FOR PARTICIPANTS ONLY ESID/SPAG/CS5 25 July 2007 UNITED NATIONS ECONOMIC AND SOCIAL COMMISSION FOR ASIA AND THE PACIFIC UNITED NATIONS POPULATION FUND UNITED NATIONS DEPARTMENT OF ECONOMIC AND SOCIAL AFFAIRS Seminar on the Social, Health and Economic Consequences of Population Ageing in the Context of Changing Families 25-27 July 2007 Bangkok COUNTRY STATEMENT MONGOLIA
UNITED NATIONS ECONOMIC AND SOCIAL COMMISSION FOR ASIA AND THE PACIFIC UNITED NATIONS POPULATION FUND UNITED NATIONS DEPARTMENT OF ECONOMIC AND SOCIAL AFFAIRS MONGOLIA Country report for Seminar on the Social, Health and Economic Consequences of Population Ageing in the Context of Changing Families 25-27 July 2007 Bangkok POPULATION AGEING IN MONGOLIA GOVERNMENT POLICIES ON POPULATION AGEING AND CHALLENGES BY: MUNKHZUL ZANDANKHUU Officer Population Development and Social Security Policy Coordination Department MINISTRY OF SOCIAL WELFARE AND LABOUR OF MONGOLIA
First of all I would like to express my sincere gratitude for warm welcome and hospitality in your beautiful country. I am pleased that we are here to discuss on seminar on the Social, Health and Economic Consequences of Population Ageing in the Context of Changing Families. I would like to introduce you Mongolian elderly situation under government ageing and social protection support policy that implemented in last a few years. Mongolia is situated in central part of Asia, bordering with Russia and China. Territory of it-more than 1.5 million km 2, and there are inhabited 2.6 million inhabitants. A conservative estimate projects a total population by of 3.2 million by the year 2020. Mongolian population growth has slowed down falling from an average of 2.6% in 1989 to 1.4 in 2000. Population projections of Mongolia which is based on the Population and Houseing census, 2000 is published by National Statistical Office in 2002. According to the population projections number of the 60 aged and over population will be doubled in the next 20 years. The elderly sex comparison will be 83.4 by 2025. At the end of 2006, total resident population is 2.6 million and the population aged 60 and over is 160.9 thousand or 6.2% of total population. The life expectancy is 65.8. Mongolia has a very young age structure compared to other countries in the world. But in the next 20 years, age structure will be changed significantly. Reasons for changes in age structure are mortality decrease from1950s, fertility decline from 1970s.
Number of persons aged 60 and over, 1979-2025 350 300 250 60-64 65-69 70-74 75+ 46.4 51.6 53.6 мян.хүн 200 150 100 50 0 37.6 96.9 38.2 26.9 33.5 37.4 63.3 30.3 23.5 28.7 26.3 27.5 20.2 45.0 22.8 22.5 37.5 45.4 145.3 35.4 32.8 31.5 107.2 70.7 36.7 36.2 42.3 50.6 50.7 1979 1989 2000 2005 2010 2015 2020 2025 Recourse: Population projection of Mongolia,2002 National policy and programs on elderly Within the framework of implementation of the Madrid International Strategy on Ageing and Shanhai Regional Strategy on Ageing, in April of 2004 the Parliament of Mongolia has approved State Policy of Mongolia on Population Development. The State policies on ageing that will be implemented until 2015 are reflected on this strategic paper. In accordance with the above policy paper, the followings are provided and it is in implementing stage. An environment will be created for elders to be active members of the society, and enjoy with a meaningful life along with their interest hence improving their quality of life. A policy will be pursued to develop rehabilitation and geriatric services to protect elderly people from pre-mature ageing and promote the healthy ageing. Quality and access of heath services for elders will be improved and sustainability will be ensured. Elders will be involved in lifetime training and re-training programs and their participation in economic and social lives will be expanded as a result of promoting employment, which is affordable to their capability, interest and needs. It will be encouraged whereby the elders pass their knowledge, skills and work experience to children and youth.
