The elderly in Nepal have traditionally been able to count on family support. But, as more older people live longer the financial burden on families has increased. Nepal’s average life span has increased from 35 for men and 37 for women in 1961, to 69 for men and 72 for women in 2014. By 2018, there were nearly 3 million people over 60 in Nepal. Family fragmentation has also resulted in physical separation between older grandparents and their children and grandchildren.
Consequently, even back in Nepal, more elderly men and women are living apart from their closest family members than ever before. Many are now suffering from the same problems as do those settled in the UK, but without pensions, allowances, and access to free medical services.
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There are relatively few specialised institutions for support and care of the elderly in Nepal. The Gurkha Welfare Trust cares for ex-Gurkhas and their families with Welfare Pensions to veterans and widows and medical treatment. But there are very few examples in Nepal of private ‘care homes’ and ‘retirement villages’ that exist in the UK.
There is now some state support, but it remains pitifully limited. The non-contributory social pension scheme introduced in 1995 was intended to provide allowances to older people aged 70 and above, to older dalits and people living in the Karnali Zone aged 60 and above, and to poor widows aged 60 and above. The allowance was doubled to, Rs2000 and the age of eligibility reduced to 65, but scheme remains inadequately implemented.
It is estimated by Pension Watch (Help Age International) that the number of people receiving an allowance is around 636,000, and 47% over 65 in Nepal receive a non-contributory pension, while 9% have a contributory pension. The total cost of the scheme is Rs15 billion, or 0.7% of GDP. By 2050, when the estimated number of Nepalis over 60 will be around 6.5 million, the cost will have more than doubled even if the same proportion of the budget is allocated to the scheme.
Last year, Prime Minister Oli proposed a social security scheme for private sector employees to provide for life-long pensions and reduce the fiscal burden by demanding that employers deposit 31% of the basic salary (20% from employers and 11% from employees) into a Social Security Fund. After 15 years, private sector employees would then be entitled to lifelong pensions, just like retired government employees.
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But even were this scheme to be introduced, it would still leave out millions working in the informal sector and agriculture, and would be too late for those already of pensionable age.
The Nepal government spends 6% of its budget on basic health care and in 2012, launched a pilot program for universal health insurance in five districts. This was followed up in 2017 by the National Health Insurance Act and in 2018 by the National Health Institution Quality Authority Act, providing the legal framework for a National Health Service.
Although Nepal’s 2015 Constitution guarantees basic health care as a fundamental right, however, access to high-quality care remains a privilege, and out of reach of most including elderly Nepalis who may want to come back home.