Zahedan University of Medical Sciences

    The University of the Third Age (U3A) in Iran: a Model for Successful Ageing

1.       Introduction

The world population is rapidly ageing due to low birth rates and rising life expectancy. It is expected that between 2000 and 2050, the proportion of people aged 60 years and over will, Increase from about 11% to 22%.    The global trend in population ageing is unprecedented, pervasive, enduring and it will affect every community, family and person.

 Population ageing is worldwide phenomenon and it is proceeding with the fastest pace in low- and middle-income countries. For instance the proportion of the aged population in France doubled over a period of 100 years.

 However, Brazil will experience the same population growth in less than 25 years.  The fast progression toward aging is affording developing countries less time to adjust to this structural change. An increasingly ageing population leads to an increase in the burden of the diseases associated with old age, such as cancers, diabetes and other chronic diseases. Hence, many countries across the world are facing the healthcare, social and economic challenges posed by these demographic changes. Countries need to prepare for an aging world to address the challenges.

2.       What is "active ageing?"

Promoting good health and healthy lifestyle in elderly is vital to the global response to the rapidly growing increase in the proportion of the aged people worldwide. Good physical, social and mental health can help older people lead full, independent and productive lives throughout the aging process. WHO has identified “active ageing” as an evidence-based strategy for diminishing the consequences of the global increase in the proportion of the population aged 65 years and over. “Active ageing is the process of optimizing opportunities for health, participation and security in order to enhance quality of life as people age”. Active ageing will result in an increase in life expectancy and improvement in the quality of life for the elderly.

 One of the major issues the seniors are facing is social isolation, which can adversely affect their health and wellbeing.  Interventions to foster participation of aged people in social activities are potential ways to tackle this problem. These may include a wide range of leisure, social, cultural and spiritual activities in the community.

3.       The University of the Third Age (U3A)

Health education plays an important role in improving the older people"s quality of life. The University of the Third Age (U3A), though not a university in the conventional sense, is a flourishing elderly education initiative that has been functioning successfully in many countries for more than 40 years. The concept of U3A was developed in France in 1972 and it spread rapidly throughout the globe. 

What is meant by the term “university” here is the concept of bringing together like-minded people who like to teach with people who want to learn by organizing them into educational groups. The term “Third Age” is based on diving life into three distinct stages: the first age is the age of youth that they learn about the world, the second stage is the age of employment and parenthood, and the third age is when they retire and do what they like. The U3A students can take part in a wide range of courses that enables them to share skills and knowledge in such fields as art, languages, music, history, life sciences, philosophy, computing and photography, etc.

4.       Quality of life, health status and U3A membership

Although a handful of studies have been carried out to evaluate the role of U3As in improving the health status in the elderly, it is clearly evident that this initiative has growingly became a global success story in educational, social ,and psychological needs of the ageing population.

A study on the quality of life of the U3A students in Poland showed that the elderly people individuals participating in these courses have satisfactory and relatively stable parameters of quality of life in all areas of functioning. Another study that compared the perceived well-being of members of U3A from Sydney, Australia with USA normative peer groups showed that members of U3A had a better general, physical and mental health. The results from this study also concluded that enrolling to U3A courses can, even in the very elderly, lead to a much more positive perception of well-being. It also has been reported that the level of self-rated health by U3A students could be modified by factors such as age, income, lack of symptoms/illness and feeling happy.

 The sense of coherence, which determines how elderly people cope with various difficult situations, is an important determinant of life satisfaction. Another study in Poland showed higher levels of sense of coherence in U3A students. This in turn can results in better adaptation to old age stage challenges life difficulties.

 With a historically unprecedented growth in the proportion of the aged people across the world and given the fact that they begin to experiences in different aspects of their health and well-being, more attention is drawn to the need for services that help them maintain their active lifestyles and activities. The promotion of U3As can potentially offer the elderly a great opportunity for personal productivity and achievement.

5.       Establishment of the first ever U3A in the Islamic Republic of Iran

The University of the Third Age (U3A) was first launched in Zahedan University of Medical Sciences in April 2012 as part of the events celebrating the International World Health Day, with the theme of "Ageing and Health."

