Understanding and Advancing the Health of Older Populations in sub-Saharan Africa: Policy Perspectives and Evidence Needs

Abstract

Background: Debate on policy challenges associated with the health of older populations in sub-Saharan Africa (SSA) has intensified in recent years, centering on a concern about older persons' vulnerability to ill-health and their exclusion from health services. Despite international policy calls and formal expressions of commitment on the part of SSA governments, comprehensive policy action has remained scant. The impasse reflects a lack of political will and an uncertainty about required policy approaches, engendered by wide gaps in understanding of old age-related health in the region. Purpose: The purpose of the paper is to pinpoint major approaches and areas of evidence needed as a priority to overcome the impasse in policy on ageing and health in SSA. Methodology: A critical review of relevant SSA and international scientific, policy and development literature conducted as part of a research project on Dimensions and determinants of health in old age in Kenya and Nigeria: implications for policy. Results: Six major areas of evidence and a spectrum of approaches are required to (i) strengthen the case on why action on old age-related health should be pursued in the SSA setting and (ii) clarify what concrete forms such action should take. Conclusion: A systematic research endeavour on the six areas is needed to advance policy and practice on the health of older populations in SSA. If accompanied by an explicit international comparative perspective such research also has the potential to significantly advance scientific debate on ageing and health globally.

Determinants of Health Service Utilization among Older Adults in Bedele Town,Illubabor Zone, Ethiopia

“…Physical and financial constraints impede timely utilization of available health care services. Impeded access can lead to underutilization of primary and preventive health care services which in turn may result in unnecessary hospitalizations, increased morbidity and higher costs of the health care system than necessary [10].…”

Health-seeking behaviours of older black women living with non-communicable diseases in an urban township in South Africa

“…Many older women report lower health status, higher disability, and poorer quality of life compared to their male counterparts [17]. This situation is not peculiar to South Africa; Aboderin [18], also reported that access to healthcare and essential medicines for NCDs is a challenge for the elderly in Africa. Such access to healthcare may be limited for older women in light of their multi-tasking roles and perhaps, cultural restrictions.…”

“…Such access to healthcare may be limited for older women in light of their multi-tasking roles and perhaps, cultural restrictions. Lack of income and limited transportation to hospitals within the continent are additional barriers which may be faced by elderly people with NCDs in their quest for proper healthcare [18, 19]. We hypothesize that these challenges may prompt older women in a South African peri-urban/township area to seek readily accessible treatment options to take care of their health conditions.…”

Editorial: The Public Health Needs for an Ageing Society

“…It addresses the multilevel approaches needed to support longer lives that are healthy and active: from life course approaches to prevention to redesign of our built environment and our institutions to support activity and independence, to adapting our health systems to provide prevention and care that better matches the health needs of people with multimorbidity -and likely at lower cost. The paper by Isabella Aboderin appropriately summarizes the policy challenges faced by sub-Saharan Africa, 13 which has both the fastest growing elderly population of any world region and the substantial persistence of classical tropical diseases, in addition to an increasing superimposition of chronic non-communicable diseases. The case report by Alban Ylli from Albania describes the situation of an already-aged society in which substantial unmet needs exist for older adults.…”