The Peruvian Supreme Decree approved by the Multisectoral National Policy for adults older than 2030

supreme decree

N° 006-2021-MIMP

THE PRESIDENT OF THE REPUBLIC

WHEREAS:

That, in accordance with the provisions of Articles 1 and 2 of the Political Constitution of Peru, the defense of the human person and respect for their dignity is the supreme goal of society and the State; and no one should be discriminated against for reasons of origin, race, sex, language, religion, opinion, economic condition or any other nature. Within this framework, by virtue of what is stated in article 4, the State and the community especially protect the elderly person in a situation of abandonment;

That, numeral 1 of article 4 of Law No. 29158, Organic Law of the Executive Power, establishes as the exclusive competence of the Executive Power to design and supervise national and sectoral policies, which are mandatory for all entities of the State at all levels of government; Likewise, the aforementioned article specifies that national policies define priority objectives, guidelines, the main contents of public policies, national compliance standards and the provision of services that must be achieved and supervised to ensure the normal development of the public and private activities;

That, through Supreme Decree No. 029-2018-PCM, the Regulation that regulates National Policies is approved, in which numeral 8.1 of article 8 establishes that national policies constitute policy decisions through which priority is given to a set of objectives and actions to solve a certain public problem of national and sectoral or multisectoral scope in a period of time;

That, numerals 15.1 and 15.5 of article 15 of the Regulation that regulates National Policies, specify that the conduct of a multisectoral national policy supposes its design and formulation jointly with the intervening ministries, as well as coordination, intersectoral articulation , follow-up and evaluation of its compliance, and exceptionally, said actions may require the formation of a working group or other mechanism that determines the multisectoral national policy or agrees on the intervening ministries, as appropriate;

That, Article 2 of Legislative Decree No. 1098, Legislative Decree that approves the Law on Organization and Functions of the Ministry of Women and Vulnerable Populations, states that the Ministry of Women and Vulnerable Populations - MIMP, is the body rector in national and sectoral policies on women and promotion and protection of vulnerable populations; Likewise, article 3 specifies that its purpose is to design, establish, promote, execute and supervise public policies in favor of women and vulnerable populations considered as groups of people who suffer discrimination or situations of lack of protection: boys, girls, adolescents, older adults, people with disabilities, displaced persons and internal migrants, in order to guarantee their rights, with an intersectoral vision;

That, through Ministerial Resolution No. 194-2019-MIMP, the MIMP approves the Sectoral List of National Policies under its rectory or leadership, which includes the National Policy in relation to Older Adults, approved through Supreme Decree No. 011-2011-MIMDES;

That, through Ministerial Resolution No. 038-2020-MIMP, a Multisectoral Working Group is formed, in order to update the National Policy for Older Adults (National Policy in relation to Older Adults), dependent on the MIMP, whose contributions were key inputs for the design of the Policy;

That, through Legislative Resolution No. 31090 and Supreme Decree No. 044-2020-RE, the "Inter-American Convention on the Protection of the Human Rights of Older Persons" is approved and ratified, respectively, adopted on 15 June 2015, within the framework of the 45th Regular Session of the General Assembly of the Organization of American States (OAS), which entered into force on March 31, 2021;

That, Law No. 30490, Law of the Elderly Person and its Regulations approved with Supreme Decree No. 007-2018-MIMP, establish the regulatory framework to guarantee the exercise of the rights of the elderly, in order to improve their quality of life and promote their full integration into the social, economic, political and cultural development of the Nation;

That, Article 3 of Law No. 30490, Law on the Elderly Person, establishes that the MIMP exercises leadership over the promotion and protection of the rights of the elderly person and within the framework of its powers and current regulations, is responsible for regulating, promoting, coordinating, directing, executing, supervising, auditing, sanctioning, recording information, monitoring and carrying out evaluations of policies, plans, programs and services in favor of it, in coordination with governments regional governments, local governments, public and private entities and civil society, which provide the necessary facilities;

That, based on the legal framework for the protection of the rights of the elderly; as well as, from the review of the scientific and statistical evidence in the country, it is verified that the structural discrimination based on age against the elderly in Peru is a public problem that requires a comprehensive vision and the adoption of adequate measures and by the Peruvian State, at its three levels of government, with the participation of the family and civil society;

That, due to the foregoing, it is necessary to approve the update of the National Policy in relation to Older Adults, to address the causes and effects of structural age discrimination against older adults, in accordance with the international commitments of the Peruvian State in terms of human rights, sustainable development and aging, the State Policies established in the National Agreement, the Strategic Plan for National Development and the Vision of Peru to 2050, guaranteeing the full enjoyment of the elderly of their rights without discrimination based on age, recognizing their valuable contributions to social development, promoting active and healthy aging, as well as the participation of the family and the community in the integration, care and attention of the elderly;

That, for the formulation of the "National Multisectoral Policy for Older Adults by 2030", it has been deemed pertinent to prioritize five objectives to help resolve said public problem: i) Guarantee the right to care and good treatment for a coexistence without discrimination of the elderly; ii) Promote healthy aging in older adults; iii) Guarantee contributory and non-contributory benefits for the elderly; iv) Guarantee the access, permanence, completion and quality of education for the elderly at all levels and educational modalities; and, v) Strengthen the social, productive and political participation of older adults;

