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Studies on the association between population ageing and health spending are inconclusive. Though per capita health spending has a strong age gradient, evidence from the developed countries attributes increasing health expenditure to high spending in terminal year of life. In India, though studies have examined the level, trends and determinants of health care spending, no attempt has been made on association of population ageing and per capita health spending across the districts of India. The objective of this paper was to examine the spatial dependencies and heterogeneities of population ageing and per capita health spending across 640 districts of India. Data from the Census of India (2011) and the consumption expenditure rounds of the National Sample Survey Organisation (NSSO) (2009–10 and 2011–2012) were used in the analysis. Univariate and bivariate LISA analysis, ordinary least square regression, and spatial error model were used to decipher the spatial pattern of population ageing and health spending in the districts of India. Results suggest that per capita health expenditure is positively associated with the proportion of the older adults (aged 60 years and above) in the districts of India. Districts with less than 5% older adults have an annual per capita health expenditure of ₹629 compared to ₹2432 in districts with older adults 12% or more. Districts of India also exhibit large spatial heterogeneity in household health spending. Bivariate Moran's I statistic of proportion of older adults and per capita annual health expenditure was 0.48, suggesting spatially association of the share of the older adults and the per capita annual health expenditure in India. Results of the spatial error model confirmed that share of urban population, mean wealth score, and mean household size are significant predictors of per capita annual health expenditure in India. This study is important to monitor the progress of universal health coverage across the disadvantaged districts and to integrate age component in universal health coverage programmes. [ABSTRACT FROM AUTHOR]

With the decline of the joint family system, middle class older adults in urban India are increasingly relying on the Self-Care approach as later-life care arrangements. In particular, these older adults are relying on the market for their everyday physical and emotional care needs. Applying the North American Successful Ageing model and the political economy and consumer culture of ageing framework, the present study highlights how the market is creating a new imagination of growing old in urban India. Additionally, through qualitative interviews, the study demonstrates how perceptions regarding the ageing body among middle class older adults in urban India are gradually transforming. Finally, the study indicates how with changing filial and intergenerational ties, familial care is being replaced by the market. [ABSTRACT FROM AUTHOR]

In rapidly ageing countries, increased life expectancies threaten the poor and low-income workers. India is such a country. The number of people over sixty will rise from the present 90 million to an expected 200 million by 2030. Giving the changing demography, family structure and settlements the need for pension products is increasing. This counts particular for women since they live longer and have less opportunities to create a pension by lack of formal labour force participation. This paper focuses on recent initiatives taken in India to analyze the improvement of the pension coverage and its capacity to prevent women's old age poverty. How can the low pension coverage in India - in particular for low-income female workers in the informal economy -, be increased? The research focuses on new pension schemes introduced by the Indian Government and new micropension provisions by grass root non-governmental organizations (NGOs) and microfinance institutes (MFIs). Results from the case-study show, that only about 6 % of the clients of the Dhan Foundation (NGO) stated to have access to pension. This is in line with the national statistics. The pilot initiative for a micro pension program of the Dhan Foundation, show a clear positive result in willingness to pay for micro pensions among their mostly female clientele To improve the low coverage rate, micropensions could be of significant added value in the so called 'multi-pillar approach' that recognizes the complementarities between the state pension, the private sector and the civil society sector pension plans. [ABSTRACT FROM AUTHOR]