BACKGROUND: Implications for the Ageing Population and the Communities they live in

Health has been declared a fundamental human right. This implies that the state has a responsibility for the health of the people. National governments all over the world are striving to expand and improve their healthcare services. The present concern in both developed and developing countries is not only to cover the whole population with adequate health care services, but also to secure an acceptable level of Health for all, through the well delivered primary health care programs.

Currently there are a little over 100 million elderly in India and many of them have no means of support. As per the Planning Commission, India’s elderly (60+years) are projected to double to almost 198 million by 2020. An ageing population places a greater demand on the health services of the community. In a rapidly graying world, healthy aging is vital for countries and is a prerequisite for economic growth. The predicted explosion of non-communicable diseases such as cardiovascular diseases, cancer, and depression in the ever increasing number of older persons globally, will result in enormous human and social costs unless preventive action is taken.

This expected alteration of the age pyramid, thus poses significant new challenges for governments, societies, and families in the 21st century. Ageing developing countries are slated to face a heavy double burden of infectious and non-¬communicable diseases, yet they often lack significant resources, including comprehensive ageing policies, to cope. The modern philosophy is that the old must continue to take their share in the responsibilities and the enjoyment of the privileges, which are an essential feature of remaining an active member of the community. The World Health Organisation suggests that the socio-economic impact of ageing can only be addressed if countries, regions and international organisations enact “Active Ageing” policies and programmes that enhance the health, independence and productivity of older citizens.
In a developing country like India the situation is not favourable for its elderly population. 5% of the aged population report disability – loss of vision (52%), movement (27%), hearing (13%), mental disorders (5%) and speech (3%). About 30% of older persons live below the poverty line and another 33% just marginally over it. For a large number of older persons and the communities they live in, essential health-care and social support services are unavailable, inaccessible and/or unaffordable. For individuals to contribute to society, good health is a key facilitator. However, good health often reflects the degree of support one receives from society. It is therefore crucial to ensure that older persons and the communities they live in have every opportunity to remain active. Just as health sustains activity, an active life predicates the best chance of being a healthy one.

The Mobile Medicare Unit (MMU) initiative is HelpAge India’s flagship programme. This programme has immediate short-term impact towards improvement in the quality of life of our marginalised beneficiaries. Our MMUs address the problems of unaffordability, inaccessibility, and non- availability of basic essential healthcare to poor elderly. The programme fulfils a vital need in the lives of our beneficiaries. From 2 units launched between 1982 and 1994, HelpAge India today runs about 136 units and our footprint continues to grow bringing healthcare to the doorsteps of India’s poorer elders.

HelpAge India’s MMU program has indeed proven to be a very effective one, in that, it not only provides health security, which is a direct and discernible effect but also gives emotional, and to an extent financial security, to the beneficiaries. Its efficacy can be judged from the fact that even the Central Government has accepted the concept of Mobile Medicare Units as a highly effective means of delivery of health services, and has been supporting some of HelpAge India’s existing MMUs across India. HelpAge India proposes the provision of primary healthcare to disadvantaged older persons and the communities they live in, through 12 Mobile Medicare Units (MMU) in the states of Himachal Pradesh, Uttarakhand, Bihar & Maharashtra in areas proximate to SJVNL’s locations as given below:

Himachal Pradesh

  • One MMU in Dhaulasidh Hydro Electric Project - DHEP
  • Two MMU in Nathpa Jhakri Hydro Electric Project – NJHEP
  • One MMU in Luhri Hydro Electric Project – LHEP 1
  • One MMU in Luhri Hydro Electric Project – LHEP 2
  • One MMU in Rampur Hydro Electric Project – RHEP


  • Two MMU in Chamoli Hydro Electric Project – CHEP 1 and CHEP 2
  • One MMU in Naitwar Mori Hydro Electric Project- NMHEP-1


  • Two MMUs in Buxar Thermal Power Project


  • One MMU in Khirweri Wind Power Project


The MMU project will is aimed at reaching out to provide healthcare to older persons above 60 years of age as well as the communities they live in—in the operational areas—who have limited or no access to healthcare either due to poor services by the existing healthcare facilities or because affordability issues due to lack of financial resources or other physical / mobility reasons. Though the treatment to people below 60 years is not being denied, it is positively reinforced to the community that the service is focused on the senior population.

