Globally, life expectancy at birth has increased by more than 30 years over the last century (Roser, 2015). A major difference between population ageing in the more developed and the still developing regions of the world is that ageing in the latter largely takes place against a backdrop of considerable economic, infrastructural and personal strain, with the family seen as the main (if not the only) source of care. Longevity, even when achieved, often means a life of compromised health with scant access to general (let alone appropriate or specialised) care and similarly constrained financial resources. These additional years, which in the more developing parts of the world do not necessarily translate into healthy longevity, challenge individuals, families, civil society and the state in terms of the social and health care of its older members. However, though much has been achieved in terms of prevention and treatment, accompanying the longevity revolution is an added imperative: understanding and developing a culture of care that is sustainable, affordable, compassionate and universal is critical (Aboderin and Hoffman, 2012).
Despite remaining younger than all the other world regions, Sub-Saharan Africa (SSA) is seeing its older populations similarly growing in absolute numbers – its current population of 44 million aged 60 and over is expected to increase fourfold to 160 million in 2050 (UNPD, 2012). Although people age in a diverse range of settings across the continent, most care for older people in SSA is provided by families, typically in settings of entrenched poverty and infrastructural constraints. Yet, debate on the experience of caregiving for older people and its implications for policy in the region is virtually non-existent, and there is very little active discussion and exploration of what the relative care roles and responsibilities of families, the state and other sectors ought to be.
In contexts of poverty (youth unemployment) and HIV/AIDS in particular, concern (especially in southern Africa) has focused on the economic and social costs of care provided by older to younger generations (Barrientos et al, 2003; Madhavan, 2004; Ardington et al, 2010). Yet little attention has been paid to questions of care for older people. Who will care for the carers?