The Potential Role of Social Quality in an Ageing Malaysian Society

1
The Potential Role of Social Quality in an Ageing
Malaysian Society

• Sharifah Norazizan Syed Abd Rashid, PhD
• Institute of Gerontology
• Universiti Putra Malaysia
• MALAYSIA
• sharifah_at_putra.upm.edu.my

2
Outline of Presentation

• Aim of Presentation
• Profile of Malaysias Ageing Population-the
  Context
• Policy Responses and achievements
• Assessing the availability of social quality
  indicators in Malaysia based on the European SQ
  Network
• Limitations of SQ framework in the Malaysian
  context

3
Profile of Malaysias Ageing Population

• Basic Features
• Ageing of the older population (OP)
• Malaysia will be aged in the year 2035 when
  the proportion of persons aged 60 years and over
  reaches the 15 mark.
• Feminization of Ageing and Poverty Double
  jeopardy
• The sex ratio for the OPs dropped from 108.4
  (1970) to 88.3 (2000)
• Ethnic Variations in ageing
• Ageing is serious among the chinese. In 2020,
  14.4 chinese will be elderly, Malays (7.9),
  Indians (10.4).

4
Cont

• Higher Degree of Rural Ageing
• Ageing is more pronounced in rural areas
  because of migration. In 1991, rate of growth
  of ageing population in rural areas (6.5) and
  urban areas (5.3). Implications on facilities
  and services?
• The old-old is increasing
• In 2020, the old-old (those aged 75) is
  expected to increase.
• Explosive growth of older persons in absolute
  numbers pose greater demands on state resources
  especially the poorer states. Can these states
  cope with the rising demands?

5
Cont

• Speed of ageing
• In 2005 (7 OPs) and in 2028 (14 OPs)
• Doubled aged population in only 23 years
• Fast speed of ageing poses serious problems
  because Malaysia is becoming old before she is
  rich!
• Dependency Ratios (DR)
• Increase in youth DR and a decrease in old age
  DR ie from 10.5 (1970) to 15.7 (2020)
• Declining support ratio indicates declining
  tax base

6
The Evolving Scenario and the Challenges

• Challenges Social Areas
  (Family)
• Facts
• The Malaysian 1994 Population Family Survey shows
  that nuclear families form majority of households
  (60).
• Co residence between adult children and their
  ageing parents might no longer be a norm
  implies the need to plan for ageing in place and
  care in the community
• More older women are staying alone effects of
  the feminization of old age (Women living alone)

7
Cont

• Late marriages
• Family shrinking in size
• Intergenerational transfer patterns in Malaysia
  is still very much a traditional structure, with
  strong emphasis on sons over daughters and the
  centrality of children in social support. This
  however will not last due to changing family
  structures and norms.
• The change in living arrangements and the
  dependence of older persons implications on the
  social support

8
Challenges - Economics

• Many do not have pensions or employee provident
  funds.
• Issues of dependency and income adequacy in old
  age are important to protect the well being of
  older persons.
• The need to work to address income adequacy among
  the OP (currently, in 2000, 22.8 are employed)

9
Financial Security

• Malaysia has several security programs
  for various types of workers, and the two main
  programs are
• Employees Provident Fund (EPF) a mandatory
  retirement savings scheme for the private sector,
  permitting pre-retirement withdrawals for
  housing and health care.computers too.
• Pension Scheme a non contributory social
  security scheme for govt employees. Designed for
  security for old age. After 10 years of service,
  gratuity benefits can be withdrawn and then
  frozen until retirement. Government pensions are
  taxable if taken at age 50 but not 56.