That, through Official Letter No. D000318-2021-CEPLAN/DNCP, the National Center for Strategic Planning attaches the Technical Report No. D000006-2021-CEPLAN-DNCPPN, through which it issues a favorable technical opinion on the National Multisectoral Policy for Older Adults by 2030, in accordance with the provisions of article 10 of the Regulation that regulates National Policies, approved by Supreme Decree No. 029-2018-PCM, as well as with the National Policies Guide, approved by Resolution of Presidency of the Board of Directors No. 00047-2018/CEPLAN/PCD;

That it is necessary to approve the National Multisectoral Policy for Older Adults by 2030, in order to guarantee the full enjoyment and exercise of the rights of older adults and contribute to their full inclusion, integration and participation in society , without any type of discrimination;

In accordance with the provisions of the Political Constitution of Peru; in Law No. 29158, Organic Law of the Executive Branch; in Legislative Decree No. 1098, Legislative Decree that approves the Law on Organization and Functions of the Ministry of Women and Vulnerable Populations; in Supreme Decree No. 029-2018-PCM, which approves the Regulation that regulates National Policies; and the National Policy Guide approved by Resolution of the Presidency of the Board of Directors No. 00047-2018/CEPLAN/PCD;

With the approving vote of the Council of Ministers;

DECREES:

Article 1.- Approval of the National Multisectoral Policy for Older Adults by 2030

Approve the National Multisectoral Policy for Older Adults by 2030, hereinafter National Multisectoral Policy, which as an annex forms an integral part of this Supreme Decree.

Article 2.- Scope of application

2.1 The National Multisectoral Policy is mandatory for all public sector entities, at the three levels of government, as well as for the private sector and civil society, insofar as it is applicable to them.

2.2. Entities at all levels of government and within the framework of their powers assume their roles, obligations and responsibilities, in accordance with the provisions of Articles 19 and 20 of the Regulations governing National Policies, approved by Supreme Decree No. 029- 2018-PCM.

Article 3.- Conduct of the National Multisectoral Policy

The Ministry of Women and Vulnerable Populations, as the governing body for the promotion and protection of the rights of older adults, leads the Multisectoral National Policy.

Article 4.- Implementation of the National Multisectoral Policy

4.1 The Ministry of Women and Vulnerable Populations directs and coordinates with the entities responsible for the National Multisector Policy, the implementation of the identified services and other interventions that contribute to the fulfillment of the priority objectives of the National Multisector Policy.

4.2 The State entities responsible for the priority objectives, guidelines and services of the National Multisectoral Policy, in accordance with their leadership in the sectoral sphere, are in charge of its implementation and execution, according to their functions and competencies, through the different plans of the National Strategic Planning System - SINAPLAN.

Article 5.- Monitoring and evaluation

5.1. The Ministry of Women and Vulnerable Populations is in charge of monitoring and evaluating the National Multisectoral Policy.

5.2. The monitoring and evaluation process is carried out in accordance with the methodological guidelines established by the National Center for Strategic Planning - CEPLAN in terms of monitoring and evaluation of policies and those that the Ministry of Women and Vulnerable Populations considers pertinent.

5.3. The State entities that are responsible for compliance with the priority objectives of the National Multisectoral Policy provide timely information to the Ministry of Women and Vulnerable Populations, in order to monitor and evaluate the implementation of the National Multisectoral Policy.

Article 6.- Financing

The implementation of the National Multisectoral Policy is carried out progressively charged to the Institutional Budget of the entities involved, without demanding additional resources from the Public Treasury.

Article 7.- Publication

This Supreme Decree and the Executive Summary of the National Multisectoral Policy are published in the official newspaper El Peruano and, on the same day, this regulation and its annex are published in the Single Digital Platform for Citizen Orientation (www. gob.pe) and in the Institutional Portals of the Ministries whose owners endorse it.

Article 8.- Endorsement

This Supreme Decree is endorsed by the Minister of Women and Vulnerable Populations, the Minister of Health, the Minister of Justice and Human Rights, the Minister of Development and Social Inclusion, the Minister of Education, the Minister of Agrarian Development and Irrigation, the Minister of Labor and Employment Promotion, the Minister of Production, the Minister of Foreign Trade and Tourism, the Minister of Housing, Construction and Sanitation, the Minister of Culture, the Minister of the Interior and the Minister of Economy and Finance.

FINAL SUPPLEMENTARY PROVISIONS

First.- Validity of the National Multisectoral Policy

The National Multisectoral Policy is valid until December 31, 2030.

Second.- Approval of complementary regulations for the implementation of the National Multisectoral Policy

The Ministry of Women and Vulnerable Populations approves the complementary norms for the implementation of the National Multisectoral Policy.

Third.- Report on compliance with Law No. 30490, Law on the Elderly

Starting in 2021, the annual report on compliance with Law No. 30490, the Older Adult Law, considers the annual progress in the implementation of the National Multisectoral Policy for Older Adults by 2030.

Fourth.- Adequacy of planning instruments

The entities involved in the National Multisectoral Policy, progressively adapt their planning instruments to the provisions of said national policy, in accordance with the provisions of numeral 11.4 of article 11 of the Regulation that regulates National Policies, approved by Supreme Decree No. 029-2018-PCM.

Fifth.- Coordination mechanism

The Ministry of Women and Vulnerable Populations, through Supreme Decree, establishes the coordination mechanism for the implementation of the National Multisectoral Policy.

