Aging in Sub-Saharan Africa Recommendations for Furthering Research (2006) / Chapter Skim
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6. The Situation of Older People in Poor Urban Settings: The Case of Nairobi, Kenya
6. The Situation of Older People in Poor Urban Settings: The Case of Nairobi, Kenya
Pages 189-213
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From page 189... ...
Africa's rapid urbanization has occurred amidst stagnating economies and poor governance, which have created massive and abject poverty in overcrowded slum settlements across major cities in the region. Recent studies have highlighted huge inequities in social indicators and in health and reproductive health outcomes between the urban poor and other subgroups, including residents of rural areas, with the urban poor recording the worst outcomes (African Population and Health Research Center, 2002; Dodoo, Zulu, and Ezeh, forthcoming; Gulis, Mulumba, Juma, and Kakosova, 2003; Magadi, Zulu, and Brockerhoff, 2003; Zulu, Dodoo, and Ezeh, 2003)
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From page 190... ...
This paper aims to reduce this dearth of knowledge by exploring the living arrangements, economic activities, and health status of older people living in two informal settlements in Nairobi, Kenya. The Study Setting Nairobi typifies the current urban population boom and its associated health and poverty problems, characteristic of many sub-Saharan African cities.
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From page 191... ...
Over 90 percent of the households do not have any organized mechanism for garbage disposal, while fewer than 5 percent have their own toilets. Similar patterns are observed for water supply: over 90 percent of households depend on poor-quality water distributed by vendors or kiosks for which they pay three or more times the tariff charged by the Nairobi City Council to pipe water to middle or upper income households (African Population and Health Research Center, 2002; Matrix Development Consultants, 1993; UNICEF, 2002)
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From page 192... ...
They addressed a number of issues relating to community perceptions and definitions of an older person, roles older people play in the community and how these might vary between men and women, support networks available, and general problems older people encounter in urban informal settlements. The focus group participants were randomly selected and stratified according to age.
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From page 193... ...
Declining physical strength and health status and increased physical and financial dependence and vulnerability were also mentioned as characterizing older people. Apart from physical features and reproductive experiences, the roles that older people play in their community, especially in arbitrating disputes and providing guidance and local leadership, are also seen as their defining characteristics.
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From page 194... ...
It is interesting that, except for those age 60 and older who feel incapacitated, people do not regard themselves as older. It is unclear the extent to which the negative images often used in describing older people in the slum communities contribute to this view.
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From page 195... ...
STUDY RESULTS Sociodemographic Characteristics of Study Participants Table 6-1 shows the sociodemographic characteristics of older people resident in the two informal settlements. There is a variation in the sex distribution across and within each slum community.
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From page 196... ...
The large disparity between older men and women from the Kikuyu ethnic group is not reflected in the overall ethnic distribution of the total population in the two slum communities. Kikuyu women account for only 34 percent of the total female population, similar to Kikuyu men, who account for 29 percent of the total male population.
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From page 197... ...
While almost two-thirds of the currently married older men in Korogocho live with their wives, only 29 percent of those living in Viwandani do so. Also, while more than three-quarters of currently married older women in Korogocho live with their spouses, fewer
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From page 198... ...
The sociodemographic profile of older people living in urban informal settlements as described above may have implications for their well-being. For example, older women who are largely uneducated and unmarried may face more severe forms of poverty, isolation, and vulnerability than men, and they may be more likely to be excluded from formal employment in the past and social support systems in the present, such as the country's contributory pension scheme.
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From page 199... ...
If you cook food, you cook your own which you know it is enough for two days or one only." living arrangements. More than half of older people in Viwandani (54 percent)
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From page 200... ...