The holistic approach will be used to improve the type, quality and access of social services aimed at assisting elders, their active life all the initiatives made in this field by civil society, NGOs and establishments will be encouraged and promoted. In 1998, the National Program on Health and Social Protection of Elderly was adopted by the government of Mongolia, and updated in 2003, with a core goals of improving quality of life and creating healthy and favorable environment for ensuring older people s active participation in social life, through improving health and social protection for them. Besides, the thematic and random surveys were conducted on the health and social protection of elderly. The government of Mongolia is implementing the laws, regulations and programs concerning elderly issues through reflecting its expenditure on the state central budget. It s considerable that the establishment of legal environment on elderly basically achieved at the moment, but on the other hand, we do not assume that the elderly issues are fully resolved and there are many undetermined confronting issues further. Health and care service for elderly Health issue of elderly is still remaining to be one of vitals of state policy and /attaching/ giving more attention to the health promotion of elderly and improvement of health services for them. According to the Law on health insurance for citizen, individuals without any cash income except pension shall be compulsory insured by health insurance and the state/government/ shall cover their contribution payments. Moreover, rehabilitation wards and units for elderly are working in each districts of city and each /aimag / province centers. Lately, varies kind of surveys on health and psychology of elderly were conducted and the survey result showed that 85.5% of the elderly responded that they have been suffering from one and more diseases, 53.5% are in uncongenial morale, 20.3% are sad, 17.4% are lonely. The most common diseases among elderly are blood pressure, followed by cardiovascular diseases, and problems with the digestive system, respiratory diseases, musculoskeletal system disorders and urine related diseases. Today the mortality is mainly caused by an old age diseases or cardiovascular diseases and cancer /tumor/ while its 60% were youth and children s disease and acute infectious diseases 50 years ago. For instance: 47.2% of total mortality is /happens/ among elderly people and it s particularly heedful issue of public health that the cardiovascular and cancers are determined to be one of mortality reasons of elderly aged above 55.
Prevailing diseases among the elders /2006/ 45 40 35 30 25 20 15 10 5 0 43.2 Diseases of circulatory 13.7 Digestive diseases 8.6 Diseases of musculoskeletal system Diseases of the genitourinary system 6.7 5.3 Diseases of the respiratory system Recourse: Report of MOH of Mongolia The issues improving and educating the health knowledge are vital to health promotion of elderly people. The provision of state care and assistance for elderly is vital to strengthen the healthiness of elderly people, but on the other hand, the community and family based services for elderly together with their own active inclusions should enable the possibilities to resolve crucial problems on the health and social services for elderly. Therefore we try to direct our action toward this approach. Duties of the family doctors and nurses are increasing by concentrating health services at the smallest health service units. However, the financial shortage, disadvantages in the health insurance system are cause to be a faulty performance of the medical institutions, especially of hospitals in rural area, affecting negatively to the quality and allotment of health services for population in remote rural area, especially for elderly people. Safety nutrition which is the basic guarantee to survive and live healthy is collapsing /get lost / in some way. It s being common that the customers take cheaper, with low quality and expired date of products due to the income rate, delivery system of the products and their choices and it affects their health badly. Housing, transportation and environment Housing issues of elderly also precedence cohesively with the housing supply of whole populations. However, housing situation of poor elderly, particularly the veterans were considered seriously by the government and construction work for their housing is also one of the challenges. Moreover issues to grant soft loans for improving their housing conditions and building new apartments are reflected in the legal acts. Also there are nursing houses for elderly who cannot live independently, single, who needs regular care and homeless old persons. However the actions for purchasing apartments and getting housing loans are still remaining insufficient.
In order to ensure active social participation of elderly, the elderly people are entitled to use public transport without any charge. Additionally, its considered to make the disabled friendly infrastructure changes, providing them with full and convenient travel access. Elders intervention in the Family The Mongolia has a tradition to live with their families from the early times, today more then 80% of our elders are living with their own families including their children and grandchildren. Therefore the members of the family, their children and relatives are taking care of them and provide with the materially and psychological /emotional/ support. Also the elders themselves, especially old women, have a significant responsibility in their family and their activities such as bringing up their grandchildren, helping in household works make great contribution into the society. The intensification of internal migration from rural to the urban area in the last a few years, specially the migration of youth with their families, is problems, which Mongolia is facing recent years. The elderly, whose children have moved to the cities, are usually left behind in countryside without support of family members. That is the issue in the center of our attention and it s required to take a set of measures regarding this issue. Social welfare and services Due to the transitional constraints and natural disaster, tendency to worsen people s living is still continuing where women, people with disability, elderly are more likely to be affected by the poverty. Especially, the consecutively occurring natural disasters like drought and zuds /winter disaster/ are recognized to be as main reason of that pushing rural population to the ranks of the poor and this circumstance negatively /heavily/ affect livelihoods of the elderly. Therefore the government of Mongolia is upholding /following/ the policy to expand the care services for elderly, especially for the single, poor with income below poverty line, disabled, and the veterans. According to the Law on benefits and services for elderly, they are entitled to receive varies kind of benefits and services including housing benefits, grant aid, free admission ticket of health resort or care homes, free domestic prothese for hearing and seeing and false teeth, legs and arms. The expenditure of all these services drawn up from the government. For instance, 15% of social welfare fund were spent for such benefits and services for elderly. Law on Social Security for elderly people updated in December 2005. In accordance with the above laws, the following social pension, benefits, allowances and services are provided for elderly poeple.
