Aging population challenges in africa distribution

Vol. 1, Issue 1
AfDB Aging Population Challenges in Africa
Alice Nabalambaa and Mulle Chikokob
November 2011 Chief Economist Complex

Content
Abstract Abstract leading to even greater vulner-
ability to poverty. Aging, how-
1. Background This brief describes trends in ever, is not visible in most poli-
population aging in Africa rela- cy dialogue, and so tends to be
2. Africa: demographic tive to those in economically deprioritized in terms of budg-
trends advanced countries. It high- etary allocations, thereby in-
lights the key drivers of the creasing the vulnerability and
3. Country-specific demo- phenomenon, both globally and marginalization of older Afri-
graphic trends in the African context more cans. Unlike children, youth,
specifically. The brief also ana- and women who are given a
4. The drivers of population lyzes country-specific trends high profile in the MDGs agen-
aging in Africa and demonstrates the reasons da, for example the elderly tend
why the proportion of popula- not to be targeted as a specific
5. Why we should be con- tion 65 years and older is grow- group in terms of poverty re-
cerned about an aging ing in many countries across duction policies. However, cor-
population in Africa the continent. Aging is highly rectly managed and with the
correlated with long-term phys- appropriate level of healthcare
6. Conclusions and policy ical and mental disability, and provision and social protection
implications a number of long term chronic programs population aging can
conditions and will likely in- present an unprecedented op-
crease personal care require- portunity for older citizens to
ments. Furthermore, most soci- enjoy a full and active life, far
oeconomic indicators for the beyond the expectations of pre-
elderly in Africa are low, and in vious generations. Policymak-
many countries poverty rates ers will need to take full ac-
Mthuli Ncube among the elderly are signifi- count of the phenomenon, to
m.ncube@afdb.org cantly higher than the national safe-guard family and commu-
+216 7110 2062 average. In countries with a nity resources and to put in
high prevalence of HIV/AIDS, place robust public pension,
Charles Leyeka Lufumpa many households are increas- insurance and healthcare sys-
c.lufumpa@afdb.org ingly headed by the elderly
+216 7110 2175
tems.

Désiré Vencatachellum
d.vencatachellum@afdb.org
+216 7110 2205
a Alice Nabalamba, Principal Statistician, Statistics Department (ESTA), a.nabalamba@afdb.org
Victor Murinde b Mulle Chikoko, Principal Social Protection Officer, Human Development Department (OSHD),
v.murinde@afdb.org m.chikoko@afdb.org
+216 7110 2072
Reviewers: Barbara Barungi, Lead Economist OSFU; Peter Ondiege, Chief Research Economist,
EDRE; Ruth Karimi Charo, Social Development Specialist, KEFO; Barfour Osei, Chief Research Econ-
omist, EDRE; Tavengwa Nhongo, Africa Platform for Social Protection, Nairobi, Kenya.

The findings of this brief reflect opinions of the authors and not those of the African Development
Bank, its Board of Directors or the countries they represent.

African Development Bank

AfDB [AGING POPULATION CHALLENGES IN AFRICA]

