Ageing and Poverty in Africa

Ugandan Livelihoods in a Time of HIV/AIDS

Alun Williams

• Publisher: Routledge
• Year: 2018
• Print ISBN: 9781138726284
• eBook ISBN: 9781351752213
• Topic: Social Sciences
• Subtopic: Sociology
• Index: Social Sciences

This title was first published in 2003. The rapid demographic aging of populations worldwide, and most dramatically in developing countries, will result in unprecedented increases in the absolute and relative numbers of the aged in these countries. Whilst developed economies already have the basic infrastructure in place through which to support their ageing populations, developing nations frequently do not, and it should not be assumed that their best course of action is to attempt to duplicate the supportive infrastructures of developed countries. In developing nations these may be culturally inappropriate, geographically inaccessible, economically or politically unsustainable, or all of these. Effective and sustainable support services must be designed with reference to the circumstances of the client group, and it is increasingly evident that knowledge of the lives of the aged in developing countries is currently very limited. This book aims to inform the reader on the livelihoods of elders in developing countries and to stimulate a discussion of appropriate methods of supporting them in maintaining their quality of life during and beyond the coming decades of demographic change. It does so through reporting the lives and livelihoods of the aged population of Kikole (a pseudonym), a highly impoverished village in Uganda. Individual livelihoods are explored from a lifecourse perspective, with present day quality of life being shown often to be the result of earlier enforced changes in circumstances arising in economic, social or cultural marginalization, political or physical insecurity, or macro-economic change, rather than in the physical or mental changes that may accompany advancing age.

Chapter 1
Ageing and Poverty in Developing Countries

The lives of many older people in developing countries are dramatically, and, most frequently, negatively, influenced by the social and economic changes that accompany the development process. Migration to cities by young rural adults in Africa undermines the traditional extended family system, as the new migrants establish nuclear families in the cities while the older generation are left to fend for themselves in rural areas (Khasiani 1987, Gaisie 1989, Hunt 1989, Udvardy and Cattell 1992). Similarly, the status of the elderly is threatened by the growth of individualism and a desire for independence and autonomy, as education provides younger people with some of the skills needed to strive to obtain the Western lifestyle displayed by the mass media (Nahemow 1979, Kendig 1987, Ingstaad et al. 1992).

The HIV/AIDS epidemic in sub-Saharan Africa magnifies the problems that elders face as a result of these changes. Those dying from HIV/AIDS are predominantly younger, economically active adults and children (Nunn et al. 1994). Fewer adults are available to grow food, to earn the money that is increasingly required as the cash economy displaces the rural peasant economy, to manage community organisations and to care for the sick, for the frail elderly, and for children (Tout 1989, Prebble 1990, Ankrah 1991, Barnett and Blaikie 1992).

Women, especially older women, are particularly vulnerable to the combined effects of socio-economic change and the HIV/AIDS epidemic. Caregiving and providing for the sick and for children is traditionally a woman’s task, undertaken within the supportive context of an extended family (Tout 1993, du Guerny 1997). Following the changes in family composition described above, elderly women are increasingly becoming caregivers to their sick and dying adult children (Rwezaura 1989) and surrogate parents to their orphaned or abandoned grandchildren (Hunter 1990, Dunn 1992).

This situation must be considered in the context of the demographic transition. Reductions in fertility and child mortality and an increase in life expectancy have been observed in many countries throughout the world (Keyfitz and Flieger 1990, Kinsella 1997), and as a result the number of older people alive is increasing dramatically. By 2020, for example, the numbers of people aged 60 years and over will be more than six times the number that were alive in 1950, and the number of those aged 80 years and over is predicted to have increased up to tenfold by the same date (United Nations Population Division 1994). One effect of this change is to increase the requirement for the provision of services to meet the needs of an increasing proportion of aged people. This is at a time when the proportion of younger people who are called upon to generate the resources with which to provide these services, is decreasing. The ageing of their populations is thus creating economic problems for countries experiencing this demographic transition (Okojie 1988, Adamchak 1989, Myers 1992).

In Uganda, life expectancy remains low, infant mortality and fertility remain relatively high, and therefore the proportion of elders among the population remains low - in 1991, only 3.3% were aged 65 and over (Statistics Department 1995). These figures should be seen in comparison with those of, for example, Sweden (18%), Japan (12%) and Argentina (9%) (Kinsella and Taeuber 1993). However, although the demographic transition has so far made little progress in Uganda, the absolute numbers of aged people in its population are predicted to increase dramatically in coming decades as the large cohorts of younger adults in its current population grow older. In addition, the continuing loss of young adults to HIV/AIDS will reduce the numbers of younger, productive adults available to support the aged.