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Income Provisions for Elderly Malaysians

• Caraher, K. (2000, p.2) concluded
• 1.Lump sum payments do not represent the best
  option for income security into old age
• 2.Increased accessibility to funds prior to
  retirement, through dedicated separate accounts,
  lessens the ability of the EPF to act as a
  reliable source of income for the elderly
• 3.Current arrangements are inadequate to meet the
  needs of an increasingly elderly population and
  thus leaves them more vulnerable to the socially
  exclusive aspects of poverty in old age

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Aged income security

• Majority of aged are not employed in the formal
  sector and need some form of income security in
  old age
• Dependent on children, but children may not be
  available
• How much is adequate?
• Many are living in poverty
• No scheme to help the informal sector aged

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Challenges - Social care

• Care of the old-old
• Social capital
• Community care
• Availability of family members
• Housing alternatives
• Integrated care

13
Challenges - Health care

• Cost of care
• Readiness of care system to adapt to change
• Long term care
• Care of the old-old
• Disability free life expectancy

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Other Challenges - some example

• Social inclusion versus exclusion
• Home bound among the OPs
• Lack of involvement and participation
• Accessibility
• Empowerment

15
Policy Response

• Social Policy (SP)
• Social Welfare Policy (SWP)
• National Policy for the Elderly (NPE)

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Social Policy in Malaysia

• Evolved within the context of political and
  economic stability and have remained integral
  components of overall national development
  strategies
• 1969 ethnic unrest has led to the adoption of a
  new development policy incorporating growth with
  equity which had an impact on social policy.
• The new development policy (in 1970) was cemented
  in the form of the New Economic Policy (NEP) with
  the goal to achieve national unity and not
  economic growth.
• NEP incorporated two prong strategies ie firstly
  the eradication of poverty, and secondly the
  restructuring of Malaysian society irrespective
  of race

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Features of Social Policy in Malaysia

• A conducive environment of economic and political
  stability
• A strong government and a public sector committed
  to improve the welfare and well being of all
  Malaysians and of particular groups of people ie
  the women, youth, children, elderly, disabled and
  ethnic minorities.
• Incorporates objectives and strategies that
  address a number of social concerns and problems
  which include health, education, training,
  housing, unemployment, poverty and income
  disparity, ethnic and community relations and
  family violence.

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Table 1 Welfare Regimes in East Asia Summary
Indicators
Korea Malaysia Thailand Philippins Indonesi Av
State Social Spending/GDP 11.0 8.2 5.9 6.0 3.1 6.8
Market Private finance in health and education as a percentage 5 36 53 66 58 53
Household Private transfers income 4 11 - 12 10 9
Welfare Outcomes HDI Poverty rate Gini index of inequality .85 - .36 .77 22 .8 .5 2 .6 .7 63 .3 .68 50 .37 .76 40 .42
Basic data Population (m) Income 000 46 12.3 22 7.0 61 5.8 75 3.5 204 2.8 408 6.2
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Where Malaysia stands

• Malaysia allocated 8 of its total spending on
  education, health and social security
• Malaysia is one of the best performers in access
  to basic and preventive health care
• Roemer (1991) classified Malaysian health care
  systems as welfare oriented
• Malaysia recorded very high (11) on level of
  saving
• Strong state provisions and investments largely
  in primary education and basic health services
• Social protection is minimal
• Family transfers and provisions remain crucial

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A Summary of Indicators for Social Policy
Public Expenditure GDP Total government revenue Total government expenditure Education, Health Social security Total education, health, social security Total social services total government expenditure
Education Net enrollment ratio Secondary Tertiary Av years of study
Health care systems National Health service Rural health service Provident fund (EPF account 3)
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A Summary of Indicators for Social Policy
Health Under 5 mortality rate Life expectancy (yrs) at birth (male,female) Maternal mortality rate per 1000 Doctors/1000 pop Nurses/1000 pop Hospital beds/1000 pop
Retirement Programmes Social assistance programme EPF Civil servants and company schemes (lump sums)
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A Summary of Indicators for Social Policy
Household transfers households receiving private transfers Average of income of receiving households Persons over 60 yearsliving with children or family ()
Poverty Incidence of poverty No of poor households (thousands) Incidence of hardcore poverty Total households (thousands)
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Social Policy a Summary

• Social Policy designed to serve a segment of
  groups or problem groups ie the older population,
  failing to create a social system with a
  sustainable welfare content
• In terms of the indicators used, the tendency to
  use objective indicators ie the usual official
  statistics
• The concerns of social policy are firstly to
  address the socio economic security of the
  population and secondly to address the issue
  about unity and equity. However, the indicators
  used are not addressing the latter.
• Social policy is subordinated to economics and
  the pursuit of economic growth.