REPEALING SUPPLEMENTARY PROVISION

Only.- Repeal of Supreme Decree No. 011-2011-MIMDES

Repeal Supreme Decree No. 011-2011-MIMDES, which approves the National Policy in relation to the Elderly.

Given at the Government House, in Lima, on the fourth day of June of the year two thousand and twenty-one.

FRANCISCO RAFAEL SAGASTI HOCHHAUSLER

President of the Republic

CLAUDIA CORNEJO MOHME

Minister of Foreign Trade and Tourism

ALEJANDRO NEYRA SÁNCHEZ

Minister of Culture

FEDERICO TENORIO CALDERON

Minister of Agrarian Development and Irrigation

Silvana Vargas Winstanley

Minister of Development and Social Inclusion

WALDO MENDOZA BELLIDO

Minister of Economy and Finance

RICARDO DAVID CUENCA COUPLE

Minister of Education

JOSÉ MANUEL ANTONIO ELICE NAVARRO

Minister of the Interior

EDUARDO VEGA LUNA

Minister of Justice and Human Rights

SILVIA LOLI ESPINOZA

Minister for Women and Vulnerable Populations

JOSE LUIS CHICOMA LUCAR

Minister of Production

OSCAR UGARTE UBILLUZ

Minister of Health

JAVIER EDUARDO PALACIOS GALLEGOS

Minister of Labor and Employment Promotion

SOLANGEL FERNANDEZ HUANQUI

Minister of Housing, Construction and Sanitation

NATIONAL MULTI-SECTORAL POLICY FOR OLDER ADULTS BY 2030

EXECUTIVE SUMMARY

I. PRESENTATION

Peru is going through an accelerated process of population aging, which consists of an increase in the number and proportion of people aged 60 and over and a decrease in the younger age groups, due to the reduction in the rates of fertility and mortality. Older adults (hereinafter PAM) add up to more than 4 million (47.8% men and 52.2% women), representing 12.7% of the national population, more than double the number in 1950, the year in which this population group represented the 6% (INEI, 2020).

The PAM are one of the most vulnerable population groups in the country, as evidenced by the gaps in access to basic education, the pension and health system, as well as their low social participation and in the labor market, the high unsatisfied demand in long-term care services or care in the family environment, the high incidence of poverty and violence that they present. This situation is even more critical in certain socially and historically excluded subgroups, such as older women, members of indigenous communities or other discriminated ethnic groups, and the inhabitants of rural areas of the country.

In this context, and based on the scientific and statistical evidence in the country, the following has been identified as a public problem that requires State intervention: "Structural discrimination for reasons of age against the elderly", due to to the following causes: 1) violation of the right to good treatment, 2) inadequate care for the elderly, 3) inadequate health system, 4) unsustainable pension system, 5) inadequate educational system, and 6) exclusion of spaces for social and productive participation.

The "National Multisectoral Policy for Older Adults by 2030" (hereinafter PNMPAM) addresses the aforementioned public problem, with a view to achieving the following desired future situation: "By 2030, in our country, structural discrimination for reasons of age towards the elderly will be reduced, allowing them to fully exercise their rights, guaranteeing their quality of life, as well as their possibilities of exercising independence and autonomy in old age”.

To this end, the PNMPAM outlines five priority objectives, twenty-two guidelines, twenty-seven services, and four regulatory proposals, which are oriented towards social, productive, and political participation, access to care and health services, access to education, access to the pension system to guarantee economic security, the promotion of good treatment and care to guarantee coexistence without discrimination and a life free of violence against the PAM.

It should be noted that the PNMPAM constitutes the first state instrument that organizes State interventions as a whole around a desired future situation, priority objectives, indicators and goals, guidelines and services to effectively address the problems faced by PAMs and that Furthermore, it defines the responsibilities of the various sectors, regional and local governments and institutions involved, as well as promotes the participation of civil society at the three levels of government. In this way, it seeks to build a country for all ages in which its citizens can exercise their rights throughout their entire life cycle without discrimination.

II. LEGAL BASE

The PNMPAM has been prepared in accordance with the provisions of the Regulation that regulates National Policies, approved by Supreme Decree No. 029-2018-PCM, as well as in the "Guide to National Policies" (CEPLAN, 2018). Likewise, it supports its intervention in the national and international regulatory framework for the promotion and protection of the rights of PAM.

2.1. National regulatory references

The Political Constitution of Peru (CPP, 1993), which establishes as the supreme goal of society and the State the defense of the person and respect for their dignity1, offering special protection to PAM in situations of abandonment2, guaranteeing the right to equality and non-discrimination3, as well as the exercise of the rights to education4, work5 and health6 of all people in the national territory without exception.

In accordance with article 5 of the Law on the Organization and Functions of the Ministry of Women and Vulnerable Populations (MIMP), and article 3 of Law No. 30490, Law on the Elderly, said Ministry exercises rectory in the promotion and protection of the rights of the PAM, and is in charge of regulating, promoting, coordinating, directing, executing, supervising, auditing, sanctioning, recording information, monitoring and carrying out evaluations of policies, plans, programs and services in favor of of said population, in coordination with regional and local governments.

Law No. 30490, Law on the Elderly, and its Regulations, constitute the regulatory framework to guarantee the exercise of the rights of PAM, in order to improve their quality of life and promote their full integration into social development , economic, political and cultural of the nation.

