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About Ageing in KSA

The growth in the ageing population is rapidly increasing and their care cost will be a challenging issue in the future. The number of elderly people worldwide (defined as those age 60 years and older) was 202 million in 1950; this number has since quadrupled to reach 841 million, and is expected to triple again by 2050. Moreover, the elderly population in the Kingdom of Saudi Arabia (KSA) is expected to increase by 2055.

These demographic changes raise a number of challenges related to their quality of life, including social communication and care, health, autonomy and utilisation of institutional services. The ageing population is a potential issue for the government of KSA, in respect of access to healthcare services. With the country experiencing growth in economic and health sectors, the aged are still at risk of health challenges if measures to address the situation are not be taken into consideration (Altamimi, 2016; Alsulami & Atkins, 2016).


The research literature indicates that aged people are those who are 60 years old or higher as defined by the United Nations.The Saudi Arabian Census established the proportion of those aged below 15 years has been declining from 49.23% to 26.6% from 1992 to 2015. It is expected that the number will drop sharply to 18.7% in 2050. In 2015, the rate of elderly people in the KSA was manageable since the share was only 5%. However, the projections by the United Nations Department of Population estimate the population of the aged in the KSA is expected to increase. In their estimates the UN suggests that the aged population (60 years and above) will be 4.3 (11.1%) million people in Saudi Arabia by 2030. Nevertheless, the ageing population in the KSA is expected to be unmanageable in the coming decades because the proportion will grow sharply to be 20.9% in 2050, and this proportion will rise to 33.5% by 2100 (Abusaaq, 2015; United Nations, 2015d; Al-shehri, 2012; United Nations, 2015c)

Significant research and studies have clarified particular causes of ageing population into three factors: fertility, mortality and international immigration.

Fertility[edit]

In the Middle Eastern and North Africa (MENA), region the total population is increasing and the ageing population is also rising, which leads to an increase in the health cost (Parkash et al., 2015). Some MENA countries show a reduction in fertility, for example, in Egypt where fertility has declined from 3.1 children per woman in 2000-2005 to reach an estimated 1.84 by 2095-2100. In Qatar, the reduction in fertility started from 2.95 in 2000-2005 as is estimated to be 1.81 in 2095-2100. In Iraq, there will be a sharp decline from 4.75 to1.97 by 2095-2100. In KSA, the projection indicates that the fertility rate is decreasing from 4.51 children per woman in 2000-2005 to an expected 1.81 in 2095-2100 (United Nations, 2013b). In 2015, the crude birth rate (per 1,000 population) in KSA was 21, which is considered lower than the regional (31.4) and global (24.3) rates (Ministry of Health, 2015). There are some factors that reduce the birth rates in some Middle East countries, such as urbanisation, female employment and higher levels of education (Norville et al., 2003). In KSA, experts have identified the reasons for reduction in fertility as late marriage between men and women, high cost of living and growing abortion (Arab News, 2015).

Mortality[edit]

In MENA region, the total population has increased, which coincides with the increase in ageing population. Therefore, the family structures and the option of care of elderly people will consequently change in the future  (Parkash et al., 2015). Because of the reduction in mortality and improvements of the healthcare system, women in MENA live longer and healthier and their life expectancy has risen by 10 years (World Bank, 2013). The average life expectancy has increased from 48.7 years in 1965 to 70.4 years in 2010. It is expected to increase to 76.9 years by 2045-2050 (Hussein, 2016), which is lower than Saudi life expectancy (81.8 years) (United Nations, 2013b).

In 2015, life expectancy in KSA was 74.3 years, which is more than the regional average by 6 years and the global average by 4 years. Crude death rate (per 1,000 population) was 3.9, which was lower than the regional rate (6.3) and approximately half the worldwide rate (7.9) (Ministry of Health, 2015). In KSA, the average life expectancy was approximately 41.9 years in 1950-1955, but, in 2000-2005, it had increased to 73.1 years, and it is expected to be 87.8 years by 2095-2100, as shown in Figure 4 (United Nations, 2013b).

International Migration[edit]

Labour immigration to KSA can be traced back to the late 1930s due to the need to explore for oil. In 2012, the Saudi Government announced that the number of non-Saudis was 9.7 million and up to 5 million of which were illegal immigrants due to visits to the two holy mosques (Bel-Air, De, 2014).

The workforce eligibility is available for both Saudis and non-Saudis. The non-Saudis are required to obtain an approval from the Ministry of Labour and Social Affairs before arriving in KSA. The KSA provides a sponsorship system that allows international workers to enter, work and leave KSA through their sponsors’approval. The workers have to undergo a medical test and then apply for an entry visa. After that, the visa will be issued by the KSA embassy in their countries. When the visa is issued, the workers are allowed to enter and work in KSA, and then an Iqama (Identity card and residency visa) is issued. Once the workers arrive in the KSA, they are required to have a fingerprint and an eye cornea scan. The employers must register their international workers in the General Organisation for Social Insurance (GOSI). In order for workers to move to another employer, they have to get approval from the previous employer (L&E Global, 2017).

Since 2000, the population of KSA has risen annually by 3% because of the migrant population. In fact, the number of migrants has grown annually by 4% since 2000, leading to increases in Saudi growth by 2%. The KSA is experiencing a major economic transformation, creating wealth and the growth needs for labour. Therefore, KSA has welcomed international workers, which has led the number of migrants to exceed the number of Saudis in the labour market. Overall, the unemployment proportion is 5.6%, but Saudi unemployment stands at 11.5%. Thus, the Saudi Government has established many programs to increase the employment of Saudis, such as the Nitagat program in the private sector. While the private sector is growing, the unemployment of Saudis is still high among young persons, at more than 39% in 2015. Hence, the Saudi government has identified five major challenges that face Saudi employment as lack of competitiveness to fulfill private sector jobs, reliance on foreign labour, high youth unemployment, inefficient job placement and matching and the low rate of female labour participation in the market. It is noticeable that foreign workers dominate mostly 83% of the private sector workforce (Ministry of Labor and Social Development, 2016).

International migration into KSA is increasing and, in 2000, there were 5 million immigrants, reaching10 million in 2015 comprising 32% of population (United Nations, 2015a). In the second half of 2015, the Saudi General Authority for Statistic reported that the total number of employed people was 11.5 million, of which almost 6.5 million were non Saudi (56%)

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