Gender-based violence (GBV) poses a significant global threat to human rights, public health and attaining the Sustainable Development Goals. There is a growing emphasis on researching to identify issues and understand the experiences of women relative to GBV. The increasing demand for policymakers and public health practitioners to adopt evidence-based approaches in addressing GBV highlights the need for research prioritization on experiences of GBV among women in resource-limited settings such as sub-Saharan Africa. This paper explored GBV among women in 25 sub-Saharan African (SSA) countries to identify and present key intervention priority areas for addressing GBV in these settings.
Methods
The study involved a cross-sectional analysis of a nationally representative dataset from the Demographic and Health Survey of 25 SSA African countries. Data was analyzed descriptively and inferentially using the Pearson chi-square (X2) at a p < 0.05.
Results
Findings revealed that women aged 25–29, living in rural areas and with primary education were at a significant risk of experiencing GBV across 25 SSA countries. A notable 44.94% of women reported experiencing at least one form of GBV, with the prevalence varying by country. Women in Comoros had the lowest reported prevalence (10.76%), while Sierra Leone women had the highest (60.27%), followed by Uganda (56.92%). Emotional and physical violence were most prevalent in Sierra Leone, while sexual violence was most common in Burundi and the Democratic Republic of Congo.
Discussion
This study highlights the urgent need for targeted …
Abstract: Background: Vaccination is a proven and safe method for combating COVID-19; however, coverage remains low in many low- and middle-income countries, including Nigeria. There is also a lack of contextual evidence regarding the public perception of and willingness to receive vaccines. This study aims to contribute to efforts to optimize the vaccination coverage and improve public health in northern Nigeria. Objective: This study investigated the perceptions of COVID-19 vaccination and willingness to uptake the vaccine in northern Nigeria, aiming to identify strategies for optimizing coverage and enhancing vaccination rates. Methods: A cross-sectional household survey was conducted across the Federal Capital Territory and five northern states in Nigeria. The survey assessed the respondents’ perceptions of COVID-19, their knowledge of the COVID-19 vaccine, and their willingness to be vaccinated. Descriptive and inferential (multivariate logistic regression) statistical analyses were employed to characterize the population and identify predictors of vaccine uptake. Results: The mean age of the respondents was 28.00 years. The majority reported at least one piece of misinformation regarding COVID-19. While awareness of the vaccine was high, its actual uptake was low, and future willingness to receive the vaccine was also limited. Employment status emerged as a significant predictor of vaccine uptake, as determined through the multivariate analysis. Furthermore, collaboration with NGOs and community-based organizations (CBOs) was identified as the most effective strategy for enhancing vaccine uptake. Conclusions: This study found a concerningly low willingness to receive the COVID-19 vaccine among participants in northern Nigeria. To address this issue, we recommend establishing partnerships with NGOs and CBOs, implementing extensive public awareness campaigns, and conducting community outreach programs. These efforts should focus on dispelling misinformation, building community trust, and promoting vaccine uptake through culturally appropriate communication materials.