In the context of the Covid-19 pandemic, regulations on the matter were reinforced with the issuance of Legislative Decree No. 1474, a Legislative Decree that strengthens the mechanisms and actions for prevention, care, and protection of people older adults during the health emergency by Covid-19.

In addition, it is relevant to indicate that the PNMPAM is consistent with other standards, such as:

- Law No. 27658, Framework Law for the Modernization of State Management.

- Law No. 27783, Decentralization Bases Law.

- Law No. 27867, Organic Law of Regional Governments.

- Law No. 27972, Organic Law of Municipalities.

- Law No. 28411, General Law of the National Budget System.

- Law No. 28983, Law of Equal Opportunities between Women and Men.

- Law No. 29158, Organic Law of the Executive Power.

- Legislative Decree No. 1098, Legislative Decree approving the Law on Organization and Functions of the Ministry of Women and Vulnerable Populations.

- Legislative Decree No. 1474, Legislative Decree that strengthens the mechanisms and actions for prevention, care, and protection of the elderly during the health emergency caused by Covid-19.

- Supreme Decree No. 003-2012-MIMP, Regulation of Organization and Functions of the Ministry of Women and Vulnerable Populations.

- Supreme Decree No. 003-2015-MC, approves the National Policy for the Mainstreaming of the Intercultural Approach.

- Supreme Decree No. 029-2018-PCM, which approves the Regulations governing National Policies.

- Supreme Decree No. 008-2019-MIMP, approves the National Gender Equality Policy.

- Supreme Decree No. 009-2020-MC, approves the National Culture Policy.

2.2. international references

In the same way, the PNMPAM is circumscribed within the framework of the international instruments ratified and/or adopted by the Peruvian State in the area of ​​human rights, aging and the rights of PAM. In this regard, the main treaties, resolutions and declarations that support this Policy are the following:

- Universal Declaration of Human Rights (1948).

- ILO: Convention No. 102 on social security (1952).

- International Covenant on Economic, Social and Cultural Rights (1966)

- International Covenant on Civil and Political Rights (1966).

- American Convention on Human Rights in the area of ​​economic, social and cultural rights (1969).

- Convention on the Elimination of all Forms of Discrimination against Women (CEDAW, 1979).

- Additional Protocol to the American Convention on Human Rights in the area of ​​economic, social and cultural rights -Protocol of San Salvador (1988).

- United Nations Principles in Favor of Older Persons (1991)

- Madrid International Political Declaration and Plan of Action on Aging (2002).

- Convention on the Rights of Persons with Disabilities (2006).

- UN General Assembly Resolution: Transforming our world: 2030 Agenda for Sustainable Development (2015).

- Inter-American Convention on the Protection of the Human Rights of Older Persons (2015).7

- WHO: Global Strategy on Aging and Health 2016-2030: Towards a world where everyone can live long and healthy lives (2016).

III. DIAGNOSIS

3.1. Public problem statement

In Peru, discrimination is a widespread problem that affects numerous groups of the population, for which it is estimated that one in three Peruvians has personally experienced this problem. However, the PAM of our country are identified as one of the population groups that are at greater risk of being discriminated against due to their age. According to the II National Human Rights Survey of the MINJUSDH (2019), 55% of Peruvians consider that PAM suffer some degree of discrimination.

Fighting discrimination based on age against PAM, as well as promoting and protecting the exercise of their rights is an obligation of the State. For this reason, it must establish the measures that are necessary through its different sectors and levels of government, with special attention to those people who are in a situation of greater risk8. This task becomes a priority in a context of population aging like the one our country is going through because it could lead to an increase in this type of discrimination.

Population aging, understood as the increase in the proportion and number of people aged 60 and over, and the decrease in the younger age groups due to the reduction in fertility9 and mortality10 rates, is the expression of the economic, social and scientific development that our country has experienced during the last century.

The elderly population of Peru has increased dramatically since the last half of the 20th century and it is projected that it will continue to grow rapidly both in number and proportion. Between the 1950s and 1980s, it had a mostly young population, and PAMs represented only 6% of the national population. However, this situation has been changing in recent decades. In the year 2020, in Peru there are 4 million 140 thousand people aged 60 and over, representing 12.7% of the total population of the country11. Likewise, at least one PAM was part of 39.1% of Peruvian households (IV quarter 2020, INEI, 2020). And for the year in which this National Policy is finalized (2030) the PAM are estimated to be 16% of the Peruvian population. Thus, it is estimated that this group will continue to increase and by the year 2050 it will be 25% (United Nations, 2019)12.

Finally, despite the fact that all the PAMs in the country are at risk of suffering discrimination based on their age, it is essential to recognize that this is not a homogeneous group and that some subgroups are in a situation of greater vulnerability, such as adult women. older people, as well as those who are part of socially and historically excluded ethnic groups, from rural areas of our country, who have one or more disabilities, are part of older age groups, among others.

In this sense, the PNMPAM addresses the public problem of "Structural discrimination for reasons of age against the elderly", in order to guarantee the full enjoyment and exercise of the rights of the PAM and contribute to their full inclusion , integration and participation in society, without any type of discrimination.

3.2. Key concepts

- Structural discrimination

Structural discrimination is understood as “a set of practices, informal or institutionalized, that deny equal treatment or produce unequal results for certain social groups and that result in deprivation or impairment of access to rights and reproduction of social inequality” (Solís, 2017: 27).