Oxfam describes development as a process which aims not only to improve the circumstances of the poor, but also to empower them to manage and direct this improvement (Pratt and Boyden 1985). However, Adamchak (1989) asserts that development is taking place largely without reference to the needs of older people, while du Guerny (1997) adds that the rural aged receive even less consideration than their urban counterparts. Gorman (1995) argues that this marginalisation stems from the negative stereotypes given to older people in all modernising societies. These represent them as out of date, passive, inflexible, non-contributing members of society, whose problems need not be addressed since they have only a relatively short life-expectancy. In view of this ageism (Apt 1992), it is perhaps unsurprising that the aged are frequently seen as either irrelevant, or an impediment, to the rapid economic growth that is the goal of many developing countries and those international organisations that facilitate such growth (Treas and Logue 1986, Warnes 1994).

Poverty amongst the aged

Chambers (1995) describes eight dimensions of deprivation as experienced by poor people: poverty, social inferiority, social or geographical isolation, physical weakness, vulnerability, seasonality, powerlessness, and humiliation. The breadth of these illustrates the potential for heterogeneity of experience among the poor, and highlights the necessity, in a study such as is reported here, to look beyond mere cash poverty when exploring their lives. Although I found all of these dimensions amongst the experiences of the aged, the major concern of all was to protect themselves and those for whom they accepted responsibility from poverty and the problems that it created. This study, therefore, is essentially one of vulnerability to poverty and its effects among a group of older people. Further, amongst the poorest members of this group, who were barely able to subsist on the resources available to them, poverty manifested itself most frequently as hunger, and vulnerability as an awareness of impending hunger. Food insecurity is, therefore, a recurring theme in this book.

Poverty is a major risk of ageing in developing countries (Sen K 1994), and the World Bank has described older people and their dependents as “poor and vulnerable” (World Bank 1993a p21). Before its extent among this group can be examined, it is first necessary to clarify what is meant by “poverty”. This has been given many definitions, and here I will discuss three:

Income poverty

In cash economies, where subsistence is achieved through the purchase of commodities which enable basic needs to be met, a level of income is calculated below which poverty is said to exist. Rowntree developed a poverty line which he defined as “the minimum sum on which physical efficiency could be maintained. [This is] a standard of bare subsistence rather than living. In calculating it the utmost economy [is] practised” (Rowntree 1941 ppl02-103). Whilst more recent poverty line definitions have been less stringent, they continue to relate poverty exclusively to income.

Basic needs, or subsistence poverty

This definition varies according to the needs which are seen as “basic” to human life. It accepts income as one of a number of essential needs, and its development can be traced from the work of Rowntree (1941), through Drewnowski and Scott’s (1966) addition of educational, recreational, security and income needs (cited in Townsend 1970), to the 1997 United Nations Development Programme (UNDP) Human Development Report, which redefines basic needs as “material requirements for minimally acceptable fulfilment of human needs” (UNDP 1997 pl6). These needs include, apart from income, access to health services and education, employment and participation in the social and political life of the community.

Just as income poverty is assessed through the application of an objective, standardised poverty line, so basic needs poverty is assessed through the use of objective indicators which describe these needs. However, defining both basic needs and income poverty is problematic when this is done by people who are not members of the same cultural group as those to whom it is to be applied. As Townsend noted: “It has always been evident that what most people would call poverty in one society would be comparative affluence in another” (Townsend 1962 p224).

Capability poverty

This makes reference to an individual’s ability to lead a life not simply lacking in impoverishment, but which is valued by and valuable to the person leading that life, and by his or her community. Thus, issues such as an individual’s ethnic background, lineage, fertility, age, education, and physical ability may all be relevant to capability poverty. It can be defined, therefore, only by the members of that community (UNDP 1997), and thus sidesteps the pitfalls of the definitions discussed earlier. It does not

Ageing and Poverty in Africa

attempt, in the first instance, to relate the values of the study population to those of another population whose circumstances may be different, or those of researchers, whose knowledge of the study population may be incomplete.