1. Background youth population (0 to 15 safety nets, increased prev-
years) and senior popula- alence of poverty, particu-
As of 2010, 36 million tion (65 or older) to the larly among elderly headed
elderly people working-age population households, and a shrink-
aged 65 years and over (16 to 64 years). It is ex- ing cohort of caregivers in
accounted for 3.6% of Af- pressed as the number of countries ravaged by the
rica’s population, up from “dependents” for every 100 HIV/AIDS epidemic.
3.3% ten years earlier. In “workers.” The senior de- Linked to the HIV/AIDS
1980, 3.1% of the popula- mographic dependency epidemic are the changing
tion was elderly aged 65 ratio is the ratio of seniors family structures where
and above, and there has to the working-age popu- older parents are increas-
been a steady increase dur- lation.2 ingly caring for grandchil-
ing the last forty years. dren left behind by victims
Population aging1 in Africa Africa’s population is ag- of HIV/AIDS. More than
is expected to accelerate ing simultaneously with its 50 percent of the orphans
between 2010 and 2030, as unprecedented growth of in Africa currently live
more people reach age 65. the youth population and with their grandparents
Projections show that the its related challenges. The with limited resources and
elderly could account for aging population in Africa unstable incomes to sup-
4.5% of the population by faces a different set of port their households
2030 and nearly 10% of challenges. Aging is highly (UNICEF, 2003).
the population by 2050 linked with long-term
(UN DESA, 2011.) In physical and mental disa- Global Aging Trends:
many countries in Africa, bility and a number of
the proportion of older long-term chronic condi- In many developed coun-
persons will be close to tions and will likely in- tries, the aging demo-
that of industrialized coun- crease personal care needs. graphic transition is al-
tries by 2030 and 2050. Yet, much of Africa faces ready taking shape as the
weak health care systems average age of populations
One important conse- to adequately address these continues to rise, as a di-
quence of an aging popu- emerging health problems rect consequence of the
lation is the shift in the among the elderly. As well, postwar II “baby boom”
demographic dependency much of the region is faced (Anderson and Hussey,
ratio. The total demo- with a lack of viable social 2000). Fertility rates have
graphic dependency ratio is declined below the re-
the ratio of the combined 2
placement rate of 2.1 in
The demographic dependency
many industrialized coun-
ratio is based on age rather than
employment status. It does not tries. Similarly, the average
1 life expectancy at birth
Population aging is described account for young people or
as the rise in the median age of a seniors who are working, nor for continues to rise. In OECD
population resulting in a shift in working-age people who are countries, for example, the
the age structure of that popula- unemployed or not in the labor
average life expectancy in
tion. It is the consequence of a force. It merely reflects popula-
number of factors, including tion age structure and is not 2007 was 79.1 years, up by
declining fertility rates, de- meant to diminish the contribu- 10.6 years since 1960
creased premature deaths, and tions made by people classified (OECD 2010).
prolonged life expectancies. as “dependents.”

2



The UN medium-scenario lights gender differences in years for men. By 2010,
projections indicate that the changing population this had risen to 57.1 years
fertility rates will remain structure. Section four ad- for women and to 54.8
below the replacement rate dresses the drivers of pop- years for men (Figure 1).
through to 2020 for most ulation aging in Africa.
of the industrialized coun- Section five demonstrates Healthy life expectancy –
tries. At the same time, the why we should be con- defined as life expectancy
proportion of persons aged cerned about an aging pop- weighted at each age to
65 years and older will ulation in Africa, high- account for levels of health
increase rapidly over the lighting many health and status over the life course –
next few decades, to reach socio-economic challenges although lower at 39.5
upwards of a quarter of the faced by Africa’s older years for Africa as a whole
population in most coun- population. The brief con- in 2000, had increased to
tries. By comparison, only cludes with some broad 42.7 years by 2002 and to
10–14% of the population policy implications to 48.9 years by 2007.
was 65 years or older at the guide policy makers and
turn of the century in most development partners in Similar to developed coun-
industrialized countries general, on how to address tries, the life expectancy
(UN DESA, 2011). emerging challenges re- figures indicate that Africa
lated to population aging. is also witnessing a shift in
The purpose of this brief is the population structure. In
to (a) highlight the chang- 1980, 3.1% of Africa’s
ing demographics on the 2. Africa: demo- population was aged 65
African continent; and (b) graphic trends and older, but this had ris-
to demonstrate the chal- en slightly to 3.5% by
lenges of an aging popula- In contrast to industrialized 2010. Women aged 65
tion and the major issues countries, in developing years and older represented
that need to be addressed. countries, particularly 3.4–3.9% of the total fe-
those in Africa, life ex- male population between
The brief is organized in pectancy at birth has re- 1980 and 2010. Men in this
six sections. The first sec- mained relatively low for age group represented 2.8–
tion introduces trends of both men and women. In 3.2% of the male total
population aging in Africa 1990, Africa’s average life population during the same
relative to those in eco- expectancy at birth was period (Figure 2).
nomically advanced coun- 52.7 years, although it in-
tries. Section two analyzes creased steadily to 56.0
Africa specific demo- years until 2010 (AfDB’s
graphic trends and demon- Data Portal, 2011)3. In
strates the reasons why the 1990, women’s life expec-
proportion of population tancy at birth was 54.3
65 years and older is grow- years compared to 51.1
ing in many countries
across the continent. In the 3
Statistics presented in this brief
third section, the brief fo- have been sourced from ESTA’s
cuses on country-specific Social and Economic Statistics
trends over time and high- database, unless otherwise attributed.

