•We welcome FG’s intention to establish six geriatric centres
Help is on the way for Nigeria’s elder citizens with the federal government’s plan to establish geriatric centres in teaching hospitals in six regions. Announcing the plan, Coordinator, Healthcare Package for Improving Quality Care on Ageing Population in Nigeria, Dr Saidu Dumbulwa, said: “The government, following the regional World Health Organisation meeting in Addis Ababa in 2016, set in motion an actionable strategy with a view to improving the health status of the elderly in Nigeria.”
We welcome the early announcement of the laudable plan to address healthcare for the elderly. It is common knowledge that Nigeria is experiencing a major demographic transition that leaves the country year on year with a much larger elderly population than before. Just as the country needs to develop policies in the interest of its teeming youth population, so does it need to respond to its increasing number of elderly citizens, attributable to a combination of factors: better access to medications, greater literacy, and better health education, among others.
It is remarkable that the current government plans to respond to WHO’s Global Strategy and Action on Ageing and Health by planning for a national initiative focused on healthcare for senior citizens. It is also instructive that, contrary to the nonchalant attitude to Nigeria’s attempts in 1989 to launch a comprehensive social policy on its rising population of old citizens, the Buhari government has opted to adopt some of the objectives of WHO: “commitment to action on healthy ageing in every country; developing age-friendly environments; aligning health systems to the needs of older populations; developing sustainable and equitable systems for providing long-term care for the elderly; and improving measurement, monitoring and research on healthy ageing.”
The plan for geriatric centres promises to be a good beginning towards achieving the afore-mentioned objectives. However, the six centres should not be conceived only as structures or facilities for teaching geriatric medicine, as good as this might be. Each of the centres also ought to be designed as research centres for producing knowledge to enable the country respond to the multidimensional character of ageing.
Worldwide, longevity is considered a sign of social advancement. It is, therefore, salutary that the government has acknowledged many of the challenges of ageing in a developing country. Apart from the lack of specialist medical knowledge to treat geriatric medical issues, there are other factors that need to be considered as part of a holistic response to the surge in the ageing population. Apart from the prevalence of chronic diseases that come with age; cardiovascular, physical disability, diabetes, depression, and memory loss, there are other social and emotional issues, such as isolation, loneliness, anxiety, that deserve attention of policy makers.
All these challenges call for integrated planning that can use research to stimulate creation of holistic approach to solving problems that are part of the human condition. For example, poverty or drastic decline in revenue for people in this demographic group may come largely from non-payment of pension for those who had pensionable jobs in their adult years, or from lack of income for self-employed citizens with inadequate preparation for old age. Associated problems, such as inability by a great percentage of the elderly to provide themselves with conducive environment in which to age, or inability of children to provide assisted living for their aged parents call for recognition by politicians and policy makers. In other words, research at the centres should provide reliable data to support comprehensive social policy in respect of the elderly.
Furthermore, activities of the centres ought not be limited to tertiary medical services for geriatrics, as important as these might be. Linking such centres to provision of geriatric primary health services in both urban and rural areas is crucial to making such centres effective. Correspondingly, relating cultures to the design of geriatric health management is vital to creating new awareness about developing a fitting architecture of support for the elderly, not only at the level of government, but also at the family level.