financing? .......................................................82
D. How should the health system respond?........................................................................................87
Annex 4.1: Regression results ................................................................................................................91
Annex 4.2: The IHP Health Expenditure Projection Model...................................................................94
5. LABOR MARKET AND POPULATION AGING.......................................................................97
A. Labor force projections: shrinking of the labor supply after 2030.................................................97
B. Working in old age ........................................................................................................................99
C. Determinants of work activity of old workers .............................................................................108
D. Obstacles for employment of old workers ...................................................................................109
E. Concluding remarks and policy recommendations......................................................................112
Annex 5.1: Tables.................................................................................................................................114
REFERENCES .........................................................................................................................................120 |