3



Figure 1: Life expectancy at birth in Africa, 1990–2010

Life expectancy at birth in years
60
57
57 56
54 55
54 53
51
51

48

45
1990 1994 1998 2002 2006 2010

Male Female Total

Source: AfDB, Social and Economic Statistics Database (2011).

Figure 2: Proportion of men and women aged 65 and above in Africa, 1980–2010

% population aged 65+
5

3.9
4
3.4
3.2
2.8
3

2

1

0
1980 1990 2000 2010

Male Female Total

Sources: UN DESA (2011); AfDB, Social and Economic Statistics Databases (2011).

4



3. Country-spe- Tunisia (4.6%). By 2010, years and older declined in
Tunisia had surpassed all Gabon, São Tomé and
cific demographic other countries as the coun- Príncipe, and Equatorial
trends try with the highest propor- Guinea, while it remained
tion of elderly population unchanged in the Central
An examination of the de- (7.3%), followed closely African Republic over the
mographic trends at the by Mauritius at 6.9%. The 20-year period. The rea-
country level reveals some elderly population of these sons for the decline in the
interesting patterns (Figure two countries nearly dou- former three countries are
3). Between 1990 and bled over the 20-year peri- not very clear. Paradoxi-
2010, nearly one-third of od. Other countries such as cally, these three countries
the countries (16 out of a Libya, Botswana, and are among those with the
total of 53) recorded that at South Africa witnessed a highest GDP per capita in
least 4% of their popula- similar phenomenon. Africa, so one might have
tions was aged 65 or expected the improved
above. In 1990, Gabon had There are marked varia- living standards to lead to
the largest elderly populations among African coun- an increase in life expec-
tion (5.6%), followed by tries though. The propor- tancy.
Cape Verde (4.8%) and tion of population aged 65

Figure 3: African countries with over 4% of their population aged 65 years and over, 1990–2010

%
8

7

6 5.6

5 4.4 4.5
4.3
3.9
4
2.9
3

2

1

0
Libya
Morocco

South Africa

Lesotho
Algeria

Zimbabwe

Congo Republic
Tunisia

Mauritius

Cape Verde

Botswana
Egypt

Gabon

Equatorial Guinea
Central African

Sao Tome & Principe
Republic

1990 2010


5



The gender dimension 4% of their total population elevated female mortality
(Figure 5) than there were in low-income countries.
While the ratio of males to in 1990. The growth in the This is largely attributable
females is about 50:50 up elderly female population to high rates of maternal
until the age of 64, it over this time frame ranged mortality, especially in
quickly changes after this from 1.2% in Algeria to Sub-Saharan Africa. This
age, with women outliving 3% in Tunisia. This repre- is exacerbated by inade-
men (Figure 4). Among sents an increase of quate access to healthcare
those aged 65 and older, 404,000 and 207,000 fe- in many countries in Sub-
there were 25% more males aged 65 or older in Saharan Africa, and to low
women than men in 2010. Algeria and Tunisia re- investments in the health
This pattern is consistent spectively. However, Ga- sector. These weaknesses
with demographic changes bon, São Tomé and Prín- in the system mean that
elsewhere in the world. cipe, and Congo Republic fewer women live to reach
experienced a decline over the age of 65 than might
In 2010 there were 17 the 20-year period. Evi- otherwise be the case
more African countries dence emerging from re- (World Bank, 2011).
with an elderly female cent gender equality stud-
population that exceeded ies points to a persistently

Figure 4: Africa’s population of men and women by age group, 2010 (millions)

65+ million 16 20 million
60-64 9 10
55-59 12 13
50-54 15 16
45-49 18 19
40-44 22 22
35-39 28 27
30-34 34 34
25-29 42 41
20-24 48 48
15-19 54 53
10-14 60 59
5-9 68 67
0-4 78 76

150 100 50 0 50 100 150

Male Female


6



Figure 5: African countries with at least 4% elderly (65 and older) female population, 1990 and 2010

%

12

10

8

6

4

2

0
Algeria
Morocco
Tunisia

South Africa

Lesotho

Congo Republic
Ghana
Mauritius

Cape Verde

Botswana

Zimbabwe
Gabon

Namibia
Egypt

Central African Republic

Sao Tome and Principe
Libyan

1990 2010

Source: AfDB, Social and Economic Statistics Databases.

