Isabella Aboderin

Modernisation and ageing theory revisited: current explanations of recent developing world and historical Western shifts in material family support for older people

Modernisation and ageing theory has provided the main platform for the debate on changes in family support for older people in both the industrialised and the developing worlds. Although its well-known proposition of an ‘abandonment’ of older people in individualistic society has received much attention and been solidly refuted, the modernisation model continues to be the principal and most common framework for explaining the decline in familial material support for older people – both historically in the West, or at present in developing countries. The main rival explanation is provided by materialist accounts. The ability of these explanations to provide a meaningful understanding of why material family support may diminish has however received little if any analytical attention, despite its vital policy relevance, especially for the developing world. This paper critically examines the content and basis of both explanatory models. For each it exposes fundamental conceptual and epistemological limitations that render neither able to provide a solid understanding of the nature and causes of decline in support. Building on this analysis, the paper proposes a new approach in order to develop a fuller conceptual and empirical understanding.

Linking Ageing to Development Agendas in Sub-Saharan Africa: Challenges and Approaches

International calls and frameworks for policies on ageing in sub-Saharan African countries, encapsulated in the UN Madrid Plan of Action on Ageing (2002) and the African Union Policy Framework and Plan of Action on Ageing (2003), have resulted in little concrete policy action. The lack of progress calls for critical reflection on the status of policy debates and arguments on ageing in the sub-region. In a context of acute development challenges and resource constraints, the paper links the impasse in policy action to a fundamental lack of clarity about how rationales and approaches for policy on ageing relate to core national development agendas. It then explicates four steps required to elucidate these connections, namely: (a) A full appreciation of key aspects of mainstream development agendas; (b) identification of ambiguities in calls for policy on ageing; (c) pinpointing of key perspectives, arguments and queries for redressing the ambiguities; and (d) addressing ensuing information needs. We argue that advocacy and research on ageing in sub-Saharan Africa need to consider the framework proposed in the paper urgently, in order to advance policy and debate on ageing in the region.

Understanding and advancing the health of older populations in sub-Saharan Africa: policy perspectives and evidence needs

AbstractBackground: 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.

Older people's health in sub-Saharan Africa

This commentary offers discusses current evidence on health challenges of older persons in sub-Saharan Africa and highlights important directions for policy and research to address them

Families, Intergenerational Bonds, and Aging in Sub-Saharan Africa

Cette note de recherche propose une justification, et offre un ensemble de paramètres initiaux, pour un effort explicite de forger une politique et une gérontologie de famille scientifiquement pertinentes à l’Afrique. Il se fonde sur une évaluation critique des discours politiques dominants dans la région et les efforts de recherche existants concernant les familles et le vieillissement, en particulier en Afrique sub-saharienne (ASS). This Research Note proposes a rationale, and offers a set of initial parameters, for an explicit effort to forge a policy and scientifically relevant family gerontology for Africa. It builds on a critical appraisal of dominant policy discourses in the region and existing research efforts on families and aging, specifically in sub-Saharan Africa.

Coming Into Its Own? Developments and Challenges for Research on Aging in Africa

This article discusses developments in research on aging in Africa over the last decade and challenges for a further expansion and advancement of the field in the coming years

Variations in disability and quality of life with age and sex between eight lower income and middle-income countries: data from the INDEPTH WHO-SAGE collaboration

Background Disability and quality of life are key outcomes for older people. Little is known about how these measures vary with age and gender across lower income and middle-income countries; such information is necessary to tailor health and social care policy to promote healthy ageing and minimise disability. Methods We analysed data from participants aged 50 years and over from health and demographic surveillance system sites of the International Network for the Demographic Evaluation of Populations and their Health Network in Ghana, Kenya, Tanzania, South Africa, Vietnam, India, Indonesia and Bangladesh, using an abbreviated version of the WHO Study on global AGEing survey instrument. We used the eight-item WHO Quality of Life (WHOQoL) tool to measure quality of life and theWHO Disability Assessment Schedule, version 2 (WHODAS-II) tool to measure disability. We collected selected health status measures via the survey instrument and collected demographic and socioeconomic data from linked surveillance site information. We performed regression analyses to quantify differences between countries in the relationship between age, gender and both quality of life and disability, and we used anchoring vignettes to account for differences in interpretation of disability severity. Results We included 43 935 individuals in the analysis. Mean age was 63.7 years (SD 9.7) and 24 434 (55.6%) were women. In unadjusted analyses across all countries, WHOQoL scores worsened by 0.13 points (95% CI 0.12 to 0.14) per year increase in age and WHODAS scores worsened by 0.60 points (95% CI 0.57 to 0.64). WHODAS-II and WHOQoL scores varied markedly between countries, as did the gradient of scores with increasing age. In regression analyses, differences were not fully explained by age, socioeconomic status, marital status, education or health factors. Differences in disability scores between countries were not explained by differences in anchoring vignette responses. Conclusions The relationship between age, sex and both disability and quality of life varies between countries. The findings may guide tailoring of interventions to individual country needs, although these associations require further study.