Will the developing world grow old before it grows rich?

Categories: Policy.

The world population is ageing. HelpAge International projects that by 2050, nearly 1 in 5 people in the developing world will be over 60 years old. In 2010, the Centre for Strategic and International Studies found that global life expectancy has risen by 21 years since 1950.

But nowhere is this global phenomenon more apparent than in the developing world. As a result of a falling birth rate and an increase in life expectancy, elderly population rates within low and middle income countries continue to grow in comparison to high income countries.

An ageing population A sign of development 

An ageing population is, in one sense, a positive sign. It suggests we are moving towards achieving the 2015 United Nations Millennium Development Goals. In this sense it is a cause for celebration.

In the wake of these development advances, it is inevitable that development strategies need to reflect this change in demographic to prevent a reverse effect on the Millennium Development Goals for 2015.

This population shift means there is a greater need for establishing more comprehensive health care services across Africa. This could not only help older persons live increasingly healthy and fruitful lives during old age, but would also provide palliative and hospice care for older persons in the end-of-life stages.

Without planning and preparing healthcare systems for the growing needs of this emerging demographic, African nations are potentially putting their future generations at risk and depriving them of the care and support they need and deserve.

Needs of older persons struggling to make the ‘agenda’

Those advocating for the rights of older persons, such as HelpAge International, have acknowledge that improved access to appropriate healthcare is one of the most important needs of an elderly population.

However, progress has been slow in all but a few African nations who have managed to offer their ageing population adequate healthcare system. These countries though can act as models for other nations looking to mainstream the needs of older persons into their own healthcare systems.

The HelpAge International report, Insights on Ageing: A Survey Report, found several factors that interfere with older people’s ability to access appropriate healthcare, including travel times and associated costs and limited or restricted access to health insurance. While these factors are crucial to consider and rectify in order to successfully deliver healthcare to older persons, the issue of healthcare access for older persons is far more systemic than situational.

The same report also found that there is a disproportionate focus on the prevention and treatment of communicable diseases, rather than chronic conditions such as cancer despite evidence that such chronic diseases account for a large portion of deaths amongst older.

The African Palliative Care Association in their report, Bridging the Gap, highlights the limited number of institutional-level palliative care and hospice care services for older persons. This leaves the burden of caring for chronically ill and dying persons in the hands of the families and communities of the older persons in need of such services.

Identifying the solutions for older persons – a call for comprehensive healthcare

To tackle the issue of adequate healthcare services and widespread access to older persons in Africa, there are a number of proposed solutions.

At the national level, policy must be amended to include the needs of this demographic. That means a non-discriminatory healthcare system that offers specialised services in geriatrics, palliative care, and hospice.

At the community level, it means delivering healthcare at the community and home-base level when possible to alleviate the burden of travelling to health centres and hospitals and the associated costs that prevent so many older persons from receiving the treatment available.

HelpAge Ghana is one organisation committed to bringing healthcare directly to the patients. The Executive Director of HelpAge Ghana, Ebenezer Adjetey –Sorsey commented saying:

“What we are realising is that as people grow older, especially when they become bed-ridden or have difficulty in walking, it becomes a discouragement to many families to take them to hospitals. And we experience a lot of self-medication in the homes, because if you are taking such a person to a hospital it means to have to arrange transportation, which is more expensive. So we believe that an intervention that takes healthcare closer to the older people will work for us and that is the main basis for our health program.”

HelpAge Ghana is also an organisation that recognises the need for psychosocial support for this demographic and their families as they face these heath issues together as part of a comprehensive healthcare strategy. Adjetey –Sorsey continued saying:

“We provide counselling to family members when there are complex situations. We also provide counselling to family caregivers who are burning out and provide them with counselling to overcome those situations and conditions.”

The Increased Demand for Palliative Care and Hospice Care in Africa

The rising needs of older persons in the developing world, and particularly in Africa, are inescapably linked to an increase demand for palliative care and hospice services. Unfortunately, these services often do not make the national healthcare agenda. Older persons in nations that do have institutions specialising in palliative care and hospice, often still lack access to them because of poverty.

In the case of Ghana, poor older persons generally are not able to access such services as they are typically delivered by private providers whose prices are unaffordable.

The Executive Director of HelpAge Ghana, Ebenezer Adjetey –Sorsey commented on this saying, “Our focus is on the poor. Right now [palliative and hospice care] is left in the hands of the private sector, and that is where the problem is. There are institutions coming up gradually in palliative care, but the poorer the person is, the more difficult for them to access those kinds of services because of poverty.”

If Africa is to successfully meet the rising needs of this growing demographic, it must continue to address the need for implementing healthcare systems that are inclusive, comprehensive, and affordable to older persons.

To ignore such a pressing issue in lieu of other development goals would be a grave disservice to the future of today’s African generations.  

Kate Kardol works as a freelance writer and is based in Switzerland.

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