Aging and Health in Africa (International Perspectives on Aging Book 4)

Annotation Population aging is a matter of global concern. It often occurs in tandem with changes in the health profile of the population. In Africa, many countries are already facing a high burden of communicable diseases. However, as more and more children survive childhood and move on to adult years and old age they are also more likely to experience health problems associated with the aging process. Population aging in Africa is occurring in the context of high levels of poverty, changing family structures, an immense disease burden, fragile health systems and weak or poorly managed government institutions. This book shows that aging is likely to lead to increased social and economic demands for the continent. However, most national governments in Africa have not begun to address the issue of how to respond effectively to the needs of the older population. This will require a better understanding of the socio-economic and demographic situation of the older population in Africa. This book fills the gaps that exist by exploring the social realities of population aging in Africa. It also focuses on the policy and programmatic responses, gaps and future challenges related to aging across the continent Aging and Health in Africa 3 Preface 5 Contents 7 Acronyms 9 Contributors 11 Chapter 1: Introduction 13 1.1 Overview of Population Ageing in Africa 14 1.2 Challenges of Healthy Ageing in Africa 16 1.3 Summary and Organisation of the Volume 19 References 20 Chapter 2: Population Ageing in Africa 22 2.1 Introduction 22 2.2 Population Ageing in Africa 23 2.3 Characteristics of the Ageing Population in Africa 26 2.3.1 The Demographic Determinants of Population Ageing 26 2.3.2 The Magnitude and Pace of Ageing in Africa 28 2.4 The Pro fi le of the African Ageing Population 32 2.4.1 The Dependency of the Ageing Population on the Working-Age Population 36 2.4.2 Regional Trends in Ageing 37 2.5 Demographic Trends in Ageing 41 2.5.1 Gender Differentials 45 2.6 The Country-Level Differentials in Population Ageing 49 2.6.1 Country-Level Demographics 52 2.6.2 Gender Differentials 55 2.7 Conclusion 59 References 61 Chapter 3: The Health Situation of Older People in Africa 63 3.1 Introduction 63 3.2 The De fi nition of Health and Well-Being 64 3.3 Why Focus on the Health of the Elderly? 65 3.4 Challenges of Measuring Health in Africa 68 3.5 Myths About the Elderly 70 3.6 Factors Affecting the Health of the Elderly 72 3.6.1 Socio-economic Conditions 72 3.6.2 Urban–Rural Residence 75 3.6.3 Gender 76 3.6.4 Education 78 3.6.5 Marital Status 79 3.6.6 Social Networks 80 3.7 Access to Health Care 81 3.8 What Do We Know About the Health of the Elderly? 84 3.8.1 Causes of Mortality and Morbidity Among the Elderly in Sub-Saharan Africa 85 3.8.1.1 Cardiovascular Diseases 85 3.8.1.2 Respiratory Diseases 87 3.8.1.3 Diabetes Mellitus 88 3.9 Risk Factors for Non-communicable Diseases 90 3.10 Conclusion 93 References 94 Chapter 4: Health and Health Seeking Behaviour in the Democratic Republic of the Congo: Perspectives of the Elderly 100 4.1 Introduction 100 4.2 Methodology 102 4.3 Health Situation of the Elderly 103 4.4 Health Seeking Behaviours 104 4.5 Discussion 107 References 109 Chapter 5: Older People in Rural Ghana: Health and Health Seeking Behaviours 111 5.1 Introduction 111 5.2 Ghana’s Health Promotion 112 5.3 Overview of Health Conditions in Rural Areas 114 5.4 Overview of Ageing in Rural Ghana 115 5.5 Objectives and Methodology of the WHO INTRA Study 118 5.5.1 Brief Pro fi le of Selected Rural Localities 119 5.5.1.1 Twepease 119 5.5.1.2 Aseseeso 119 5.5.1.3 Ashivie 119 5.6 Findings 120 5.6.1 Basic Characteristics of the Rural Participants 120 5.6.2 Older People’s Perception of Health and Well-Being 121 5.6.3 Use and Non-use of PHC Services 122 5.6.4 Health Seeking Alternatives 122 5.7 Emerging Implications for Policy 123 5.8 Conclusion and Recommendations 124 References 126 Chapter 6: Growing Old in the Era of AIDS: Perspectives and Experiences of Older Men and Women in South Africa 128 6.1 Introduction 128 6.2 Context 130 6.3 Methods 131 6.4 Results 132 6.4.1 Personal Awareness of AIDS 132 6.4.2 Informal Caregiving 136 6.5 Discussion 140 References 143 Chapter 7: The Impact of HIV/AIDS on Older Persons in Uganda 146 7.1 Introduction 146 7.2 Study Context 148 7.3 Methods 149 7.4 Data Analysis 150 7.5 Results 151 7.5.1 Impact of AIDS 151 Sec8 152 Sec10 153 Sec12 155 7.5.2 Coping Strategies 156 Sec15 157 7.6 Discussion 158 7.7 Conclusion 160 References 160 Chapter 8: On the Fringe of Poverty: Care Arrangements for Older People in Rural Cameroon 163 8.1 Introduction 163 8.2 Data and Methods 164 8.3 Findings 166 8.3.1 Care Patterns and Survival Arrangements 166 8.3.2 Does Social Capital Count? 