- Discrimination based on age in old age

Discrimination based on age in old age - also called 'old age' - is defined as the process of stereotyping and systematic discrimination, that is, distinction, exclusion or restriction against PAM based on chronological age (OEA, 2015; Butler, 1969; Bytheway, 2005; Salvarezza, 1998). The most common old age prejudices associate old age and all PAM with being sick, unproductiveness, loneliness, inability to learn, and negative changes in personality and behavior. In addition, it is assumed that all PAM are asexual, unable to decide about their lives or function in society (Angulo et al., 2020; Victor, 2005). These prejudices are expressed through discriminatory attitudes and practices present both in daily social interactions between individuals, as well as in legal norms, policies, and institutional practices. In this sense, discrimination based on age is a social problem that transcends individual wills and is of a structural nature (Solis, 2017) whose objective or effect is to nullify or limit the recognition, enjoyment or exercise under equal conditions of rights. human rights and fundamental freedoms of the PAM, putting them in a subordinate position and at risk of social exclusion (OEA, 2015; Álvarez, 2013). It should be noted that the PAM, being more exposed to discrimination or situations of lack of protection, are considered groups in a situation of vulnerability.

- Aging

Gradual process that develops during the course of life and that entails biological, physiological, psycho-social and functional changes of varied consequences, which are associated with dynamic and permanent interactions between the subject and their environment (OAS, 2015) .13

- Active and healthy aging

Active Aging is a conceptual and policy framework created by the World Health Organization (WHO) in 2002 to guide global intervention on aging14. His proposal is radically opposed to a discriminatory view of old age as it is based on the recognition of the human rights of all PAM and their potential to be agents that actively contribute to the well-being of their families, communities and nations. This policy framework guides States in the implementation of public policies and programs that aim to provide opportunities to improve the well-being and quality of life of the PAM in the physical, mental and social spheres (WHO, 2002; OEA, 2015). . It indicates that they must prioritize four priority action areas or “pillars” to achieve this objective. These pillars are: health, safety and care, education and participation (WHO, 2015). In this sense, the concept of active and healthy aging implies a profound transformation both individually and of the population and society as a whole (OAS, 2015).

- Older adults at risk

They are those who are in a situation of poverty or extreme poverty; dependence; fragility; victims of any type of violence in the family, social or institutional sphere, be it physical, psychological, sexual, economic or abandonment violence, whether on the streets, health centers, prisons or other circumstances.15

3.3. Public problem model

This section presents the public problem model, which incorporates the conceptual and operational structuring of "structural discrimination based on age against older adults" in the country.

The discrimination experienced by PAM limits the exercise of their human rights. The latter are universal legal guarantees that protect individuals and communities against any action or omission that may interfere with their freedoms and dignity.

To address this problem, in 2002 the World Health Organization (WHO) created the conceptual and policy framework for 'Active and Healthy Aging', which seeks to guide global intervention on aging16. Its proposal is aimed at eradicating discrimination in old age, it is based on the recognition of the human rights of older women and men and their potential to be agents that actively contribute to the well-being of their families, peer groups, communities and nations participating in the social, economic, cultural and political spheres.

In this context, the possibility of an older adult living or not living an active, healthy old age in which it is possible to develop and maintain functional capacities and in full exercise of their rights depends on a variety of factors and circumstances in which the people are born, grow, live, work and age, which are called "social determinants of health" (DSS). The WHO (2002; 2020) explains how our behaviors, behaviors, lifestyles, the characteristics of the physical environments, the social, cultural and economic context, as well as the access to protection services to which we have accessed and in which we have experienced throughout our lives negatively or positively affect our health, participation and security in old age. Likewise, it is highlighted that social inequalities for reasons of gender, ethnicity or socioeconomic level are important markers of difference, since certain socially and historically excluded groups in our societies accumulate a set of disadvantages throughout the course of their lives that ultimately has repercussions. negative effects on the ability to live an active and healthy old age.

Illustration 1: Social determinants of health of active and healthy aging

Source: WHO 2002

In this sense, the active and healthy aging approach proposes that it is the responsibility of our society as a whole to ensure that the PAMs of our country reach an old age with quality of life and well-being.

3.4. Current situation of the problem

Some statistical data is presented to show the current state of the public problem, its causes and effects. According to the main sources, the statistical data collected by the 2017 National Census XII Population, VII Housing and III Indigenous Communities (CVP, 2017), National Household Survey (ENAHO) 2019 and the quarterly technical reports of the National Institute of Statistics and Informatics-INEI on the "Situation of the Older Adult Population" (2020), the current situation of the problem is:

Poverty: By 2019, 16.98% of the PAM in Peru were in a situation of poverty or extreme poverty. Of the total, 26.70% were between 60 and 64 years old; 20.73% between 65 to 69 years; and 52.57% of 70 years and over. Of the total PAM in a situation of poverty or extreme poverty, 51.69% are women and 48.31% are men (INEI, 2019).

Access to health services and care: In recent years, great efforts have been made in the health sector to ensure universal access to health for all Peruvians, for which currently 85.5% of the population Older adult has some type of health insurance. However, not all of this group belongs to the same health system (INEI, IV Quarter 2020). This implies that, in most cases, these services do not guarantee care for mental and chronic illnesses and rehabilitation services that are mainly requested by the country's PAMs, nor access to geriatric and gerontological health services.

