South Africa: Funding Elder Care in South Africa

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South Africa: Funding Elder Care in South Africa
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The primary concern with current spending at community level is that very few older persons benefit, and then only the very frail, with inconsistent reach across provinces. There is very little support for older persons who have high care needs and are at home, nor for active older persons.

How do we support elder care in South Africa, and how do we ensure equitable care for all our elders? Two reports recently published by the Family Caregiving of Older Persons in Southern Africa Programme outline how funding for elder care is structured and changing in South Africa, and the related experiences of older persons, caregivers, as well as careworkers.

"Our investigation therefore looked at DSD spending, while remaining cognisant of the fact that the Department of Health also funds programmes and provides services to older persons," Dr Moore added.The Funding Elder Care in South Africa report, released on International Day for Older Persons on 1 October, seeks to provide an overview of spending on the country's older persons over the past two decades.

It has also not been adequately linked to inflation. While spending per person, adjusted for inflation, is 5% higher in 2022/2023 compared to 2006/2007, provincial funding has decreased by 13% during the same period. Spending on community-level care, which includes both community-based services and residential care homes, increased from R460 million to R1.6 billion during the review period, representing a 13% decrease in funding when adjusted for inflation and increased numbers of older persons.

The report also revealed vast regional disparities in provision of community-based and residential care. Some provinces also receive significantly more funding than others. For example, the Western Cape receives R259.5 million in funding, and KwaZulu-Natal only about R181 million, even though the latter is home to more older people. The funding is based on the number and reach of care services that meet DSD operational requirements, and on the number of people assisted.

"It's challenging because when I'm not home, I'm always worried about her and I have to come back as soon as possible."

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