Figure 6 shows that far (4.1%). By 2000, the num- Gabon also witnessed a
fewer countries have a ber had nearly doubled decrease in its male elderly
male elderly population with the addition of Mau- population from 5.1% in
exceeding 4% of their total ritius, Morocco, and Egypt 1990 to 4.0% in 2010. Tu-
populations, compared to and this increased to a total nisia, Mauritius, and Mo-
their elderly female popu- of nine countries by 2010. rocco recorded the highest
lations. By 1990, only four The new additions were increases in the proportion
countries had a male el- Libya, Algeria, and Côte of elderly male population
derly population of 4% or d’Ivoire. However, São between 1990 and 2010,
greater, namely Gabon Tomé and Príncipe’s male while Côte d’Ivoire and
(5.1%), Tunisia (4.8%), elderly population dropped Libya also made good pro-
Cape Verde (4.4%), and from 4.1% in 1990 and gress over the 20-year pe-
São Tomé and Príncipe 2000, to 3.4% by 2010. riod.

7



Figure 6: African countries with at least 4% elderly (aged 65 years and over) male population,
1990–2010

%
7
6
5
4
3
2
1
0
Cape Verde

Libya

Mauritius
Algeria

Egypt

Morocco

Africa
Côte d'Ivoire

Tunisia
Gabon

Sao Tome & Principe
1990 2000 2010

Source: AfDB, Social and Economic Statistics Databases.

4. The drivers of The rise in the elderly pop- proportion of the national
ulation in many of these population can be at-
population aging in countries corresponds to a tributed to a shrinking
Africa sharp decline in the fertility adult age cohort due to a
rates compared to the rest high prevalence of HIV-
Overall, it has been the of Africa over a 40-year AIDS, linked to the fact
middle-income countries – period (Table 1). Likewise, that HIV-AIDS is concen-
such as Mauritius, Tunisia, many of these countries trated in the younger pop-
Morocco, Algeria, Egypt, have made remarkable ulation. In fact while fer-
and South Africa – which strides in improving health tility rates have dropped
have witnessed the greatest care delivery systems, re- substantially, the life ex-
increase in population ag- ducing child mortality and pectancy of all five coun-
ing. These countries’ pop- as a result are experiencing tries has declined over the
ulations aged 65 years and improved life expectancy 20 year period (Tables 1
older range between 4.5% at birth and healthy life and 2). Similarly, the adult
and 7.3% of the total pop- expectancy (Table 2). age cohort has either expe-
ulation. Other countries However, for countries rienced stagnant or nega-
such as Libya, Botswana, such as South Africa, Bot- tive growth (Figure A3)
Zimbabwe, and Djibouti swana, Lesotho, Zimbabwe when compared to coun-
have also witnessed a sig- and Swaziland, the in- tries such as Mauritius and
nificant increase in their crease in the size of the Tunisia where the
elderly population. elderly population as a

8



same age cohort has grown from 20-32% and 10-24% among 25-44 and 45-64 year olds respec-
tively (Figure A4).

Table 1: Fertility rates for selected African countries, 1980–2010
1980 1990 2010
AFRICA, average - 5.30 4.40
Mauritius 2.76 2.23 1.80
Tunisia 5.33 3.63 1.83
Morocco 5.65 4.03 2.31
Cape Verde 6.44 5.31 2.61
Lesotho 5.59 4.92 3.20
Algeria 6.91 4.71 2.32
Egypt 5.61 4.56 2.77
Gabon 5.17 5.18 3.17
South Africa 4.79 3.66 2.48
Libya 7.38 4.81 2.59
Botswana 6.22 4.70 2.78
Zimbabwe 7.10 5.19 3.29
Seychelles nd nd 2.30*
Source: AfDB, Social and Economic Databases.
Notes: *Estimate is for 2008.
nd: Data not available

Table 2: Life expectancy at birth, total and disaggregated by gender, for selected African coun-
tries, 1980 and 2010
Life Expectancy at Birth
Total Men Women
1980 2010 1980 2010 1980 2010

AFRICA, average 50.1 55.7 51.1 54.5 48.5 56.8
Libya 67.8 74.3 65.8 72.0 70.5 77.2
Tunisia 68.6 74.2 66.9 72.1 70.6 76.3
Algeria 67.0 72.7 65.9 71.2 68.3 74.1
Mauritius 69.2 72.1 65.5 68.5 72.9 75.8
Morocco 64.1 71.6 62.3 69.4 66.1 73.9
Egypt 62.9 70.3 61.6 68.6 64.3 72.2
Botswana 64.2 55.1 61.9 55.1 66.4 54.8
South Africa 61.4 51.7 57.8 50.3 65.2 53.1
Lesotho 59.3 45.6 57.4 45.0 61.0 45.7
Swaziland 60.5 46.4 58.3 47.1 62.6 45.5
Zimbabwe 60.8 45.7 57.5 45.3 64.3 45.6
Source: AfDB, Social and Economic Databases (2011).

