Box 315 Casestudy Nigeria

Nigeria is the most populous African country, with about 130 million inhabitants. According to United Nations estimates, it is likely that the figure of 0.5 million (4.7% of the whole population) people over 60 years of age in 2000 will have more than trebled by 2040 (1.8 million people, i.e. 7.5% of the population). Old people have traditionally been cared for within the extended family. Social and economic changes have disrupted this system, however, especially by young people moving into the towns and leaving the old people to cope on their own. No effective alternatives have been provided for their care.

Specialist health services are in short supply. In 2005 there were only about 77 psychiatrists and three occupational therapists in the country. Industrial therapy was not offered anywhere. Specialist social workers are few and work under severe limitations. There are no specialist services for the elderly (geriatric or psychogeriatric services, meals on wheels, respite care or drop-in centres) and few nursing homes. There is no insurance cover for medical services for elderly people.

Usually record-keeping, accountability and political will are poor, so that many elderly people who retire do not receive their benefits. Recently the Federal Government has introduced a contributory pension scheme, but in the past elderly people found it difficult to learn about and access their entitlements. Elderly Nigerians are among the poorest groups in the country.

A national policy on elderly care was published in 2003, and a National Implementation Plan is now under way, but is being piloted only among certain Federal civil servants.

Assessing the extent of dementia among this huge, varied and shifting population is not easy, but what little research has been done suggests prevalence rates for dementia may be low. Interest in the mental health of elderly Nigerians is only just beginning: for example in the past three years, old-age mental health clinics have been established at two universities. There is no formal training for geriatric medicine and psychiatry. Anti-dementia drugs are rarely available.

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