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.
Highlights
International debate on the policy challenges associated with the health of ageing populations in sub-Saharan Africa (SSA) has intensified in recent years, based on two key points of departure
Older populations in SSA are deemed to be at high risk of ill-health and disability from age-related chronic non-communicable disease (CNCD), due to a lifetime of exposure to conditions of deprivation and a growing prevalence of modifiable CNCD risk factors.[5,9,12]
The remainder of this paper provides perspectives on the kinds of evidence that are essential for advancing policy and practice on ageing and health in SSA
Summary
International debate on the policy challenges associated with the health of ageing populations in sub-Saharan Africa (SSA) has intensified in recent years, based on two key points of departure. While the share of persons aged 60 and over*2will remain much lower than elsewhere (increasing from presently 5 percent to only 9.1 percent by 2050), their absolute number will see the sharpest rises globally: from 42.6 million in 2010 to 160 million by 2050.2 Second is SSA’s status as the poorest and ‘least developed’ major world region,[3,4] which implies that the ageing of its populations is largely unfolding in contexts of widespread economic strain.[5] Against this backdrop, the discourse on challenges of ageing and health in SSA centres not, as it does in industrialized countries, on queries about expected trends in old age morbidity, mortality and disability and the sustainability of existing health and care systems.[6,7,8] The focus, rather, are concerns about a heightened vulnerability of older persons to detrimental health outcomes – in two respects. If accompanied by an explicit international comparative perspective such research has the potential to significantly advance scientific debate on ageing and health globally
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