171 8.3.3 Fulani Herders and Lineage Transactions 172 8.4 Policy Implications 173 8.5 Conclusion 175 References 175 Chapter 9: Ageing in Post-Apartheid South Africa: An Analysis of the “Nearly Old” 177 9.1 Introduction 177 9.2 Poverty, Unemployment, and Health of Older People 180 9.3 Analytical Framework 185 9.3.1 The Young Years (15–29) 186 9.3.2 The Middle Years (30–49) 186 9.3.3 Near-old Age (50–59) 187 9.3.4 Early Old Age (60–69) 187 9.3.5 Late Old Age (70+) 188 9.4 Data Analysis 188 9.5 Multivariate Analyses 194 9.6 Discussion 197 References 199 Chapter 10: Understanding the Experiences of the Elderly in Rural Areas in Rwanda 203 10.1 Introduction 203 10.2 Study Site 205 10.3 Methodology 206 10.4 Analysis 207 10.5 Findings 207 10.6 Discussion 212 10.7 Conclusion 214 References 214 Chapter 11: Policy and Programme Responses 216 11.1 Introduction 216 11.2 International Responses to Population Ageing: A Focus on Health Care 218 11.3 National Policy Responses 223 11.4 Impediments to Policy Development and Implementation 224 11.5 Age-Speci fi c Policies and Programmes for the Health of Older Persons 227 11.6 Age-Mainstreaming Policies and Programmes for the Health of Older Persons 229 11.7 Social Protection for Older Age Groups and Its Implications for Health 230 11.8 Civil Society Responses to Ageing and Health 234 11.9 Conclusion 236 References 239 Index 242 Countries with a high percentage of elders risk a serious disease burden and increasing stress on health and social welfare systems. Nowhere is this more evident than on the African continent, where high poverty rates, civil unrest, and unsteady government structures exist alongside medical advances and longer lifespans. Aging and Health in Africa examines this multilayered scenario in abundant detail, providing both a continent-wide overview and nation-specific dispatches regarding an often-marginalized population. The books demographic and socioeconomic profile of elders clarifies the connection between aging and health, and offers keys to better understanding our aging planet. Current and emerging policies and programs to improve health promotion and health care for older people are critiqued, and the author analyzes what still needs to be done to achieve world health goals, especially as nations continue to modernize and rebuild. For each country, the relationship is explored between the experience of elders and the larger social context, including: South Africa: the situation of the nearly old. ʺUganda: the impact of HIV/AIDS on the elderly. Camaroon: elder care arrangements in rural areas. Ghana: elder health and health-seeking behaviors. Congo: health perspectives of older people. Rwanda: understanding the experiences of the rural elderly. A groundbreaking research reference for a wide range of readers including Africa specialists, cross-cultural psychologists, sociologists, demographers, gerontologists, public health professionals, policymakers, and advocates, Aging and Health in Africa will be valued by an engaged, interdisciplinary audience "Countries with a high percentage of elders risk a serious disease burden and increasing stress on health and social welfare systems. Nowhere is this more evident than on the African continent, where high poverty rates, civil unrest, and unsteady government structures exist alongside medical advances and longer lifespans. Aging and health in Africa examines this multilayered scenario in abundant detail, providing both a continent-wide overview and nation-specific dispatches regarding an often-marginalized population. The book's demographic and socioeconomic profile of elders clarifies the connection between aging and health, and offers keys to better understanding our aging planet. Current and emerging policies and programs to improve health promotion and health care for older people are critiqued, and the author analyzes what still needs to be done to achieve world health goals, especially as nations continue to modernize and rebuild. For each country, the relationship is explored between the experience of elders and the larger social context, including South Africa: the situation of the "nearly old", Uganda: the impact of HIV/AIDS on the elderly, Camaroon: elder care arrangements in rural areas, Ghana: elder health and health-seeking behaviors, Congo: health perspectives of older people, and Rwanda: understanding the experiences of the rural elderly"--Publisher's description Front Matter....Pages i-xii Introduction....Pages 1-9 Population Ageing in Africa....Pages 11-51 The Health Situation of Older People in Africa....Pages 53-89 Health and Health Seeking Behaviour in the Democratic Republic of the Congo: Perspectives of the Elderly....Pages 91-101 Older People in Rural Ghana: Health and Health Seeking Behaviours....Pages 103-119 Growing Old in the Era of AIDS: Perspectives and Experiences of Older Men and Women in South Africa....Pages 121-138 The Impact of HIV/AIDS on Older Persons in Uganda....Pages 139-155 On the Fringe of Poverty: Care Arrangements for Older People in Rural Cameroon....Pages 157-170 Ageing in Post-Apartheid South Africa: An Analysis of the “Nearly Old”....Pages 171-196 Understanding the Experiences of the Elderly in Rural Areas in Rwanda....Pages 197-209 Policy and Programme Responses....Pages 211-236 Back Matter....Pages 237-244