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National Welfare Policy in Malaysia (NWP)

• In Malaysia, the term welfare often denotes
  state hand outs or charity.
• Formulated in 1990 with ultimate objectives of
  ensuring a secure and stable society in line with
  Malaysian 2020 to be a fully developed nation.
• Emphasises on enhancing well being and social
  stability and the establishment of a Caring
  Society
• The guiding principle of the policy is the
  attainment of self reliance and an equalization
  of opportunities for the less fortunate.

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Provisions made by the NWP

• Provide federal assistance schemes for the older
  persons (BOT)
• Complemented with state welfare or zakat money
• Maintains and supports 130 old folks homes and 9
  state run shelters, day care centers
• Tax relief in 1992 for adult offsprings for the
  medical expenses incurred by ageing parents
• The medical benefits enjoyed by civil servants
  are now extended to include their parents

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A Summary of the NWP

• Situation of the older persons is formally
  addressed by related govt agencies but its
  approach is still very welfare based
• The prevalent image of the elderly is one that of
  dependency, misery and vulnerability.

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National policy for the Elderly (NPE)

• Policy statement
• To ensure that the social status, dignity and
  well being of the elderly as members of the
  family, society and nation by enabling them to
  optimise their self potential, have access to all
  opportunities and have provision for their care
  and protection

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NPE Objectives

• To enhance the respect and dignity of the elderly
  in their family, society and nation
• To improve the potential of the elderly so that
  they continue to be active and productive in
  national development, and to create opportunities
  to assist them to continue to be self reliant
• Encourage the establishment and availability of
  specific facilities to ensure the care and
  protection of the elderly towards enhancing their
  well being

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Policy Analysis - Some Criticisms

• Absence of clear performance indicators in its
  action plan
• Most of the programs and activities are carried
  out in isolation and the usual departmental
  boundaries are highly visible
• The adoption of the Resolution 46/91 ie the UN
  principles for the older persons which was the
  catalyst to the NPE did not fundamentally changed
  the welfare oriented approach of the
  administration.
• Older persons are still regarded as passive
  recipients of social work rather than subjects of
  empowerment.
• NPE is a loose non interventive and low impact
  entity with a broad focus that is largely
  undirected.

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Assessing the Availability of Indicators of
Social Quality in Malaysia
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Socio Economic Security
Domains Sub Domains Social Indicators Social Indicators for Older Persons
Financial Resources Income Sufficiency Income Security - The average monthly consumption expenditure of household in Malaysia (RM1953 per month) - Food and non alcoholic beverages RM 393 - Clothing and footwear RM59 -Health RM27 -Housing, water, electricity, gas and other fuel RM430 (DOS, Household Exp Survey 2004/05) - Sources of own annual income of older persons - Expenditure and number of older persons receiving government allocation financial aid (Dept of Soc Welfare) - Intergenerational transfer - The total number of elderly aid recipients under the Elderly Support Scheme
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Domains Sub Domains Social Indicators Older Persons
Housing and the environment Housing security Housing conditions Environmental conditions (social and natural) -Proportion of people who have certainty of keeping their home (DOS) -Average number of person per occupied housing unit 4.7 Proportion of population living in houses with lack of functioning basic amenities (water, sanitation and energy) - of housing units with electricity 97.8 -Piped water -Living arrangements Av household size and rate of household types by stratum for urban and rural areas (DOSM) -Causes of falls among older persons in their home environment -Status of poverty from the perspectives of housing conditions (Housing Survey) Proportion of older persons living in houses without basic amenities
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Domains Sub domains Social Indicators Older Persons
-People affected by criminal offences per 10,000 inhabitants (6.2 cases) -Quality of the environment index 98.22 based on air, water quality and forested land) (DOS, Pop and Housing Census, Malaysian Quality of Life Survey)
Health and care Security of health provisions Health services Care services -Proportion of medical doctors per 10,000 inhabitants -Average distance to hospitals/health care centers/clinics (accessibility) (DOS, Pop and Housing Census, Malaysian Quality of Life Survey) - Functional status of older Malaysians (MOH) - distribution of main causes of death among older persons (MOH) -Accessibility to medical facilities (average distance) (MOH)
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Domain Sub Domain Social Indicators Indicators for the Older Persons
Work Employment security Working conditions -No of accidents (fatal and non fatal) at work per 10,000 employed persons -Mean hours worked in Malaysia Labour Force Survey Report 2004 - distribution of employed persons by occupation and age group (DOSM)-Employment status among older male and female
Education Security of education Quality of education -Proportion of pupils leaving school education without finishing compulsory education -Proportion of students who within a year of leaving school with or without certificate are able to find employment. - -tage education levels of Older persons (DOSM)
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Contd on education
-Workforce without formal education (4.7) -School participation rates and higher education participation rates -Percentage of population literate (Literacy rate 94)
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Indicators of Social Inclusion
Citizenship rights Constitutional/political rights -Proportion of residents with citizenship-Proportion having rights to vote in local elections and proportion exercising it.Based on census
Labour market Access to paid employment - distribution of labour force by age, sex, educational attainment - distributions of employed persons by age groups - distributions of unemployed persons by age group - distribution of employed persons by occupation and age groups - distribution of labour force by age, sex, educational attainment - distributions of employed persons by age groups - distributions of unemployed persons by age group - distribution of employed persons by occupation and age groups

