Opinion: Ageing issues in Sub-Saharan Africa

The number of people living beyond the age of 60 years in both developing and developed countries is increasing. By 2050, the proportion of older people will have doubled resulting in approximately 2 billion. It is expected that eight in every ten of these will be from developing nations. Whilst ageing may depict a triumph in health, it is also associated with a number of health concerns such as the onset of chronic conditions, frailty and increased vulnerability to communicable diseases. The increase in the proportion of older persons requiring chronic care management in Sub-Saharan Africa causes challenges for health service provision since health care resources are limited. 

Issues concerning the older persons in SSA are currently not being given as much attention as they require. Although the Vienna and Madrid Action Plans for Ageing recommend cues for action in both developing and developed countries for ageing persons, the implementation of these recommendations has not yet taken precedence in the sub-continent. Some issues related to ageing in SSA are highlighted here: poverty, care for the elderly, end of life decisions and Older Persons Policies.

Significant proportions of the older persons in SSA live in poverty. Most have never been employed and have no pension fund. For those who have worked, the pension funds could have been greatly affected by the global economic crisis and the individual country inflation. The only meaningful possible solution would be social grants. South Africa has a grant for older persons but contrary to other SSA countries South Africa is middle income country. The fact that South Africa affords to pay old persons grants does not warrant that other countries in the region are able to do so.

Less than 10% of the older persons in SSA stay in formal care institutions, partly because of the limited capacity. Previously this has never been a problem as most older persons remained at home being supported by family within community structures. However, the challenges brought about by HIV have impacted negatively on the family structures. Whilst older persons are known to be caregivers to HIV orphans, very little is said about the orphans who miss school when taking up care giving roles for the older persons.

There are lots of ethical debates about euthanasia (passive, active, voluntary) and physician assisted suicide in the developed world, but very little debate, if any, is going on in SSA. There is pressing need to engage in discussion and debate about the subject of end of life decisions.  

Finally, older persons need to be meaningfully engaged in the development of policies that affect them. Special Older persons policies should be developed (like in South Africa, although these are not well implemented). SSA should focus on policies that will enable healthy ageing yet still respect individuals’ rights and are beneficial to the individual and the community at large.

In conclusion, SSA needs to take up an active role in taking care of older persons in the communities. 

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