 The U3A membership eligibility: "U3A membership is not related to a specific age but to a period in one’s life (the third age) after the second age of full-time employment and parental responsibility". Anybody in their third age can join U3A and this includes people who are working part-time. Membership includes many with experience and expertise in almost all walks of life and letters. Participants need to be 55 years and older and have a high school diploma. The duration of the courses are planned as one month period. The lecturers include public health experts working in the Sistan and Blaouchestan Provincial Health Center, university lecturers from the School of Public health, and medical doctors affiliated with the Zahedan University of Medical Sciences. All the lecturers are experts in their individual fields and highly regarded for their intellect and contributions to their respected disciplines.

The course details: The range of subjects embraced by the U3A is mind-boggling. Typical courses include: the principles of self- care during the aging period with the aim of the prevention and management of common non-communicable diseases of the aged population including cardiovascular diseases, diabetes, cancers, and so on, healthy nutrition and physical activity ,mental health, drug abuse and first aids. Given the fact that the Sistan and Balouchetsan Province in southeast of Iran still have the highest burden of communicable diseases such as malaria, tuberculosis, and Crimean-Congo Hemorrhagic   Fever, and influenza,   subjects   on    infectious   diseases   have   been incorporated in the training courses.

The established U3A in Zahedan has a special logo that is a mixture of ZAUMS and the international generic U3A logos. The students will be issued an ID card during their enrollment in the training courses and will receive "graduation certificate" at the end of the course. 

3A students ID card	U3A logo

U3A Certificates

Most of the subjects have a prepared syllabus, which is based on the public health experts’ opinions and some recommendations from the elderly people who participated in the U3A training courses. However, there is a room for the participants to have a say during the courses. Members share their skills and life experiences: the learners teach and the teachers learn, and there is no distinction between them. The classes are conducted in such a way that to prompt conversation and research. There are also many less educationally focused activities, including gardening, library, computer skills, cultural heritage activities, and so on. The courses also include some training on the history, literature and Islamic culture.

So far 16 courses have been held (as of December 2016) and a total of 244 students have been graduated. After graduation all the participants may enroll to the Skilled Community Health Volunteers program. At the end of the course, the participants in a formal graduation ceremony take oath to have a proactive role in maintain and promoting the health status of themselves and their community, and they receive a certificate signed by the ZAUMS deputy for health. 

6.       The U3A members in action

The University of the Third Age (U3A) movement is a unique and exciting organization which provides, through its U3As, life-enhancing and life-changing opportunities. Retired and semi-retired people come together and learn together, not for qualifications but for its own reward: the sheer joy of discovery.

The U3A members actively participate in all of the public health events organized by ZAUMS

The U3A members participate in all the conferences and seminars planned by the ZAUMS deputy for health 

"International Day of Older Persons" observed in Zahedan University of Medical Science

 In February 2012, a group of the U3A members went on a tour of Kish Island, a 91.5-square-kilometre resort island in the Persian Gulf. Kish Island was ranked among the world’s 10 most beautiful islands by The New York Times in 2010, and is the fourth most visited vacation destination in Southwest Asia after Dubai, United Arab Emirates, and Sharm el-Sheikh. These  recreational activities were initiated by theU3A members and have been held on many occasions.

The U3A members participated in First Aid classes that were held at a tertiary-care teaching hospital clinical skills lab. During this class they learn the basic life support activities.

The U3A students visiting the Blood Transfusion Organization of Sistan & Balouchestan Province

Cooperation in setting up some exhibitions organized by the ZAUMD deputy for health affairs

Chess contest for elderly held in a public park, organized as part of activities observing the “Mental Health Week”

Painting competition for U3A members organized to observe the “International Day of Older Persons”

The U3A members observing “Neighbors Day” ceremony.

In June 2015, the U3A members themselves have established a loan fund for the members, which are considered as one of the empowering activities of the students.

 The U3A members visiting the Zahedan Cultural Heritage Museum 

7. The U3A members living a better life after participating in the training courses

Our experience of almost 4 years showed that the majority of the elderly, who are graduated from U3A, are joyfully planned to continue their lives. Some of the positive effects of attending U3A classes are considered as improving family relationships, increased participation in social activities, increasing physical activity and improving dietary habits.

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