9



5. Why we cent show that the preva- implications, principally
lence of chronic conditions that the burden of care is
should be concerned such as angina, osteo-ar- increasingly being shifted
about an aging pop- thritis and diabetes is not to those least able to afford
ulation in Africa only on the rise, but more it. A study of 15 countries
than twice as high among in Africa showed that large
Population aging is highly elderly population aged 60 proportions of the lower-
correlated with physical and above compared to income populations resort
and mental disability and those under 60 years (Fig- to borrowing and selling
an increase in the preva- ure A5). assets to cope with high
lence of a number of long- healthcare expenditures
term chronic conditions. In The management of long- (Leive and Xu, 2008). This
2006, the World Health term chronic conditions practice drives many fami-
Organization (WHO) pro- and related disabilities re- lies into even deeper pov-
jected that diseases associ- quires a considerable erty and poorer health.
ated with aging such as amount of resources – both
Parkinson’s disease, Alz- human and financial – An even bigger challenge
heimer’s and other forms from governments, com- for Africa is the decline of
of dementia, accounted for munities, and families. Yet informal systems of social
6.3% of disability-adjusted in much of Africa, gov- protection in the form of
life years. This is signifi- ernments still spend far cash and support from both
cantly higher than the con- less per capita on extended family and com-
tribution to disability-ad- healthcare in general, let munity sources. An addi-
justed life years globally of alone social protection, tional challenge is the
HIV/AIDS (5.5%), all can- than is the case in most change in family structures
cers (5.3%), heart disease developed countries. Few and shrinking social sup-
(4.2%) and respiratory dis- African countries have port networks. Tradition-
eases (4.0%). Alzheimer’s public pension programs or ally, the informal social
and other forms of demen- formal systems for caring protection has been effec-
tia alone account for 12% for older persons; indeed, tive for generations in
of the burden of neurologi- most rely on traditional providing a major share of
cal disorders. More recent family structures. For ex- support to the elderly par-
studies suggest that these ample, in 2005, govern- ents and the most vulnera-
conditions are on the rise ments in 48 of the 53 Afri- ble. With increasing ur-
due to an aging population. can countries spent US$ banization, and the ravages
More alarming is the evi- 25.7 per capita on health of HIV/AIDS, this support
dence suggesting that these on households, while pri- network is increasingly
conditions will increase vate households spent being dismantled. In fact in
more rapidly in developing more than twice that some societies, particularly
countries than in developed amount (US$ 58.2) per those experiencing the
countries. capita (ICP-Africa data, HIV/AIDS epidemic, the
2005). Such a high dispar- roles have been reversed.
Data from six countries ity in healthcare expendi- On the one hand, older
with an elderly population ture between governments parents are increasingly
equal or exceeding 4 per- and households has several caring for grandchildren

