To improve the well-being of older people in Asia, HelpAge International and HelpAge Cambodia are piloting an Older People’s Association (OPA) model in Bangladesh, Cambodia, and Indonesia. These multifunctional community-based organisations mobilise older people to improve their own lives and contribute to community development across several domains including health and social welfare. Health-related activities include health check-ups and referrals, health education, and financial and social support. This research aimed to identify strategies for appropriate integration of health and care activities of OPAs into health and social welfare systems in Cambodia.
Using secondary data sources, phase one of this research identified that Cambodia is experiencing an ageing population, with older people facing vulnerabilities due to social and geographic isolation, poverty, and lack of access to clean water and sanitation. Data sources showed that older people also face an increased burden from non-communicable diseases (NCDs), with high rates of disability also reported in some observational studies. While policies such as the National Population Policy (of which the National Ageing Policy falls under), National Health Care Policy and Strategy for Older People and National Multisectoral Action Plan for the Prevention and Control of Noncommunicable Diseases have been implemented to address Cambodia’s ageing population and increasing burden of NCDs, lack of social security for older people remains an area for increased action. Despite improvements in recent years, Cambodia’s health system faces inadequate service coverage and quality issues with high OOP payments and low access to health insurance representing barriers to universal health care (UHC).
Using focus group discussions and key informant interviews with OPA stakeholders in Cambodia, phase two of this research identified that OPAs addressed their members' health concerns by providing health education sessions, home visits, transportation, health check-ups, and referrals. OPAs sometimes collaborated with local health centres to deliver these activities, which provide a useful model for OPAs to integrate with the health system at commune level. While the research found that OPAs assist members to obtain ID Poor cards, this concession was not entirely suitable for older people. Participants called for a Senior Citizen Equity card that aligned with the unique health and social vulnerabilities of older people. Recommendations of the research included strengthening collaborations between OPAs and health practitioners to increase health education and health check-ups, and increased advocacy for older people’s allowances, prioritisation in vaccinations and services for NCDs. These findings demonstrate that OPAs could be an appropriate model for addressing older people's health concerns in Cambodia and other low-income countries in Asia.