This article is part of a series on age disaggregated data. Take a look and let us know what you think:
- Age disaggregated data — An experiment in Open Policy Making
- Help us to improve age disaggregated data: Youth
- Age disaggregated data — Technical discussion paper
To make sure everyone benefits from the Global Goals we need to improve the quality, consistency and use of age disaggregated data and we need your help.
Currently the data systems in many Low and Middle Income Country contexts are failing older people. At both national and international levels, data on older women and men is often not collected. When the data is collected, it is not fully analysed, reported or utilised. This means there are gaps in knowledge about the social, economic and political challenges older people face. Too little is known about the support that older people need to live secure, healthy lives free from fear and poverty. To ensure older people are not left behind, data should be collected, analysed and reported in five year bands along with data on sex and disability status.
The data challenge
The following section highlights examples of how data systems are failing to measure progress in areas of violence and abuse, health, humanitarian and emergency situations, and social protection.
Violence and abuse
Research from the WHO (2014) has found that only 17% of 133 countries have any survey data on abuse of older men and women. Surveys are predominantly conducted in high income countries and where data exists it shows a wide variation in rates of abuse — from 0.8% in Spain to 18%, and 32% in Belgium. There are two global mechanisms that collect data on gender based violence. The Demographic Health Survey domestic violence module is carried out in over 25 less developed countries and focuses on prevalence, awareness, and behaviour. UNICEF Multiple Indicator Cluster Survey (MICS) collects data on attitudes toward domestic violence in over 100 low, middle and high income countries. Both mechanisms exclude women over the age of 49. There is lack of data and research on violence against older women and men, older people with disabilities, and in humanitarian and conflict situations.
At the global level, older people are excluded from monitoring and reporting on HIV. The Demographic and Health Survey, which is the primary source of data on HIV prevalence, awareness, attitudes, and behaviour, systematically excludes older people. The same is true of the UNICEF Multiple Indicator Cluster Surveys which only captures data on HIV testing or condom use of people who are between the ages of 15 and 49. This problem is not limited to surveys on communicable diseases. The global monitoring and reporting of Non-Communicable Diseases also excludes older people. The global targets in the World Health Organisation Global Action Plan for the prevention and control of Non-Communicable Diseases 2013–2020 focus on premature mortality and the percentage of people who ‘die too young, between the ages of 30 and 70’. The primary global Non-Communicable Diseases target is focused on reducing premature mortality. Standardised mechanisms for collecting, analysing and disseminating data on Non-Communicable Disease risk, used by the WHO is only conducted with people aged 25–64.
Humanitarian and emergency contexts
At the level of both national and local governments and international and national aid agencies, collection of age disaggregated data is not always carried out. A 2011 Tufts University study found “almost no documented and published cases in which lead agencies […] collected Sex- and Age-Disaggregated Data properly, analysed the data in context and used those findings to influence programming.” The biggest challenge in addressing older people’s under-nutrition is their almost complete invisibility to humanitarian actors. Older people are still excluded from assessments in which data is routinely only collected for children under the age of 5 and pregnant and lactating women. As a result there are very few specific nutrition interventions targeting older men and women.
Global Goal 2.2 calls to end malnutrition in children under the age of 5 and to address nutritional needs of adolescent girls, pregnant and lactating women and older persons. Yet the proposed indicators to measure this target only measure malnutrition among children.
Cross cutting issues
Two issues may be pertinent to all surveys across the highlighted themes — a single respondent and sample size. Household surveys collect information from a single individual within a household. The response provided by the individual may be biased about needs of other household members. Additionally, income and expenditure surveys generally do not capture intra-household dynamics (e.g. control and allocation of resources, support and unpaid care given or received within a household).
Disaggregation of data by age bands beyond 60 or 65 is considered challenging where a target group (e.g. older people, older women and men with disabilities) represent a small proportion of the population.
The response to the data challenge
The monitoring framework and indicators developed to track progress towards achieving Global Goals and to ensure accountability of governments to their citizens needs to be inclusive of people of all ages with data disaggregated by age, sex, and disability. The monitoring framework should include an agreed system for disaggregation so that there is consistency. This must provide a minimum level of age disaggregation that ensures consistency and allows for comparison, but does not prohibit an additional, further level of age disaggregation within these groups as appropriate. HelpAge are calling for disaggregation of age data to be in cohorts of 5 years.
How can we fix this?
There needs to be concerted action to ensure older people are not left behind and to address the problems and gaps in the data on older people. The use of existing internationally comparable surveys needs to be expanded. Work must also be undertaken to improve existing targets, indicators and surveys:
- In line with shifts in global epidemic monitoring by UNAIDS to include people aged 50 and over in HIV prevalence data, Demographic and Health Surveys should include people over the age of 49. Expanding the sample group would provide a crucial set of data on both older women’s experience of violence and the attitudes and behaviours of older people in relation to HIV.
- To measure violence and abuse through lifecycle the Demographic and Health Survey domestic violence module and Multiple Indicator and Cluster Surveys should include people over the age of 49.
- Include The Washington Group questions in all surveys as they provide an internationally comparable methodology for disability age and gender measurement.
- All internationally held and managed survey templates and data collection mechanisms, including Multiple Indicator and Cluster Surveys should include women and men over the age of 49.
- The Demographic and Health Survey module on gender based violence covers physical and sexual violence. The module should be expanded to include other forms of abuse such as emotional, financial, violation of rights, and malicious accusations abuses.
- The WHO Global Action Plan on Non-Communicable Disease targets and indicators should be inclusive of people of all ages.
- Global Goal 2.2 can be measured by the Rapid Assessment Method for Older People, a simple, low cost, accurate, and reliable survey method for assessing the nutritional status, vulnerabilities and needs of older people.
- The WHO Study on global AGEing and adult health (SAGE) collects data on the health and well-being of adults aged 50 years and older. However it currently only covers 6 countries. There is a need to extend it globally.
- To obtain representative data on small groups (e.g. ‘older old’ and older people with disabilities) consideration needs to be given to weighting the sample over-sampling the particular group.
- In humanitarian context, partners can follow guidelines on collecting sex, age, and disability disaggregated data outlined by Humanitarian Charter and Minimum Standards in Humanitarian Response and Minimum Standards for Age and Disability Inclusion in Humanitarian Action.
- Also in humanitarian contexts, ECHO’s Gender and Age Marker, the integration of age into the IASC Gender Marker and policy commitments made by DFID and USAID are examples of recognition of ageing in humanitarian actions. It is critical that such initiatives are replicated by other humanitarian donors and that donors take a lead role in ensuring partners are held accountable to the delivery of age inclusion commitments.
What happens next and how do I get involved?
One of our main goals is to see this problem from a range of different perspectives so that we can understand the impact that it is having on people making policy, statisticians, advocates and real life people like you and me. The good news is that we have already started. We have been reaching out to experts, academics and partners to help us to scope this work. They have helped us to tell the story of this problem from a range of different perspectives. Now it’s your turn!
You can have your say too! There are two ways for you to feed in to this process:
So share your views with us, have your say and help to ensure that people of all ages can benefit from the Global Goals. This paper has been truncated for reading ease. You can find the full version using this link.
Want to know more about Open Policy Making?
- The Policy Lab in the Cabinet Office have created lots of useful tools, guidance, case studies, tips and advice to help you take your first step toward a more open, collaborative and better policy making process. Pay them a visit over here. If you’re just getting started have a read at the Policy Lab’s introduction to design in policy making for more information on how to apply design thinking and policy making.
- To follow this Open Policy Making process — follow DFID Inclusive Societies on Medium. We’re on Twitter too!