< 15 years 7.3 1.1 6.9 1.3 10.0 0.7 Lives with spouse only 4.8 9.5 4.6 12.1 6.0 3.7 Lives with spouse and children < 15 1.4 5.2 1.6 6.9 0.0 1.5 Lives with at least 1 adult (not spouse) 48.9 37.3 49.0 38.6 48.0 34.3 Relationship to Household Head: Head 77.8 92.6 78.4 92.5 74.0 92.7 Spouse 9.6 1.6 10.1 2.0 6.0 1.0 Other relative 12.6 5.6 11.4 5.2 20.0 6.6 Number of Cases 356 442 306 305 50 137 SOURCE: African Population and Health Research Center (2002-2003)
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From page 201... ...
Economic Status Table 6-3 shows the labor force participation of the study population, the type of activity they are engaged in, and reasons for not working for those not engaged in any type of income-generating activity. Although the retirement age in Kenya is 55, more than half and close to two-thirds of older women and men, respectively, living in the two slum communities were engaged in an income-generating activity at the time of the study.
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From page 202... ...
Indeed, the difference between the two slum communities also points to this fact. In Viwandani, where about 40 percent of the older men report having formal employment, almost one in four reported receiving social security support compared with only 2 to 4 percent of older men in Korogocho and women in both slum communities who receive social security support.
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From page 203... ...
A majority of the residents work in the informal sector, and even those who have formal employment often lack job security despite working in high-risk jobs. The case in Box 6-3 highlights the complex linkages between economic activity, health status, and aging among the urban poor.
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From page 204... ...
2.2 10.2 2.3 4.3 2 23.4 Number of Cases 356 442 306 305 50 137 SOURCE: African Population and Health Research Center (2002-2003)
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From page 205... ...
Men are more likely to report respiratory illnesses, with one in four in Viwandani reporting this compared with only 15 percent of the women in Korogocho and Viwandani. Equal proportions of men and women in Korogocho reported gastrointestinal illnesses, reflecting the common environmental conditions affecting health in this particular slum community.
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From page 206... ...
29.6 18.1 28.8 19.6 34.7 14.6 Type of Illness: Musculoskeletal 57.1 43.8 56.8 46.7 58.8 35.0 Respiratory 15.2 22.5 14.8 21.7 17.7 25.0 Gastrointestinal 5.7 7.5 6.8 6.7 0.0 10.0 Central nervous 13.3 16.3 12.5 18.3 17.7 10.0 Other 8.6 10.0 9.1 6.7 5.9 20.0 Sought Care for Illness 44.8 47.5 42.0 45.0 58.8 55.0 Number of Cases 356 442 306 305 50 137 SOURCE: African Population and Health Research Center (2002-2003)
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From page 207... ...
Interaction of Living Arrangements, Health, and Economic Status Table 6-5 looks at the health and working status of older people in the two slum communities by their living arrangements. In Korogocho where the sample is large enough, older women and men living alone are more likely to report being sick than those who live with a spouse or children (or both)
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From page 208... ...
Medicine is expensive. The amount you pay for government hospital wards and the health services is as much as you pay to private clinics for one or two pills.
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From page 209... ...
CONCLUSION Differences do exist between the two slum communities, Viwandani and Korogocho, both in terms of the share of older people living in the particular slum and also in the sociodemographic characteristics of the older population. Older people are more likely to reside in the Korogocho community, although Viwandani has a larger share of the total population of the two communities.
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From page 210... ...
Older people living alone were also more likely to report being sick compared with those living with a spouse or other adults, but they are less likely to seek treatment in a health facility. This paper has provided an overview of the sociodemographic characteristics, living arrangements, health, and economic status of older people living in two slum communities of Nairobi.
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From page 211... ...
ACKNOWLEDGMENTS The authors acknowledge support for the Nairobi Urban Health and Demographic Surveillance System from the Rockefeller Foundation (Grant no.
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From page 212... ...
. Canberra: Health Transition Centre, National Centre for Epidemiology and Population Health, Australian National University, Oucho, J.O.
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From page 213... ...
. Urbanization, poverty and sex: Roots of risky sexual behaviors in slum settlements in Nairobi, Kenya.
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