Likewise, PAM who have disabilities and live alone require a family and community network to a greater extent for their comprehensive attention, care and protection, according to their needs. It should be noted that 38.4% of the total PAM aged 70 and over live alone (INEI, 2017). In addition, 47.6% of people over 60 years of age have some type of disability to see, speak, hear, understand or learn, interact with others, use arms and legs, among others; This condition being more recurrent in older adult women (50.7%) than older adult men (44.6%), and in older age groups, with its prevalence being 15.1% among those aged 60-70 and 32.5% among those older than 71 years old (INEI, IV Quarter 2020).

Access to the social security system and economic participation: The PAM that continue working represent 54.5% and are usually part of the informal labor market. While only 34.6% have access to some pension system (INEI, IV Quarter 2020). In this sense, for many older women and men, economic activity is still essential, despite no longer belonging to the working-age population (PET), given that they do not have a pension that guarantees them a monetary income or receive a insufficient pension that does not allow them to cover their needs and that of their family whom, in many cases, they still have to support.

Access to education: The educational level attained by the country's elderly population is quite low, especially in the case of women and populations in rural areas. Precisely, 14.6% of them do not have an educational level and only 39.8% have an initial level, 27.3% reached complete primary school and 6.5% reached non-university higher education and 11.9% higher university education (INEI, IV Quarter 2020).

Finally, according to what has been indicated, it can be pointed out that the barriers faced by older adult women are access to education, access to the social security system, the right to good treatment and care, for which, They present some data disaggregated by sex and analyzed from a gender perspective, which complement the causality surrounding the identified public problem:

Violence: the majority of complaints made by PAM registered in the CEMs during the year 2020 were made by women (73.64%), making visible an extremely wide gender gap, which is why interventions are needed that combine the gerontological and gender approach to deal with these particular cases. Additionally, two surveys carried out by INEI provide information on this topic. On the one hand, ENAHO (2019) provides knowledge about violence and discrimination against PAM that is exercised by public institutions.

Temporary protection measures: During the year 2020, temporary protection measures of an administrative nature were issued in favor of 513 PAM in a situation of risk due to violence, fragility, dependency, poverty or extreme poverty, of which 60% were men and 40% women. These PAM risk situations are not exclusive, having identified that 68% of PAM with temporary protection measures have a multiple risk situation.

Care service: According to information from the National Population and Housing Census (INEI, 2017), 38.4% of the total PAM aged 70 and over live alone. The proportion of this population is similar both in urban and rural areas. However, the latter presents a more serious situation because there is less accessibility to different public health and care services, which puts them in a situation of greater neglect and vulnerability. Likewise, notable gender differences are evident, being 53.8% the percentage of older adult women who live alone compared to 46.2% of older adult men in the country.

Illiteracy: 18.3% of the population aged 60 and over cannot read or write (INEI, IV Quarter 2020). This situation is higher in women, 28.0% of older adult women are illiterate, being more than three times that of their peers in men (7.5%). Lastly, the gaps in the figures for educational level attained and illiteracy deepen when other variables such as ethnicity are incorporated. For example, the educational level reached by the PAM who self-identify as Afro-Peruvian or Afro-descendants is concentrated in primary (47%) and secondary (26.1%), 19.5% stated that they did not know how to read or write (67% women and 33% men). (CPV, 2017). Likewise, illiteracy is higher in the PAM that speak languages ​​other than Spanish, especially if they are women.

Health benefits: Currently, most of the PAMs in Peru have at least one chronic disease (76.1%). The older adult population with some chronic health problem is higher for women (82.3%) than for older men (69.1%) (INEI, IV Quarter 2020). For the same period, it is identified that of the total adult population aged 60 and over, 85.5% have some type of health insurance, whether public or private.

Regarding the Comprehensive Health System (SIS), the department of Lima concentrated in 2019 the largest number of insured (569,903), of which 309,673 are women and 260,230 men. Another notable aspect of that year is that of the PAM that had SIS, 79.1% live in rural areas, 40.3% in the urban rest, and 25% in Lima, according to the files sent by INEI. Other departments with the largest number of SIS affiliates were: Cajamarca with 70,045 men and 79,414 women; Piura with 70,226 men and 73,916 women; La Libertad with 62,391 men and 72,881 women.

Pension system: Women in Peru still have a weak connection with the labor market, this accounts for the burden of women in care roles, which translates into lower levels of pension coverage. The average participation rate for women in the labor force in LAC is 56% compared to 83% for men (IDB, 2015). Likewise, women report fewer years of formal employment and greater career interruptions than men (IDB, 2015; Ombudsman, 2019). Therefore, only 26.7% of older adult women in the country have a retirement pension, compared to 55.4% of older adult men (INEI, 2020). The differences intensify when contrasting the reality of poor older adult women living in rural areas with non-poor older adult men in urban areas. Only 0.1% of the former have access to an old-age pension compared to 45.6% of the second group (Olivera, 2015).

3.5. desired future situation

After having described the public problem that the PNMPAM addresses, it is up to us to ask ourselves about the future situation that we want to achieve by the year 2030, that is: How do we want Peruvian seniors to live in a certain time horizon? The desired future situation is determined as the most favorable and feasible situation to be achieved at the end of the PNMPAM's validity period, considering all the context variables. This vision for the future has been developed in a participatory manner taking into account the opinions and aspirations of the older adult population17, as well as the analysis of scientific evidence that allows us to foresee future trends, contextual scenarios, risks and opportunities associated with the public problem.