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Indicators of Social Inclusion
Domains Sub Domains Social Indicators Indicators for Older Persons
Services Transport Education Health Services Civic/Cultural services -Proportion of population who have access to public transport system -Density of public transport system and road density -No of public sport facilities per 10,000 inhabitants -No of public, private civic and cultural facilities per 10,000 inhabitants some of the indicators overlapped in the socio economic security domain -Number and percentage per age group of older persons who have mental health problems-Total number of RSKs, daily care centers,

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Indicators of Social Cohesion
Domains Sub Domains Social Indicators Indicators for Older Persons
Social Networks Networks -Membership to political, voluntary, charitable organisations -membership or involvement in organizations/activities by age and sex -Types of voluntary work involvement by age, ethnicity and sex,
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Indicators of Social Empowerment
Domains Sub Domains Social Indicators Indicators for Older Persons
Knowledge base Application of knowledge Availability of knowledge - own PC - internet subscribers -No of internet users internet users per 100 inhabitants -Estimated PCs per 100 users (DOS, Malaysia) - own PC - internet subscribers -No of internet users internet users per 100 inhabitants -Estimated PCs per 100 users (DOS, Malaysia)
Personal relationships Provision of services supporting physical and social indepoendence - of national and local budget devoted to disabled people (mental and physical -Expenditure and number of older persons receiving government allocation financial aid (Dept of Soc Welfare)-Recipients of home-help service (Central Welfare Council Malaysia)
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National Policy for the Elderly A Summary

• Malaysia has 20 out of the 95 social quality
  indicators developed by the European Network on
  SQ for the various conditional factors. However,
  the score was lowest for the social inclusion,
  exclusion and empowerment factors.

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Limitations of the SQ Indicators for Malaysia

• Malaysia is a multi ethnic society and the SQ
  indicators developed have not taken this issue
  into account, thus presenting problems on issues
  like shared identities, norms and values.
• The Malaysian government is aware that resources
  are scarce and the respect and relationships
  between people and the environment is not
  reflected in the SQ indicators. This would
  contradict with the Malaysian Planning Doctrine
  which upholds the three relationships ie
  Relationships between Man and his Creator
  Relationships between Man and Man and lastly
  Relationships between Man and His Environment.

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contd

• Malaysia has always put the issue about
  integration and unity centerstage, but failed to
  develop indicators to measure this.
• Unity and integration in the Malaysian context
  can be achieved via economics ie by restructuring
  society irrespective of race.
• Indicators must move beyond the standard official
  statistics but to focus more on the four
  conditional factors of SQ.

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Contd

• The Governments quest to move beyond welfare
  oriented approach towards older persons will have
  implications on the potential role of the SQ
  approach in Malaysia.

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Conclusions

• SQ framework is timely in Malaysia to address the
  issue of persistent inequality and to address the
  four conditional factors.
• There is the need to develop SQ indicators to
  suit Malaysian socio cultural context.

45
Thank You
For your kind attention