With the changing African family, who will support the elderly?
Globally, the world is entering what experts call the “age of longevity.”
By mid-century, the number of people aged 60 and older is expected to reach 2.1 billion, more than double the figure recorded in 2017. (File photo)
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In a small village in central Uganda, a grandmother prepares dinner while her grandchildren run through the compound.
Their parents are far away working in Kampala, Nairobi, or somewhere in the Middle East.
For millions of African families, this quiet arrangement has become increasingly common: grandparents raising children while younger generations migrate in search of work.
It is a small glimpse of a demographic shift that researchers say will soon reshape societies across the continent.
A new World Bank report warns that countries such as Uganda, Rwanda, Malawi and Zimbabwe will see their populations aged 60 and above quadruple by 2050, creating new challenges for health systems and families alike.
The report, The Silver Opportunity, warns that this is one of the fastest ageing trends anywhere in the world, and that is why the World Bank suggests that African governments must begin building mixed long-term care systems that combine family support with community-based services and professional healthcare.
Globally, the world is entering what experts call the “age of longevity.”
People are living longer than ever before. By mid-century, the number of people aged 60 and older is expected to reach 2.1 billion, more than double the figure recorded in 2017.
For generations, elder care in Africa has been handled within families because that is how life is on the continent: the young take care of the old. But social changes are beginning to reshape that model as urbanisation is drawing young people toward cities. Migration is separating families across borders, to Europe, America or the East, looking for a chance to earn better.
Additionally, more women, who are the traditional primary caregivers, are entering the workforce. The result is a growing strain on family support systems.
A new World Bank report, The Silver Opportunity, warns that the number of people aged 60 and older in countries such as Uganda, Rwanda, Malawi and Zimbabwe is expected to quadruple by 2050.
This is one of the fastest ageing trends anywhere in the world, and that is why the World Bank suggests that African governments must begin building mixed long-term care systems that combine family support with community-based services and professional healthcare.
Primary health systems, the report says, should form the backbone of this transition.
As life expectancy rises and fertility rates gradually decline, the number of older citizens will increase dramatically over the coming decades. The health system will have to adapt.
Currently, formal eldercare facilities are rare. Most older Ugandans rely on family support, often in rural communities. But as migration increases and families become more dispersed, that traditional safety net is weakening.
A chance to prepare
The World Bank argues that the coming demographic shift does not have to become a crisis.
Instead, it presents what the report calls a “silver opportunity.” Older adults remain active contributors to society — caring for children, sharing knowledge and supporting communities.
If governments invest now in preventive healthcare, chronic disease management and community-based support systems, aging populations can remain healthier and more productive.
Integrating elderly care into primary healthcare clinics, expanding community health worker programmes, and strengthening screening for chronic diseases could help countries manage the transition.
Time to enact plans
The challenge, experts say, is timing. Aging may seem like a distant issue in young countries like Uganda, but the demographic shift is already underway. Countries that act early may build healthier societies and stronger healthcare systems. Those who wait may find themselves facing a far more difficult future.
A healthcare system under pressure
Aging populations bring a different set of health challenges. Instead of short-term infections, doctors increasingly treat chronic illnesses such as heart disease, diabetes and cancer.
These conditions require long-term care, rehabilitation and regular monitoring.
Most health systems, however, are designed to treat sudden illness — a fever, an injury, a malaria infection.
As a result, many countries will have to redesign their healthcare systems to support ageing populations.