The global rise in the elderly population is a significant concern, yet it has not received sufficient policy attention, particularly in developing countries like Nigeria. Africa is expected to witness a substantial increase in its elderly population, projected to grow from 11% to 22% between 2000 and 2050.[1] In the context of Nigeria, the number of individuals aged 65 and above has risen dramatically, escalating from 2,907,740 in 1991 to 4,536,761 in 2006[2]&[3]. This indicates a rapid growth of 1,629,021 within a mere two decades. Projections suggest that the elderly population in Nigeria will continue to expand, reaching 11.5 million by 2025 and a staggering 25.5 million by 2050. These figures stand in contrast to the 6.4 million recorded in 2005, to constituting approximately 10% of Nigeria’s total population. This demographic shift emphasizes the pressing need for comprehensive policies and initiatives to address the evolving needs and challenges associated with an ageing population.[4]
In Africa, the process of ageing transcends mere biology; it holds profound social, cosmological, and spiritual significance. This transformative journey is accompanied by a tapestry of cultural practices that underscore its sacred nature. Among the Ngwo people in Enugu State, located in the southeastern region of Nigeria, the elderly are revered and celebrated through unique names and customs. Titles such as “adukwurum,” “orinandu,” “amushi,” “ogeenyi,” “noomu,” “ogbun’agodo,” “Ogbu Ibuo,” and “Ite Ogbo” are bestowed upon them, symbolizing their role as esteemed progenitors, custodians of wisdom, and bearers of extensive life experiences.[5]
These distinctive names symbolize celebrations and honour bestowed upon elderly men and women, acknowledging their enduring vitality, industriousness, and accomplishments in nurturing successful generations. Specifically, the term “Adukwurum” embodies the celebration of individuals—both male and female—whose lives extend to witness the presence of (great)grandchildren and the achievements of their offspring. “Orinandu” denotes an elder who lives to see old age, enjoying the fruits of their children’s prosperity. Meanwhile, “Amushi” and “Ogbu n’agodo” pay tribute to elderly males and females, respectively, revered for their exceptional fertility levels. The title “Noomu” is reserved for a resilient elder woman who has withstood the trials of labour numerous times, having given birth to ten or more children. Furthermore, designations like “Og’enyi,” “Ogbu Ibuo,” and “Ite Ogbo” encompass additional variations of cultural festivities honouring elderly men and women, celebrating their enduring longevity and progeny.
Yet, within these celebrations, the complex dynamics of ageing persist. While old age is widely respected, for some, it presents a challenging phase marked by functional limitations and other adversities. As individuals age, they may contend with disabilities, ailments, financial hardship, diminished income, and other socioeconomic difficulties. This sobering reality, particularly prev[i]alent in developing nations, unfolds amidst a backdrop of inadequate political commitment to institute comprehensive welfare policies for the elderly.
ISSUES, NARRATIVES AND LESSONS LEARNT
Delving deeper in light of the aforementioned, a southeastern Nigeria study conducted among 816 older adults,[6] underscored a significant prevalence of disability. Notably, seven out of every ten elderly individuals required assistance with Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL). Intriguingly, this study illuminated a gender disparity, revealing that men were twice as likely as their female counterparts to necessitate such assistance. Furthermore, the research indicated a noteworthy correlation between education and disability risk. Elderly respondents with limited or no formal education faced an elevated likelihood of experiencing disabilities. This linkage can be attributed to the fact that education plays a pivotal role in fostering a proactive approach towards preventive healthcare, bolstering the capacity to effectively manage various pathologies, and preempting the onset of chronic conditions.
Additionally, the study highlighted the critical importance of physical exercise. Those who refrained from engaging in regular physical activity exhibited a staggering seven-fold increase in the risk of disability concerning ADL, alongside a twofold risk elevation for IADL-related disabilities, when compared to their exercise-practising counterparts. This emphasizes the vital role of physical activity in promoting functional independence and mitigating the onset of disabilities among the elderly population.
Mobility-related disability, primarily stemming from stroke, imposed the most substantial burden among all types of disabilities. The prevalence of strokes was higher in males than in females. Upon further examination, it was found that alcohol consumption, specific occupational choices, and smoking were correlated with an increased risk of strokes. Among the elderly, those with lower levels of education faced a heightened risk of dementia compared to their tertiary-educated counterparts. Notably, individuals with no formal education exhibited a twelve-fold greater susceptibility to this disability.
Pain-related disability, centred around osteoarthritis and rheumatism, ranked as the second most prevalent form of disability. Elderly females were found to be 20% more susceptible to this category of disability compared to males. This discrepancy not only limited their engagement in social activities but also intensified their discomfort and other associated disadvantages. Additionally, elderly females were twice as likely as males to experience mental health issues. Physical exercise emerged as a significant factor linked to mental well-being. Engaging in physical activities served as a protective measure against mental-related disabilities, particularly dementia, mitigated the impact of disabilities in advanced age, and contributed to overall health promotion.
The study also shed light on instances of reported abuse. Emotional abuse was more frequently reported by males (64.7%), while physical abuse was more prevalent among females (53.8%). These instances of abuse were predominantly perpetrated by individuals in positions of trust. Unfortunately, a prevalent reason for not reporting such abuses was the fear of abandonment by caregivers, often family members.