As a guideline, HelpAge India also ensures that at least 50% beneficiaries belong to economically weaker sections (EWS) of the society.
The mobile health program is a proven intervention in delivering health care to vulnerable and unreached sections of the society. It overcomes barriers that the elderly and vulnerable sections encounter in accessing ‘for free’ services.


The MMU is designed to provide Primary Healthcare services for the elderly, namely:

Free treatment: The doctor examines patients and, based on available equipments, clinically diagnoses them and prescribes medicines. Where required, the patients are referred to pathological laboratories for detailed investigation/ secondary/ tertiary health care service providers for specialist treatment and care.

Free medicines: The MMU stocks medicine for all common ailments among the elderly including Hypertension, Diabetes, Arthritis, etc. These medicines are issued to the patients free of cost by the Pharmacist on the basis of the Doctor’s prescription. The Pharmacist also explains the dosage of medicines and their side effects, if any, to the patients.

Basic diagnostics: The MMU van is equipped with basic diagnostic equipment such as stethoscope, BP apparatus, thermometer, weighing machine etc. for checking the vital signs. In addition to this there is a ‘glucometer’ for blood sugar testing.

Home visits by doctor (in case of bedridden patients): The doctor and the paramedic team conduct weekly visits the houses of bedridden elders who otherwise cannot approach or be brought to the vehicle. The doctor and paramedic team examines & clinically diagnoses the problems presented by the elder patient or caregivers and prescribes medicines and advice the patient and their caregivers.

Counseling for patients, elders, family members and caretakers: The counsellor and the doctor provide necessary advice and counselling to patients and caretakers on various ailments and home care. The project team also conducts regular counselling sessions on various aspects for healthy ageing i.e. (a) diet and nutrition; (c) weight reduction; (b) regular exercise; (d) smoking; (e) alcohol; (f) social activities. By adopting a healthier lifestyle, the risk of a whole range of diseases can be reduced.

Community awareness on the rights of the elderly: : Every person has the right to freedom and respect and the right to be treated fairly by others. A positive, supportive and caring attitude by family, friends, caretakers and the community will help people to continue as integral, respected and valued members of society.

Creating awareness in the community especially among the younger generation will help to sensitize them on the various aspects of taking care of the aged and in long term will also help them in preparing for their old age.  

Other value added services include Referral services / facilities viz.

Referral linkage with local health providers: The team promotes initiate linkages with private as well as government health care facilities so as to ensure that the required services would be available on demand. The linkage between the HelpAge India beneficiaries and these identified institutions would ensure accessibility and affordability of the services.

Linkage with Govt. schemes and programmes: This initiative aims to increase awareness among the elderly poor about various social security, food security and habitat security schemes, and thus enabling them to advocate/ demand their rights. We realize that elderly people need support to avail these schemes. The MMU plays a facilitating role in linking them with the local and district administration and also collecting the information from the government offices and disseminating this information to the concerned/eligible beneficiaries thus improving their access to social welfare schemes.


All HelpAge MMUs are equipped with the following team of personnel:

    mmu team
  • Social Protection Officer:Leads the team, coordinates social and health awareness aspects of the project, and looks after all the administrative works of the project. This team will also be responsible for organizing Health Camps in the proposed locations.
  • MBBS Doctor: Examines patients and prescribes medicines, and is also the prime person for the health activities of the project.
  • Pharmacist: The Pharmacist is required legally for stocking medicines and he issues the medicines to the patient. The pharmacist also explains the dosage of medicines and their side effects.
  • Driver cum Community Facilitator: He holds a valid driving license and is trained to assist the MMU team in registering the beneficiaries. He also plays a major role in mobilizing the community.


  • Increased awareness among the community, especially the elderly beneficiaries, care givers and youth, on the rights of the elderly, govt. schemes, and preventive healthcare.
  • Facilitating the process of active ageing among needy elders in the community.
  • The elderly beneficiaries will be made aware and educated on the basics for active ageing.
  • The elderly will have easy access to primary health care and referral needs.

The current state of the aged in the country necessitates society to promote interventions in favour of older persons, which would facilitate them to active lives to the extent possible and medical support to live with dignity and respect.