Social insurance pensions and benefits; Social welfare pensions; Conditional cash benefits; Assistance and discounts; Targeted nursing care services; Community based social welfare services; Expenditure on in-cash social welfare has been constantly increasing. The current system defines eligibility for in-cash social pensions, benefits and services strictly on the basis of certain exclusively defined categories or incidences according to the Law on Social welfare, Law on Social Benefits and Services for the Elderly and Law on Social Welfare for People with Disabilities. The objective of the Law is to identify ages for elderly, duties of entities, institutions and responsible people on social welfare of elderly and eligibility for and coverage of assistances and services rendered to the elderly. Education of Elderly According to the Constitution, Mongolian citizens are entitled to free basic education. Existing elderly have attained their education at least 30 years ago, which indicates that most of them have lower education or uneducated. Consequently, the education level of older people, particularly of older women is generally low. The older people of today were mainly working during the former society and they have faced psychological difficulties, caused by their life, affected by transition period of market economy. Thus, measures were taken in regard to train them in market economy life, to provide them with relevant information, to conduct advocacy on law and regulations, concerning the elderly and to involve them in various projects and programs. In these activities mass media is used broadly. Although Mongolia is considered with young population, the age structure has already started to change. Therefore, in other to successfully overcome the approaching difficulties, it is significant to take activities to educate the entire population of Mongolia in ageing and ensuring relevant preparatory activities. In 1999 Rehabilitation Center of Gerontology, responsible to conduct training and survey and provide with methodological advises on population ageing and health issues of older people in national level, was established. Additionally, the study on reflecting the ageing and health issues in curricula of all level of education, including secondary school, is in its process.
Issues on old age pension Nowadays, the main living source of Mongolian elderly is their pension. According to the Law on Social insurance, men and women, having attained 60 and 55 years old respectively, are getting retired and the social insurance coverage rate is comparatively high. By first quarter of 2007, the number of the retired is 201.3 thousand and the average pension provided from the Pension fund is 68.0 thousands tugrug / 58.4 $ /.According to the law on Pension and Benifits provided by Social Insurance fund, the minimum pension should be not less than 75 percent of the minimum wage. Also, due to the inflation rate in the economy the Government of Mongolia has taken several actions to increase nominal pension amounts. For instance, during 2005-2007, the Government has increased average pension by 75 percent. Summary of legislation on Pension Insurance Legal environments Law on pensions and Benefits Provided with Social Insurance Fund 1 Participation Mandatory for all employed person, and voluntary for all self -employed and herders 2 Retirement ages 60 for men and 55 for women who are not subject to any special early retirement rules 55 for men with 20 years of service, 12 of which in hazardous conditions 50 for women with 20 years of service, 10 of which in hazardous conditions 55 for men with 20 years of service, 10 of which underground or in high heat 50 for women with 20 years of service, 7 of which underground or in high heat 50 for women who have brought up 4 children. 3 Contribution Rate 4 5 Old age Pension For people born before 1960 Old age Pension For people born after 1960 7 Disability Pension 8 Pension indexation 9 Minimum pension 19% of wage from employer, and 10% of wage from employees. For people born after 1960, this rate is subsided into a 15% component, and a 4% component, The 15% rate is for the notional accounting system, and the 4% rate is for disability and survivor pension Pension = Pension base* service factor Pension Bas= Average of best 5 years of wages, with partial adjustment for inflation Service factor =45% for first 20 years, plus 1.5% for each additional year Pension = notional account balance / average life time at retirement Account balance = contribution accumulated; interest rate = wage growth Contribution = 15%of the total 19% are recorded in notional balance. For people born before 1960, the defined benefit formula for old age pensions is used. For people born after 1960, the disability pension is equal to 60% of the beneficiary s average wage over the three years preceding disability. In practice, pension increase are determined by parliament on an ad-hoc basis, although the law actually states that pension should be increased in relation to changes in the cost of living For people born before 1960, the minimum pension is 75 % of minimum wage. For people born after 1960, the minimum pension is 20% of the average economy-wide, plus an additional 0.5% of the average wage for each additional service year beyond 15.