For this, the documents prepared by CEPLAN have been used as a reference: "Peru 2030: Global and regional trends", "2020 Report on Global Risk and Opportunities for Peru", "Contextual scenarios: global changes and their consequences for Peru"; as well as reports on aging and life cycle prepared by the World Health Organization.

It is worth mentioning that for each of the trends, the risks and opportunities that could affect the implementation of the PNMPAM were identified, which were qualified considering their level of impact and probability of occurrence.

The desired future situation, in addition to taking into account the aspirations of the people, considers the trends and contextual scenarios that could be associated with and impact the public problem, as well as an analysis of evidence of alternative solutions

“By 2030, in our country, structural discrimination based on age towards older adults will be reduced, allowing them to fully exercise their rights, guarantee their quality of life, as well as their possibilities of exercising independence and autonomy in old age”.

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This change will be reflected in the evolution of the following indicators:

- Percentage of older adult women and men who declare having suffered some type of discrimination in the last 12 months will be reduced to 3.9%.

- Percentage of older women and men with chronic diseases will drop to 74.6%.

- Percentage of elderly women and men who have some type of pension will increase to 41.4%.

- Percentage of adult women and men over 60 who did not access or did not complete Regular Basic Education (EBR) will be reduced to 53.8%.

IV. PRIORITY OBJECTIVES AND GUIDELINES

According to the development of conceptual aspects, the problem tree, the desired current and future situation and the analysis of solution alternatives, the five priority objectives of the PNMPAM are presented below. The objectives are the center of the strategic commitment of the PNMPAM, they contain indicators that will measure its performance, and guidelines that will specify the interventions of each sector towards the established time horizon. It should be noted that the objectives and guidelines will be implemented taking into account the diversity of older adults, including their characteristics, needs and interests in the different areas in which it is developed; as well as the transversal approaches of human rights, gender, intergenerational, interculturality, gerontological, life course, territorial, disability, intersectional and differential for the effective enjoyment of the rights of the older person. There are five priority objectives and 22 guidelines that are described below:

V. PROVISION OF SERVICES

The priority objectives allow to achieve the main challenges of the PNMPAM, this in turn, are implemented through the guidelines, which can be implemented through regulatory instruments (such as strategies, standards, plans, among others. ), provisional services, non-provisional services or intermediate services, which are delivered to older adult women and men in response to their differentiated needs. Services are provided without discrimination based on nationality or any other nature.

The identification and design of services was carried out with the sectors involved in the PNMPAM, which for each guideline opted for a service. In this sense, the list of services that implement the guidelines is presented.

On the other hand, in the case of those PNMPAM services that do not have projected goals for the year 2030, once the policy is approved, the DIPAM, in coordination with the sector in charge of implementing the service, will establish in the In the short term, a Work Plan for the collection of information from the sources described in its Technical Data Sheets of Indicators, as well as the determination of its baseline and projection of corresponding goals, in such a way that one year after the start of implementation of each service , such information is available.

VI. MONITORING AND EVALUATION

The monitoring and evaluation process of the PNMPAM will be accompanied and assisted by the Planning Office (OP) of the General Office of Planning and Budget (OGPP) of the MIMP, in its capacity as a member of the National Strategic Planning System (SINAPLAN), so it has to comply with the objectives, guidelines and directives issued by CEPLAN19.

The technical manager for monitoring and evaluation of the PNMPAM is the General Office for Monitoring, Policy Evaluation and Decentralized Management (OGMEPGD) of the MIMP.

6.1. Follow-up

Monitoring is a process that includes the periodic collection of information, its recording and descriptive analysis in order to account for the progress in compliance with national policies, taking into account the transversal approaches of the PNMPAM.

The OGMEPGD carries out the monitoring process of the PNMPAM once a year, in coordination with the Directorate of Older Adults (DIPAM) and the Senior Management Body on which the Policy depends, according to the methodological guidelines established in the guide for Monitoring and Evaluation of National Policies (process, reporting structure, guidelines, schedule), so that it is subsequently sent to the OGPP in its final version for registration and/or verification of the information in the CEPLAN Application .

This process is fulfilled when the OGPP issues the Monitoring Report of the CEPLAN Application according to the information submitted, ensures its publication in the MIMP Standard Transparency Portal (PTE) and sends the report to the holders of the ministries involved in the PNMPAM.

6.2. Assessment

The PNMPAM is evaluated annually in terms of its implementation and results through the following documents:

- Implementation evaluation: It is an evaluation of the execution of the PNMPAM with respect to what was planned, with the aim of providing feedback to the learning processes.

The OGMEPGD will conduct the implementation evaluation and prepare the respective report in coordination with the DIPAM and the Senior Management Body on which the PNMPAM depends, and based on the coordination carried out with the entities involved in the Policy. Likewise, it will be in charge of communicating its results in the MIMP Standard Transparency Portal (PTE) and to the corresponding instances.

- Evaluation of results: Analyzes the achievement of the objectives of the PNMPAM, contrasting the actions implemented with the results obtained; in order to identify the factors that contributed to or prevented the good performance of the national policy or plan in terms of effectiveness or efficiency.

- The OGMEPGD will conduct the evaluation of results and prepare the respective report in coordination with the DIPAM and the Senior Management Body on which the PNMPAM depends, and based on the coordination carried out with the entities involved in the Policy. Likewise, it will be in charge of communicating its results in the MIMP Standard Transparency Portal (PTE) and to the corresponding instances.