Furthermore, approximately 47.7% of the respondents self-assessed their health as poor, indicating the presence of comorbidities in older age (Figure 1).
Figure 1: Respondents’ Self-reported Health Status in Percentage
Over half (56%) of the participants reported having experienced an illness within the four weeks preceding the study. These illnesses encompassed a range of conditions such as malaria, typhoid, fever, headaches, high blood pressure, ulcers, prostate cancer, waist pain, and cough, among others. Of the respondents, 46.8% rated the quality of healthcare they received as fair, while the remaining individuals perceived it as either good or poor as shown in Figure 2 below.
Figure 2: Quality of Care Received by Respondents
In another survey[7] conducted among older adults with disabilities in South-eastern Nigeria, the findings indicated that more than 70% of the participants had unmet needs.
Figure 3: Percentage of Elderly with Unmet Needs
This signifies a lack of access to fundamental requirements, encompassing financial resources, proper nutrition, healthcare, suitable housing, as well as rights and entitlements, including pension benefits. Mobility also emerged as a significant area where needs were not adequately fulfilled.
Based on the study’s findings, the most deficient areas of care and support were centred on financial assistance, with health care ranking second due to the burden of out-of-pocket payments, followed by insufficient access to proper nutrition. Article 25 of the United Nations Universal Declaration of Human Rights, established in 1948, defines adequate standards of living as encompassing the ability to fulfil fundamental necessities such as proper diet, suitable shelter, clothing, housing, healthcare, long-term care services, and possession of resources to alleviate the impact of illnesses, disabilities, widowhood, old age, or the loss of a means of livelihood. Regrettably, a significant majority of respondents indicated their inability to afford a healthy lifestyle and meet adequate living standards. Among the participants, 66.0% did not utilize any form of assistive device, while the remaining 34.0% primarily relied on walking sticks (canes). Notably, none of the respondents utilized modern devices to navigate their surroundings effectively. Their environment was generally not ageing-friendly.
A sight-impaired woman living in a physical environment that is not ageing-friendly given the lack of handrails
The respondents’ coping mechanisms were influenced by their interpretation of the underlying causes of their disabilities. Some individuals, who attributed their disabilities to supernatural or preternatural factors, sought assistance from spiritual practitioners. Conversely, those with a medical understanding of their conditions leaned towards medical interventions to enhance their quality of life in their remaining years. Survival strategies often revolved around receiving financial support. This primarily took the form of remittances, often provided by their children. Additionally, some resorted to seeking alms as a means to sustain themselves.
An elderly begging for alms along the roadside
CONCLUSION
In each of these studies, participants shared their personal challenges and articulated their preferences for effective assistance as stated above. Therefore, it is crucial to provide support to the elderly through well-designed, need-based policies and initiatives. Drawing inspiration from established systems of care in countries such as Canada, Japan, Russia, the Netherlands, and China, there is an opportunity to examine and analyze these models with the aim of crafting a tailored approach for the elderly population in Nigeria.
Furthermore, it is proposed that a community-based healthcare system be developed, one that incorporates informal caregivers. This approach would ensure a seamless continuum of care, utilizing the support of individuals whom the elderly have been familiar with throughout their lives. To achieve this, a public-private partnership could be established. This partnership may encompass a well-structured home care and rehabilitation services framework, including specialized interventions like physiotherapy, delivered by trained professionals who collaborate with informal caregivers at the community level. Additionally, the implementation of innovative assistive technologies can play a pivotal role in enhancing the elderly’s independence and overall quality of life, and ensuring an ageing-friendly environment is crucial Establishing vibrant recreational centers that promote social engagement and combat feelings of loneliness and isolation is equally vital. This comprehensive approach strives to elevate social interaction equality, fostering a supportive environment for the elderly in Nigeria.
As the ongoing demographic transition continues, the imperative for a comprehensive collective welfare system becomes increasingly evident. This takes the form of a pension system designed to encompass all categories of the elderly, alongside community-based care and welfare policies, which together offer a targeted approach to policy interventions. In light of Nigeria’s commitment to achieving healthcare equity, the findings from these studies present a significant opportunity to address challenges and enhance access to healthcare and social safety nets for the elderly population. One potential avenue for achieving this is through the enhancement of the National Health Insurance Scheme (NHIS). While currently covering only a fraction of the population, strategic modifications can extend its benefits to elderly individuals, particularly those living with disabilities. A crucial step involves broadening the NHIS’s eligibility criteria to encompass elderly individuals and fostering community-based outreach efforts. Valuable lessons can be gleaned from successful schemes in other countries to inform these enhancements.