Participatory methods of estimating poverty

Comparing the extent to which these conceptualisations of poverty incorporate emic values, it can be seen that the criteria of both income and basic needs poverty are unlikely to have been identified by a member of the group of people that is the subject of the study. Only in the third, capability poverty, are the criteria which describe relative wealth and poverty set by the subjects themselves. As such, it is a qualitatively different measure from both income and basic needs poverty.

To assist in deciding which method of poverty assessment is most appropriate for the current study, it is useful to review an oft-quoted research report by Jodha (1988). Jodha believes that by choosing a limited number of variables with which to estimate poverty, and then allowing these variables to have only a limited number of values, usually during the application of a quantitative survey, researchers fail to identify or examine all the factors which influence poverty in their study population. In his study of changes in the incidence of rural poverty in Rajastan between 1966 and 1984, Jodha found that the village discourse on economic status, which emphasised qualitative issues such as the availability of choice when making life decisions, and social status and patronage, was very different from that which had previously been employed by other researchers in the same community, who focused on quantitative factors such as income, expenditure and employment. When the emic indicators were applied to the study population poverty was found to be decreasing, while the etic indicators showed it to be rising.

Having raised the issue of inconsistencies between the results of research using etic and emic studies, Jodha calculated the differences between the results of previous studies which used etic criteria to obtain values for a variety of variables, and the values given to the same variables in emic studies, and found them to be between 11% and 144%. For example, household cash income estimated through etic surveys was exceeded by that obtained through emic in-depth interviewing and participant observation by 11%, while the costs of credit from institutions were reported to be 144% greater after emic than after etic studies. In each case he ascribes the inaccuracy to the failure of the etic study to take account of one or more issue-specific factors, which subsequent emic studies identified as relevant (Jodha 1988).

Jodha’s conclusion, in part, has been responsible for the acceptance of the importance of community participation in social research. Recently, for example, Amartya Sen (1997) has advocated the involvement of communities as an empowering action:

The evaluation of quality of life and of diverse capabilities call for public discussion as a part of a democratic “social choice” procedure. (p25)

Further, the UNDP (1997) stresses that any selection of criteria contains an inescapable element of judgement, and it is therefore desirable that public discussion should play a part in the selection process:

It is very important that the standards to be used are not determined on a top-down basis, but are open to - if possible, emerge from - a participatory, democratic process, (pi 6)

Poverty and well-being

To avoid confusion between poverty defined as a level of income or resource deprivation and poverty that results from the multiple dimensions of deprivation discussed above, the term “well-being” is now widely used to describe the latter. Well-being is most simply defined as the experience of a good quality of life, and “ill-being” the experience of a poor quality of life (Chambers 1997). It should be noted, however, that although well-being is influenced by material wealth, it also contains social and psychospiritual factors, identified by the population to which it is applied:

Unlike wealth, well-being is open to the whole range of human experience, social, mental and spiritual as well as material. It has many elements. Each person can define it for herself or himself. Perhaps most people would agree to include living standards, access to basic services, security and freedom from fear, health, good relations with others, friendship, love, peace of mind, choice, creativity, fulfilment and fun. (Chambers 1997 pp 9-10)

Well-being can therefore increase or decrease without any accompanying change in wealth. Thus, in attempting to estimate well-being, the identification of monetary and non-monetary factors which influence quality of life should be considered equally important.

The exploration of well-being through participatory techniques has the specific objective of enabling members of the study community to identify those factors which mediate their quality of life for better or worse. These factors can vary widely between communities, as the following examples show. Scoones (1995) reports a wealth ranking exercise in rural Zimbabwe, in which the study community identified non–monetary aspects of wealth. Most relevant to the current study, in the context of the reported declining status of the aged, is the value they placed on the status of an individual within his or her community. Seeley et al. (1996) found that householders of the MRC cohort said their lives benefited from factors such as having a high level of education, being part of a large social circle, and having diverse sources of income, and suffered if th...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Contents
• List of Figures
• List of Tables
• List of Text Boxes
• Preface
• Acknowledgements
• Glossary
• List o f Abbreviations
• 1 Ageing and Poverty in Developing Countries
• 2 The Elders of Kikole
• 3 Land Tenure and Usage
• 4 The Rural Economy
• 5 The Health of Elders in Kikole
• 6 Elders’ Social Status and Relationships
• 7 The Impact of the HIV/AIDS Epidemic
• 8 Vulnerable Livelihoods: Coping With the Challenges of Old Age
• 9 Sustainable Livelihoods for the Aged?
• Bibliography
• Index