DESK REVIEWS | 04.01.01. Is dementia included within the portfolio of one or more ministries in the national government?
DESK REVIEW | 04.01.01. Is dementia included within the portfolio of one or more ministries in the national government?
Yes. Dementia is included in the portfolio of the Brazilian Ministry of Health, as part of healthcare policies for older people. Some examples are the National Healthcare Policy for Older People, the Alzheimer’s disease Clinical Therapeutic Protocol, and the Older People’s Statute (Brazilian Ministry of Health, 2006a, 2017c; Presidency of Republic of Brazil, 2003).
Brazilian Ministry of Health. (2006a). Política Nacional de Saúde da Pessoa Idosa. http://bvsms.saude.gov.br/bvs/saudelegis/gm/2006/prt2528_19_10_2006.html
Brazilian Ministry of Health. (2017c). PCDT Alzheimer. Brazilian Ministry of Health.
Presidency of Republic of Brazil. (2003). Estatuto do Idoso. Presidency of Republic of Brazil; National Congress of Brazil’s Information System. http://www.planalto.gov.br/ccivil_03/leis/2003/l10.741.htm
The Ministry of Social Justice and Empowerment (MSJE) is the Nodal Ministry for welfare of senior citizens in India (Ministry of Social Justice and Empowerment (MSJE), 2022b, pp.14). Both the Ministry of Health and Family Welfare (MoHFW) and the MSJE have a number of programmes that are relevant to and applicable to persons with dementia. Few programmes are summarised in Table 4.1.
Table 4.1. Overview of national programmes
|Main national programmes||Aspects of programmes relevant to dementia|
|National Programme for Healthcare of the Elderly (NPHCE) (MoHFW, 2011)||Provision of preventive, general and rehabilitative geriatric care services.|
|National Program for Prevention and Control of Cancer, Diabetes, Cardiovascular diseases (CVD) and Stroke [NPCDCS] (MoHFW, 2017b)||While it does not specifically mention dementia, it addresses risk factors and co-morbid conditions of persons with dementia.|
|National Programme for Palliative Care (NPPC) (MoHFW, 2019)||End of life care for persons with terminal illnesses is currently primarily provided for persons with cancer and AIDS. Provision should be expanded to persons with dementia.|
|National Mental Health Programme (NMHP) (MoHFW, 2017a)||Prevention, treatment, and rehabilitation of mental health disorders.|
|Atal Vayo Abhyudaya Yojana (AVYAY) (MSJE, 2022a)
|This is an umbrella scheme that brings together several sub-schemes for senior citizens that address the needs for basic welfare (shelter, food, medical care etc.), nutrition for the elderly, provision of assistive living devices etc. It mentions care homes for persons with dementia under the Integrated Programme of Senior Citizens scheme (IPSrC).|
|Ayushman Bharat (MoHFW, 2022)||Consists of two main pillars: 1) Ayushman Bharat-Health and Wellness Centres (AB-HWCs); 2) Ayushamn Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY),
Under the AB-HWCs scheme, there will be provision of elderly and palliative care services at the primary care level.
Source: MoHFW (2011; 2017a; 2017b; 2019; 2022); (MSJE, 2022a)
Ministry Of Health and Family Welfare. (2011). OPERATIONAL GUIDELINES National Programme For Health Care Of The Elderly (NPHCE). Available from: https://main.mohfw.gov.in/organisation/Departments-of-Health-and-Family-Welfare/national-programme-health-care-elderly-nphce
Ministry of Health and Family Welfare. (2017a). Directorate General of Health Services: National Mental Health Programme.
Ministry of Health and Family Welfare. (2017b). National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular diseases, and Stroke (NPCDCS).
Ministry of Health and Family Welfare. (2019). National Programme for Palliative care (NPPC): National Health Mission.
Ministry of Health and Family Welfare. (2022). Ayushman Bharat-Health and Wellness Centres. Ministry of Health and Family Welfare, Government of India.
Ministry of Social Justice and Empowerment (2022a). Atal Vayo Abhyuday Yojana. Available from: https://grants-msje.gov.in/display-avyay
Ministry of Social Justice and Empowerment (2022b). Scheme for Welfare of Senior Citizens. Press Information Bureau. Available from: https://pib.gov.in/PressReleaseIframePage.aspx?PRID=1806506
The Ministry of Health through its Mental Health Directorate and Family Health Directorate work on dementia. The Ministry of Health also launched the National Dementia Plan, which identified other ministries as stakeholders for the action steps, which include the Coordinating Ministry for Human Development and Cultural Affairs, Min. Domestic Affairs, Min. Family Planning, Min. Social Affairs, Min. Education, Min. Finance, and Social Insurance Administration Organisation (Ministry of Health Republic of Indonesia, 2015b). The Ministry of Social Affairs also has a social rehabilitation program for older people, named PROGRES LANSIA, which includes installation/rehabilitation centre for dementia/Alzheimer (Ministry of Social Affairs Republic of Indonesia, n.d.).
Ministry of Health Republic of Indonesia. (2015b). National Strategy: Management of Alzheimer and Other Dementia Diseases: Towards Healthy and Productive Older Persons. Ministry of Health Republic of Indonesia.
Ministry of Social Affairs Repulbic of Indonesia. (n.d.) Program Rehabilitasi Sosial Untuk Lanjut Usia (Progres Lansia). Central Jakarta: Ministry of Social Affairs Republic of Indonesia. Available at: https://intelresos.kemensos.go.id/v4/user/registration/progres/point/2
In Mexico, ageing has been recently considered a relevant issue, and therefore it has been positioning within the public agenda in the past two decades. However, there is still no Ministry that oversees clinical or social aspects of dementia. As a consequence, to date, there are no national policies or programmes for dementia, and there are no strategies that aim at diagnosing, monitoring, or providing treatment and behavioural management options for people with dementia and/or their carers.