Introduction: older people as care providers

The ageing and care interface in Sub-Saharan African contexts has not yet been extensively investigated. Moreover, care provision for older Africans requires further understanding in terms of its quantitative and qualitative dimensions. In particular, intra- and intergenerational care provision, where older people provide care to other older people is still largely under-researched. This contribution outlines how such care practices and arrangements in Tanzania occur and affect old-age vulnerability in relation to health and illness; and how both older caregivers and care-receivers navigate within and between social spaces in circumstances of critical health moments.

From the perspective of an older person who needs support, old-age vulnerability is strongly shaped by the presence or absence of care provision (Van Eeuwijk, 2006b). Normative attitudes and views in most societies assign the provision of care to younger generations, and in particular to women (Bongaarts and Zimmer, 2002; Whyte et al, 2008; Sokolovsky, 2009). This picture is embedded in ideal or idealised imaginations based on, for example, kinship relations, filial piety and generational responsibility, gender roles, family solidarity, religious obligations and moral reciprocity, and professional ethics (Van Eeuwijk, 2014). Yet, real care practices show that older people – and to a great extent older women – also implement, govern and maintain care provision. Old-age vulnerability in relation to the ambivalent social valuation of ‘good care’ or ‘bad care’ certainly builds on these culturally shaped normative and ideal premises (Mol et al, 2010). Care provided by older people for older people does not meet social expectations, does not comply, to a great extent, with normative attitudes and is often construed as a transgression or implicit violation of these meaningful social and cultural codes. In other words, older care-receivers are thought to have become more vulnerable with regard to care and health as a result of the increased vulnerability of their aged carers.

Generally, older people as caregivers are no longer a rare or uncommon phenomenon in the social sciences. Many studies on ageing, health and care in low- and middle-income countries show that, because of major societal transformations, such as demographic and epidemiologic transitions, social transformations, change of lifestyle, migration and urbanisation, older people increasingly assume roles of major caregivers in their households.