An assessment of the implementation of the national policy on older persons' objective to facilitate reasonable care and assistance by families and the state in Kisumu city, Kenya

Abstract

Population aging, also called the “graying of the planet” is increasing in developing countries. The UN Report on aging (2023) demand for long term care is soaring in many countries as the population of older persons increases. UNFPA (2022) highlights Kenya’s 2019 census that points to the expected trebling of the number of older people to 10.3% by 2050. The life expectancy in Kenya between 2019 and 2023 rose from 66.70 to 67.47 while total fertility rate declined from a high of 8.1 in 1977-78 to 3.4 children per woman in 2022. This rapid population aging is happening on the backdrop of limited economic and social resources. Current trends indicate that many older African adults are now permanent residents in cities. Most studies on older peoples’ experiences in urban contexts are in richer countries. The National Policy on Older Persons in Kenya explicitly includes the objective to facilitate the provision of reasonable care and assistance to older persons by both family and the state. This is grounded in the Constitution of Kenya (2010), particularly Article 57, which obligates the state together with families to ensure older persons can participate in society, pursue personal development, live with dignity, and receive protection and reasonable care. The main aim of this study was to interrogate the National Policy on Older Persons objective of facilitating the provision of reasonable care and assistance to older persons by both family and the state. in Kisumu city, Kenya. The specific objectives of the study were to assess the care needs of the elderly population; to examine family and non-family-based strategies of gerontological care; and to assess elderly care challenges of NPOPA in Kisumu City as experienced by the elderly. This study used a pragmatic philosophical paradigm based on experiences, context and solutions. Structural functionalism was adopted as the theoretical framework and mixed methods as the research design. Narrative interviewing was applied to collect qualitative data. For quantitative data, descriptive cross-sectional survey was preferred. The study focused on the older population (70+ years). Sample determination was based on Krejcie and Morgan table and the 2019 Kenya Population and Housing Census data. Using multi stage sampling, Northern, Kaloleni and Bandari sub-locations were chosen in Kisumu Central Sub-County, Central Division and 270 persons aged 70 and above traced with the help of village elders. Using Krejcie and Morgan table, 165 were randomly selected for this research. Key informant interviews with national and county government officers were done. Descriptive data analysis was used to generate means, percentages and frequencies of the data on the quantitative side. On the qualitative side, both thematic and narrative analyses were deployed to draw themes and narratives from the findings. The study found that the state offers minimal care services to the elderly beyond cash transfers, which were helpful but inadequate, and that family-based care-giving for the elderly has changed more towards transactional than obligatory. There is need to adjust policy to the new realities. The study recommended devolving management of elderly care services for better reach and context, mainstreaming ‘active ageing’ as a major policy for government and further studies to establish what happened to respondents beyond age 80 as many were untraceable in the study area, and also to do comparative and longitudinal studies to enrich findings.