NATIONAL PROGRAMME FOR HEALTH CARE OF THE ELDERLY (NPHCE)

As per 2001 census in India approximately 7.593 cr. Population is over the age of 60 years. Elderly peoples have tripled in last 50 years in India and will relentlessly increase in near future. In 2001, the proportion of older people was 7.7% which will increase to 8.14% in 2011 and 8.94% in 2016. Hence, Govt. of India has initiated National Programme for Health Care of the Elderly (NPHCE) with 80% Central Govt. and 20% State Govt. financial share.
The population ageing represents an unprecedented global demographic transformation and this is expected to intensify as the twenty-first century progresses. In 2011 census, the 60+ population formed 8.6% of India’s population, accounting for 103 million elderly people. Growing at around 3% annually, the number of elderly of age 60+ will rise to 319 million in 2050. The demographic changes of population ageing will pose complex health, social and economic challenges to which our country must rapidly respond.

Specific Objectives:

• To provide an easy access to promotional, preventive, curative and rehabilitative services to the elderly through community based primary health care approach.
• To identify health problems in the elderly and provide appropriate health interventions in the community with a strong referral backup support.
• To build capacity of the medical and paramedical professionals as well as the care-takers within the family for providing health care to the elderly.
• To provide referral services to the elderly patients through district hospitals, regional medical institutions.

Core Strategies to achieve the Objectives of the Programme are:

• Community based primary health care approach including domiciliary visits by trained health care workers.
• Dedicated services at PHC/CHC level including provision of machinery, equipment, training, additional human resources (CHC), IEC, etc.
• Dedicated facilities at District Hospital with 10-bedded wards, additional human resources, machinery & equipment, consumables & drugs, training and IEC.
• Strengthening of 8 Regional Medical Institutes to provide dedicated tertiary level medical facilities for the Elderly, introducing PG courses in Geriatric Medicine, and in-service training of health personnel at all levels.
• Information, Education & Communication (IEC) using mass media, folk media and other communication channels to reach out to the target community.
• Continuous monitoring and independent evaluation of the Programme and research in Geriatrics and implementation of NPHCE.

Core Strategies to achieve the Objectives of the Programme are:

Sr. No	Year	Number of the District	Name of the District
1	2010-11	6	Amravati, Bhandara, Chandrapur, gadchiroli, Wardha, Washim
2	2015-16	7	Nandurbar, Osmanabad, Parbhani, Sindhudurg, Nashik, Jalna And Nanded
3	2017-18	15	Akola, Yavatmal, Ahmednagar, Aurangabad, Beed, Buldhana, Dhule, Gondiya, Hingoli, Kolhapur, Latur, Raigad, Satara, Pune, Ratnagiri.
4	2018-19	6	Thane, Jalgaon, Nagpur, Solapur, Sangli, Palghar.

Regional Geriatric Centre:

Grant Medical College is selected as the regional Geriatric Centre for Maharashtra, Goa, and North Karnataka. Following facilities are to be made available at this centre:

• Tertiary health care to the cases referred from medical colleges, district hospitals, and below.
• Specialized OPD for the Elderly.
• 30-bedded Geriatric Ward for in-patient care and dedicated beds for the elderly patients in various specialties such as Surgery, Orthopedics, Psychiatry, Urology, Ophthalmology, Neurology, etc.
• Laboratory investigation required for elderly with a special sample collection centre in the OPD block.
• Introducing PG courses in Geriatric Medicine and in-service training of health personnel at all levels.

District Hospital:

Following facilities are available at the district hospital:

• Dedicated OPD services to the Elderly.
• Facilities for laboratory investigations for diagnosis and provision of medicines for geriatric medical and health problems.
• Ten-bedded Geriatric Ward for in-patient care of the Elderly (out of which in Washim district the infrastructure is constructed separately, and in other districts it is in process).
• Existing specialties like General Medicine, Orthopedics, Ophthalmology, ENT services, etc., will provide services needed by elderly patients.
• Provide services for the elderly patients referred by the CHCs/PHCs, etc.
• Conducting camps for Geriatric Services in PHCs/CHCs and other sites.
• Referral services for severe cases to tertiary level hospitals.

Community Health Centre:

Following facilities are made available at CHC:

• First Referral Unit (FRU) for the Elderly from PHCs and below.
• Geriatric Clinic for the elderly persons twice a week.
• Rehabilitation Unit for physiotherapy and counseling.
• Domiciliary visits by the rehabilitation worker for bed-ridden elderly and counseling of the family members on their home-based care.
• Health promotion and Prevention.
• Referral of difficult cases to District Hospital/higher health care facility.

Primary Health Centre:

Following facilities are made available at PHC:

• Weekly geriatric clinic run by a trained Medical Officer.
• Maintain record of the Elderly using standard format during their first visit.
• Conducting a routine health assessment of the elderly persons based on simple clinical examination relating to eye, BP, blood sugar, etc.
• Provision of medicines and proper advice on chronic ailments.
• Public awareness on promotional, preventive, and rehabilitative aspects of geriatrics during health and village sanitation day/camps.
• Referral for diseases needing further investigation and treatment, to Community Health Centre or the District Hospital as per need.

Sub-centre (SC):

Following facilities are to be made available at SC:

• Health Education related to healthy ageing.
• Domiciliary visits for attention and care to home-bound/bedridden elderly persons and provide training to the family care providers in looking after the disabled elderly persons.
• Arrange for suitable calipers and supportive devices from the PHC to the elderly disabled persons to make them ambulatory.
• Linkage with other support groups and day care centers, etc., operational in the area.

HR Status at District Level

Post	Sanction	Filled	Vacant
Medical Officer / Physician	34	14	22
GNM	82	72	10
Physiotherapy	17	13	4
Multi Rehabilitation Worker	20	19	1

Physical Performance

S.No.	Care Services provided	2022-23	2023-24	2024-25 (December 2024)
1	Elderly persons attended OPD	702749	422912	934085
2	Cases admitted in wards	33327	24778	63088
3	Persons given rehabilitation services	20669	13395	46711
4	Lab. tests performed on elderly	327152	188974	581552
5	Elderly persons provided home based care	4081	4137	14999

Financial Performance

Sr.No	Year	Approved PIP	Expenditure	Percentage
1	2022 – 2023	307.30	51.59	16.79
2	2023 – 2024	313.30	194.65	62.13
3	2024 – 2025	220.06	97.90	44.48

Beneficiary:

as mentioned above

Benefits:

as mentioned above