To further fortify the safety net for the elderly, the establishment of a dedicated health fund is strongly recommended. Given that elderly individuals often heavily rely on extended family and friends for both healthcare and social support, the creation of a health fund could alleviate the economic burdens borne by both the elderly and their households. Recognizing the pressing need, there is a call for the implementation of a sustainable unconditional, non-contributory pension scheme. This measure aims to mitigate the adverse effects of poverty and economic hardships prevalent in contemporary Nigeria.
Despite the current lack of prioritization of ageing-related issues by the Nigerian government, as evident in the widespread out-of-pocket healthcare expenditures and a lack of political will to enforce ageing welfare policies, it remains crucial to acknowledge the formidable challenges that have already surfaced, including catastrophic health expenditures. Addressing the issues of disability and the challenges faced by the elderly in Nigeria is, therefore, of paramount importance. Such efforts are essential to enhance their quality of life and imbue their lives with greater significance as they approach the end of life.
OpenEdition suggests that you cite this post as follows: Judith I. Ani (August 15, 2023). Ageing in South-Eastern Nigeria: Issues, Personal Narratives and Lessons Learnt. Threads of Time. Retrieved May 19, 2025 from https://timethreads.hypotheses.org/149
Authors: Chris Chukwunyere Njoku, Judith Ifunanya Ani, Norah Lucky Katende-Kyenda
Publication date: 2024
Background:
Injecting drug use is a global public health challenge with multifaceted consequences, not only for Injecting Drug Users (IDUs) but also for society at large. Their vulnerability necessitates a deeper exploration of their health information needs, aiming to leverage evidence-based research to shape effective interventions for their well-being. Method: This study employed a qualitative method to gain insights into disease conditions and health information needs of IDUs. Through purposive sampling, 71 in-depth interviews were conducted and thematically analyzed. Results: The study included 43 males and 28 females, predominantly aged 26-35 (59.2%) who had poor socioeconomic status. The most commonly reported disease conditions varied and included malaria, infections and diabetes. Findings revealed a complex understanding of their disease conditions and management practices. Participants emphasized a critical need for access to reliable and comprehensive health information, while also highlighting the significant barriers they face in obtaining this information. Additionally, their preference for receiving health information in video formats, written articles, and through outreach programs underscored their desire for knowledge to make informed decisions. As co-creators and stakeholders in their health, participants expressed a clear demand for sustainable and free healthcare, mosquito nets, and regular outreach programs. Conclusions: While drug use presents a significant public health issue, effective interventions for IDUs require a multifaceted approach that begins with understanding their perspectives and actively …
Unmet needs for support relate to daily requirements for independent functioning among the elderly but which are unavailable, consequent upon declining informal support and challenges of accessing formal ones. This study explored unmet needs for support, including finance, assistive device, food and healthcare, among older persons with disability in Enugu State Nigeria. Using a multistage sampling and a triangulation of research methods, a total of 1030 older persons were selected for the study. Seven in every ten older persons in the sample (71.0%) had an unmet need. Of all the support received, financial support (79.8%) was the most inadequate. The predominant assistive device was the walking stick (84.9%). Only about four (38.0%) out of ten had three square meals with no recourse to a balanced diet. Of all the unmet felt needs, healthcare/medication (60.2%) was the most predominant followed by financial support. Their physical environment was neither disability-supportive nor ageing-friendly. We conclude that the high percentage of unmet needs among older persons in Enugu State Nigeria is consequent upon the absence of formal social welfare policies and programmes for the elderly. Unfortunately, the elderly would continue to have unmet needs given the declining safety nets traditionally provided by family members vis-à-vis the increasing economic hardship in the society. It is therefore recommended that governments at all levels should formulate and implement social welfare programmes to bridge the needs gap among senior citizens who had spent their vibrant years serving the government and society.