10



left behind by victims of such as: (i) rapid popula- security of formal sector,
HIV/AIDS. For example, tion growth, evidencing in wage-dependent markets.
more than 60% of orphans high youth populations and
in South Africa, Zimba- high unemployment; (ii) Economic indicators for
bwe, and Namibia – and high infant and child mor- the elderly show that
50% in Botswana, Malawi tality rates, (iii) excessive households headed by old-
and Tanzania – live with urban expansion; and (iv) er persons are among the
their grandparents high maternal mortality poorest. For example, in
(UNICEF, 2003). On the rates, etc. This has resulted Kenya and Tanzania,
other hand, the rise in in governments and socie- households headed by old-
HIV/AIDS death rates has ties de-prioritizing older er people have a poverty
led to a rapidly increasing people in favor of other, rate that is over 20% high-
new category of neglected often more vocal age er than the national aver-
elderly individuals or older groups. Governments’ de- age. In Sierra Leone and
adults living alone, without velopment priorities are Uganda, the poverty rate of
the benefit of any caregiv- tending to favor expendi- these households is 8% and
ers. tures that invest in the 5% higher than the national
long-term productive po- average (Kakwani & Sub-
Despite these serious de- tential of the young. In barao, 2005; HelpAge,
mographic shifts, aging is recent years, we have seen 2011). Poverty in old age
not visible in most policy governments focusing on often reflects poorer eco-
dialogue. The invisibility the youth because of high nomic status earlier in life
of vulnerable older people levels of unemployment and has the potential to be
in major policy documents among this age group and transmitted to the next
is reinforced by their in- their potential to create generations if effective
visibility in most national social and political unrest interventions are not ap-
development plans. While if their demands and life plied.
the MDGs provide specific chances are not fulfilled.
targets for children, youth Thus countries accord low 6. Conclusions
and women, they do not priority in their national
refer to older people as a development policies and and policy implica-
specific group. As a result, programs to the aging pop- tions
older people are less likely ulations.
to benefit from targeted This brief has discussed the
development support. Lack The continent is not well problems of an aging pop-
of recognition of aging prepared for a major in- ulation and the major is-
even in the MDG agenda, crease in its aging popula- sues that need to be ad-
which is the overarching tion. For example, contrib- dressed. There is a need for
framework for interna- utory pension schemes governments, development
tional development priori- cover very few people due partners, communities, and
ties, contributes to this lack to the informality of most families themselves to be
of attention. livelihood activities and aware of the problem and
employment. Most socie- to collaboratively work out
The African continent has ties are predominantly ru- a way of tackling the needs
other urgent and pressing ral and much of the popu- of this growing segment of
demographic problems lation operates outside the the population. Some broad

11



proposals for governments social protection that cater free and subsidized health
and health services in par- to the specific needs of services, medication and
ticular are outlined below older people. However, longer-term healthcare
to be included in policy South Africa, Mauritius, facilities for the elderly.
discussions. Development Lesotho, Botswana, Cape
partners can also assist Verde, and Namibia have Community and family
through research and tar- introduced non-contribu- care.
geted support. tory social pension pro- Family and community
grams for the elderly. will remain the basic re-
Budgetary provisions. source for the older per-
Governments should pay National old-age pension sons in the absence of pub-
greater attention to issues schemes will need to ex- licly funded social security
of aging. There is an urgent tend coverage and also schemes. There is need to
need to develop and im- consider contributory pen- support and promote com-
plement coordinated na- sion plans for those who munity-based care in order
tional policies for this age are working now, in a bid to ensure that better ser-
cohort and to mainstream to alleviate old age pov- vices are provided to the
aging issues in national erty, guarantee a minimum aging population. The in-
development frameworks income for older people, formal systems of social
and poverty reduction and prevent the intergener- protection through extend-
strategies. This is in order ational transmission of ed family and community
to address the socioeco- poverty. The majority of support will continue to be
nomic needs and rights of Africa’s population is self- a viable option for short to
older people and improve employed and works in the medium term. Therefore
their well-being. One re- informal and agriculture improved employment
quirement is to make ade- sectors. This sector does opportunities to induce
quate provision in national not offer much in terms of younger people to remain
budgets for the provision social security and protec- in rural homes could bene-
of social services for the tion, including for old age. fit the elderly both eco-
elderly. The focus should Therefore, public–private nomically and socially and
be on the provision of shel- partnerships (PPPs) should would facilitate adequate
ter, healthcare, food securi- be explored as a way of support and care for the
ty, nutrition, and social promoting and expanding elderly. Strengthening the
security schemes, among contributory pension resources of women, who
others. schemes. are the traditional caregiv-
ers, would benefit all fami-
Scaling up social protec- Targeted healthcare. ly members, including the
tion schemes. Healthcare systems will elderly. This would expand
Most African countries need to be responsive to the impact of existing self-
will need to develop and the needs and demands of help and mutual aid
improve the coverage of an aging population, in- groups. Therefore policies
comprehensive social pro- cluding the greater access should also aim at im-
tection systems for their to specialist services and proving the situation of
senior citizens. The major- treatments. In particular, rural communities, and
ity of African countries do governments need to con- specifically target women
not have formal systems of sider introducing access to