Average years in pension In 2005: Average years in pension for male 13.3 yrs Average years in pension for female 15.3 yrs 2030 and onwards: Average years in pension for male 15.4 yrs Average years in pension for female 17.1 yrs. The current social insurance programs provide a solid foundation of Social Security for the Mongolian population. As the government has gained experience in operating these programs and in understanding the social impact of the change in economic structure, however, it has become clear that the current programs need to be improved. Needed improvements include further strengthening of the financial status of the pension program, more adequate benefits in a variety of circumstances, improved systems of social security for herders and other self employed workers, increased emphasis on prevention of occupational injuries and diseases, and encouraging more private sector participation in assuring social security. Retired older people are still taking an active participation in social life and possess opportunity and willingness to increase their income through employment. Thereupon, the Government has conducted survey and assessment on extension of working life and prolonging the retirement age and has taken the first steps in this regard. Income security and Employment of elderly To increase income of elderly Government policies are on promoting their employment and enabling them to be employed in appropriate jobs. The concerning issues were reflected in Labor Law of Mongolia, revised in 1999. For instance, the employment right of pensioners, the case of working pensioner s salary is should not be reduced and provision of reduced working hours and transferring to another suitable jobs considering the older people s request were legalized. The majority of employed elderly are self-employed and most of them are men, while women are involved without payment in family businesses. A large proportion of the Mongolian population relies on herding for their survival and older people in rural areas are more likely to be employees in private sector herding.
The opportunity to continue their work until age 60 for women, considering their willingness, was reflected in the related law and the matter of increasing the retirement age up to 62 for both men and women by gradually increasing is being considered. Moreover, issues, concerning re-qualification and involvement in training of related field of retired elderly, their provision with micro credit and support to establish small-scale enterprises and services through cooperation, are being taken into consideration. Cooperation Efforts made by the Government are not sufficient to solve every matter concerning the elderly. Therefore, it is substantial if the Government cooperates with national and international non-governmental organizations, private sectors, research institutions, public and international organizations. One of our significant goals in this era where the interconnection in the world becomes stronger is to get world commonwealth assistance in development of Mongolia and use them more appropriately. UN and other international organizations and donors carefully observing the economic situation of our country and have been supporting in relation to quality improvement of rural infrastructure, health and education, employment promotion and advancement of social protection system. Representatives of Government and non-government organizations of Mongolia have attended regional meetings and consultations and taken an active participation in implementation of programs and projects. The National program on health and social protection of elder people will be implemented until the year of 2008. It has a great impact on international relations development of elderly issues, that Mongolian Association of Elderly people, who involves the most of the country s older people, has joined the Help Age International. Moreover, the Government of Mongolia promotes establishment and initiatives of non-governmental organizations, which activates on population groups, by keeping close cooperation and providing them with financial assistance. CONCLUSION Although the demographic composition transition is being slowly in Mongolia, the future ageing issues will pose a multitude of complex social and economic challenges for families, societies, governments and civil society organizations alike. The Government of Mongolia is focusing to prepare for these socio-economic implications of ageing populations and to develop own country strategies and programs to meet the health, income, security, and other needs of the elderly.
Projections showed that pension expenditures would have far greater than could be supported by the income from contributions if the old system remained in effect. The annual pension fund deficit would grow continually if no changes were made in the program. Conduct research on the social and health impacts of aging in Mongolia and make necessary amendments on main social security and protection related Laws and regulations including Social Insurance and Social Welfare Laws. Improve the access to social and health services of elderly people in regards to epidemiological transition and disability happened commonly during this old age and strengthening the quality of services and set up necessary standards for such services. Provide technical and financial support to establish psycho-counseling and rehabilitation centers as well as self-support groups that could ensure effective collaboration of elderly people to support each other in preparing themselves to be ready to deal with aging problems, protect to become poor after the pension Improve the Government capacity to mainstream the aging issues into development policies and programs and integrate with existing efforts done by the Government, Civil Society and Private sector. Thank you for your attentions.