A/HRC/14/31
the State to guarantee timely and appropriate access to health care and address underlying
determinants of health, such as access to safe and drinkable water or an adequate supply of
safe food.
93.
The living conditions of persons living in extreme poverty clearly impact on their
health status throughout their life. Higher incidence of ill-health and premature mortality
correlates with socioeconomic factors in all regions of the world. Ageing increases a
person’s susceptibility to illness and disability, and this phenomenon is further aggravated
by poverty as they are less likely to be able to afford health care and more likely to
maintain poor nutritional diets. They are also more likely to have engaged in physically
demanding work for a living. Therefore, policies must take into account that older persons
living in poverty may have a greater need for health care.
94.
In such circumstances, receiving a social pension can increase access to health care,
especially in the long run as it represents a stable and predictable source of income.
However, social pensions can only positively affect older persons’ enjoyment of the right to
health if adequate health-care services are in place. Research shows, however, that public
health policies often prioritize younger women and children and lack consideration of the
specific needs of older people.39 Thus, health services are not geared towards fulfilling
these needs and there can be significant gaps in the provision of services. This is
particularly true about long-term care, for which resources and capacities are limited
everywhere.
I.
Ensuring gender equality
95.
Non-contributory pensions are the most efficient means of ensuring the right to
social security for older women and compensating them for their years of unpaid or
inadequately paid work. However, to ensure equal access by women to a social pension,
special measures must be implemented to overcome possible barriers to older women
caused by structural discrimination, such as lack of access to adequate documentation and
identification; difficulties to approach administrations or lack of gender sensitive social
services.
96.
In some countries, structural discrimination against women and increased
competition for family resources from younger members often means older women lose
control of assets once owned by their husbands and are left without a source of income. In
extreme cases, they are subjected to accusations of witchcraft. The context in which
accusations of witchcraft are made is complex, resulting from deep-seated cultural beliefs,
and the need to apportion blame and seek redress for a negative event, such as a death in the
family or crop failure and poverty. Nevertheless, the low status of women and their
inability to defend themselves makes them the primary targets of such violence.
97.
In such contexts, the income security and empowerment that a social pension
provides is vital. However, the importance of social pension for women must not absolve
States of their duty to take other measures to ensure gender equality and protect women
against gender-based violence. In most countries, women’s vulnerability to poverty will not
change with a social pension alone. Measures such as access to land and economic
resources for women, fair inheritance rights and full legal capacity are essential to improve
their standard of living.
39
18
Di McIntyre, “Health Police and Older People in Africa” in Peter Lloyd-Sherlock (ed.), Living
Longer (UNRISD, 2004).
GE.10-12583