12



who make up the majority tion of statistics pertaining World Bank, Washington,
of the elderly population. to aging trends to better DC.
inform policy decisions;
The role of statistics: scal-  Provide leadership Kalasa, B. (2001). “Popu-
ing-up the availability of in the analysis of emerg- lation and aging in Africa: a
age-disaggregated data. policy dilemma?” Paper
ing issues around popula-
presented at the Interna-
tion aging;
tional Scientific Study of
Governments need to  Enhance policy ad- Population’s XXIV General
strengthen their national vice and support for coor- Population Conference, held
statistical systems and to dinated long term solu- in August 2001 in Brazil.
collect age-disaggregated tions to promote social
data for all relevant sec- protection programs that Kidd, S. and E. Whitehouse
tors. This will allow gov- include the critical needs (2009). “Pensions and old
ernments to monitor pro- of the elderly. age poverty,” in R.
gress, for example, in re- Holzmann, D. Robalino, and
ducing old-age poverty and References: N. Takayama (eds.), Closing
in tracking how health the Gender Gap: The Role of
funds are being expended Social Pensions. Washing-
for this age group. Such ton, DC: World Bank.
Group, Data Portal (ac-
data should be made read- cessed May 2011).
ily available to policymak- Leive, A. and K. Xu (2008).
“Coping with out-of-pocket
ers and other data users, Anderson, G.F. and P.S. Hus-
health payments: empirical
including development sey (2000). “Population
evidence from 15 African
partners. Further research Aging: A comparison among
countries. Bulletin of the
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14



Annex 1.

Figure A1: Estimated proportion of elderly population, 65 years and above, in Africa, 1950–
2010

%
5

4 3.5
3.3 3.3
3.1 3.1 3.1 3.1
3

2

1

0
1950 1960 1970 1980 1990 2000 2010

Male Female Total


Figure A2: Projection of elderly population, 65 years and above, in Africa, 2020–2050
%

8
7 6.6
6 5.3
5 4.5
3.9
4
3
2
1
0
2020 2030 2040 2050

Male Female Total


15



Figure A3. Southern Africa: The Effect of HIV/AIDS on the Adult Age Cohort

% Zimbabwe
60
48 46
50
39
40
30 25
21 22 23
18 20
20
10 9 9
10 3 3 4
0
0-14 15-24 25-44 45-64 65+

1970 1990 2010

% Botswana
60
48
50 45
40 33
28
30 24
22 21
19 20
20 13
9 9
10 3 3 4
0
0-14 15-24 25-44 45-64 65+
1970 1990 2010

% Lesotho
60
50 44 44
40 37

30 23 25
20 20 20 21
20
12 11 10
10 4 4 4
0
0-14 15-24 25-44 45-64 65+

1970 1990 2010

16



% South Africa
60

50
42
39
40
30 29
30 24 26
19 20 20
20 16
12 12
10 3 3 5
0
0-14 15-24 25-44 45-64 65+

1970 1990 2010

% Swaziland
60

50 47 48
38
40

30 25 23
19 20 20 20
20
11 9 10
10 3 3 3
0
0-14 15-24 25-44 45-64 65+

1970 1990 2010


17



Figure A4. The Effect of HIV/AIDS on the Adult Age Cohort: Selected Comparison Countries

% Mauritius
60

50 44
40
30 31 31
30 24
22 23
20 21
20 17
14
10
10 7
3 5
0
0-14 15-24 25-44 45-64 65+

1970 1990 2010

% Tunisia

60

50 46
38
40
32
30 25
23
18 20 19 20 18
20
12 12
10 7
4 5
0
0-14 15-24 25-44 45-64 65+

1970 1990 2010


18



Figure A5: Prevalence of Selected Chronic Conditions by Age, Africa

% Prevalence of selected chronic conditions by age, Africa
70

60

50

40

30

20

10

0
Osteo-Arthritis

Osteo-Arthritis

Osteo-Arthritis

Osteo-Arthritis

Osteo-Arthritis
Diabetes

Osteo-Arthritis
Diabetes

Diabetes

Diabetes

Diabetes

Diabetes
Angina

Angina

Angina

Angina

Angina

Angina
Mauritius Tunisia South Africa Morocco Congo Zimbabwe

Under 60 yr 60+ yr

Sources: WHO (2002); World Health Survey: Results from Mauritius, Tunisia, South Africa,
Morocco, Congo and Zimbabwe.

19


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