6.3. compliance report

This report describes the progress and current situation of the PNMPAM, which seeks to solve the public problem. In this sense, the progress, the main interventions and the proposals for improvement of the priority objectives of the national policy are described.

The OGMEPGD annually reports the information in coordination with the DIPAM and with the Senior Management Body on which the PNMPAM depends, so that it is subsequently sent to the OGPP in its final version for its information registration in the CEPLAN Application .

This process is fulfilled when the OGPP registers the information sent by the OGMEP in the CEPLAN Application, and sends the Compliance Report to CEPLAN.

The entities involved in the PNMPAM are responsible for timely providing the information that the DIPAM, in coordination with the OGMEPGD and with the Senior Management Body on which the Policy depends, requests within the framework of the monitoring and evaluation phase of the PNM- PAM.

The recommendations of the PNMPAM implementation and outcome evaluation reports must be taken into account by the entities responsible for the provision of services, thus implementing opportunities for improvement and providing feedback to the strategic planning cycle.

The entire monitoring and evaluation process must be carried out under the methodological guidelines established by CEPLAN in terms of monitoring and evaluation of policies and under the guidelines that the MIMP, in its capacity as rector of the PNMPAM, deems appropriate.

On the other hand, in the case of those PNMPAM services that do not present projected goals, once the policy is approved, the DIPAM with technical assistance from OGMEPGD coordinates with the sector in charge of implementing the service, which must establish in the short term, a Work Plan for the collection of information from the sources described in their Technical Data Sheets of Indicators, for the determination of their baseline and projection of corresponding goals.

1 Political Constitution of Peru. Article 1.

2 Political Constitution of Peru. Article 4.

3 Political Constitution of Peru. Article 2.

4 Political Constitution of Peru. Article 16.

5 Political Constitution of Peru. Article 23.

6 Political Constitution of Peru. Article 7.

7 Congress of the Republic. Legislative Resolution no. 31090. Published in the Official Gazette El Peruano: December 17, 2020; and, Ministry of Foreign Relations. D.S. no. 044-2020-RE. Published in the Official Gazette El Peruano: December 23, 2020. The Convention constitutes the first binding legal instrument on the protection of PAM rights worldwide. It highlights "the need to address the issues of old age and aging from a human rights perspective that recognizes the valuable current and potential contributions of the older person to the common well-being, to cultural identity, to the diversity of their communities, to the development human, social and economic and to the eradication of poverty”. It also stresses that as people age, "they must continue to enjoy a full, independent and autonomous life, with health, security, integration and active participation in the economic, social, cultural and political spheres of their societies". Thus, it also underscores the responsibility of the State, and the participation of the family and the community in the active, full and productive integration of the elderly person into society, as well as in their care and attention. In turn, the participation of the PAMs in the preparation, application and control of public policies and legislation aimed at the implementation of the Convention is promoted.

8 The prohibition of discrimination based on age is based on article 2 of the Political Constitution of Peru, article 323 of the Penal Code and article 5 of Law no. 30490, Older Persons Law.

9 In the 1950s, Peru was approaching what is called “natural fertility” because each woman of reproductive age had 6.95 children, suggesting that there was very little birth control in that period. Currently, this has changed dramatically, since, on average, each Peruvian of reproductive age has 2.16 children. This is due to the increase in the use of family planning methods, going from 59% in the 1990s to 75% in 2018 (United Nations, 2019).

10 This is because life expectancy at birth has gone from 44 to 77.4 years between 1950 and 2020; and it is projected that by the year 2050, every newborn child expects to live to be 83 years old on average. Similarly, in the 1950s, a PAM expected to live only 13.8 years longer on average (up to age 73). However, in the year 2020, a PAM estimates to live 22.86 more years (until 82) (United Nations, 2019).

11 INEI. In Peru there are more than four million older adults. 2020. Retrieved from: http://m.inei.gob.pe/prensa/noticias/en-el-peru-existen-mas-de-cuatro-millones-de-adultos-mayores-12356.

12 This statistical projection does not consider the impact of COVID-19 on the older adult population.

13 Inter-American Convention on the Human Rights of Older Persons. Article 2.

14 In 2002, the WHO made public the “Active Aging” policy framework, during the Second World Assembly on Aging organized by the United Nations when the Madrid International Plan of Action on Aging was approved.

15 Law No. 30490, Law of the Elderly Person. Art.25.

16 The WHO in 2002 made public the “Active Aging” policy framework, during the Second World Assembly on Aging organized by the United Nations when the Madrid International Plan of Action on Aging was approved.

17 The approach of the desired future situation has been obtained from methodological tools of direct consultation with the population. In the first place, the Survey of expectations, preferences and aspirations on the Multisectoral National Policy for Older Adults was applied. This was aimed at social organizations of older adults and public servants dedicated to the protection and promotion of the rights of this population. Secondly, a participatory workshop was held in which 40 organizations of older adults participated at the national level.

18 This service is not a program referred to in article 38 of Law No. 29158, Organic Law of the Executive Power.

19 Legislative Decree No. 1088: The bodies of the National Strategic Planning System maintain a technical and functional relationship with the National Center for Strategic Planning (CEPLAN) in matters within their competence and are obliged to comply with the objectives, guidelines and directive issued by CEPLAN.