“They Do Not Care about Us Anymore”: Understanding the Situation of Older People in Ghana

Abstract

While existing research acknowledges copious challenges faced by older adults (people aged 60 and over) in Ghana and most countries in sub-Saharan Africa, they fail to situate the lived experiences of this vulnerable group within the broader context of health geography and public health. This paper draws insights from ecological systems theory and the “geographies of older people” literature to examine the lived experiences of older people in Ghana. Data for the study were gathered using interviews (42) and sharing circles (10). Our findings reveal a complex mix of experiences consistent with the different levels of the environment. Dominant themes include access to social support, functional impairment and poor health status, social status, poor access to water and sanitation services, food insecurity, economic insecurity, and caregiving burden. These findings support the wide-held notion that the experiences of older people are complex and produced by the interplay of both individual and structural factors. Our findings demonstrate that sociocultural, economic, political, and climatic factors are important consideration in promoting elderly wellbeing and quality of life in Ghana.

An ecological systems analysis of food access barriers and coping strategies adopted by older adults in Ghana

“…The microsystem, the first level, entails the interactions between the older person and their immediate environment such as family, peers, and workplace. Many older adults depend heavily on their immediate environment for both physical and social supports (Doh et al 2014;Braimah and Rosenberg 2021)-hence, the interactions between them and their immediate environment may either facilitate or hinder food access. The mesosystem is much broader and consists of the interrelationships between settings in which the older person is situated.…”

“…In fact, EST is one of the most prominent ecological theories in developmental research and has been widely applied in studying older adults in a range of contexts. For example, the literature adopts the theory to explain living environments and older people's quality of life in New Zealand (Stephens et al 2019), food security among low-income lone senior women in Canada (Green-Lapierre et al 2012), and lived experiences of older adults in Ghana (Braimah and Rosenberg 2021). EST has also been applied in research involving other population groups including children (see Paat 2013;Yendork 2020).…”

“…While efforts have been made over the years to promote the well-being of older adults in Ghana, in line with the United Nations global development agenda, concerns exist relative to the efficacy and accessibility of existing social protection programs (Kpessa-Whyte and Tsekpo 2020; Braimah and Rosenberg 2021). For instance, the Livelihood Empowerment Against Poverty (LEAP) program provides cash grants to extremely poor people, including older adults over age 65 without productive capacity (Angeles et al 2017;Agyemang-Duah et al 2019).…”

“…In the case of the LEAP program, payments are sporadic and small (Angeles et al 2017). Likewise, the National Health Insurance Scheme (NHIS) free enrolment policy excludes a considerable proportion of older adults as it only covers people that are 70 years and over (Kpessa-Whyte and Tsekpo 2020;Braimah and Rosenberg 2021). Further, several health issues affecting older people are not covered under the scheme.…”

“…There are projections this proportion will more than double, to 12.6%, by 2050. Given the projected growth and older adults' vulnerability to food insecurity, there is growing need for empirical evidence on elderly food security in Ghana (Gyasi et al 2020;Braimah and Rosenberg 2021). However, research on food security among older adults in Ghana is limited.…”