15 July 2024
Charl Greeff

Navigating the ageing landscape: challenges and strategies for south africa

In numerous low- and middle-income countries (LMICs), populations are experiencing a rapid increase in ageing, a well-established risk factor for various chronic diseases. The diagnosis and management of these conditions pose considerable challenges for individuals and strain on healthcare systems. Recognising the significance of this trend is crucial for effective health system planning. However, limited research has been conducted on this matter in South Africa. Exploring and understanding this impact is essential to better address the unique healthcare needs arising from the ageing population in the region.

Africa foresees a threefold increase in its elderly population, rising from 46 million in 2015 to 157 million by 2030. This demographic shift is closely tied to a rise in chronic diseases, disability, and an escalating care burden. Acknowledging and addressing these factors is crucial for managing the evolving healthcare landscape and ensuring the wellbeing of the ageing population in the region.

“With more South Africans living past the age of 60, the country faces a growing chronic disease burden.” - (Solanki, Kelly, Cornell, Daviaud, & Geffen, 2019).

Anticipated Ageing Patterns in the South African Population

As of Wednesday, January 10, 2024, the present population of South Africa is 60,733,192, according to Worldometer’s analysis of the latest United Nations data. (Worldometer, 2024).
As of 2022, South Africa’s estimated population encompassed over five million individuals aged 60 or older, constituting 9.2 percent of the total South African population. Moreover, the majority (60.9%) of the elderly population in South Africa comprises females. (Stats SA, 2023).
The annual growth rate for the population over 60 is 2.7%, almost double that of those under 60.
According to the WHO World Report on Ageing and Health, the long-term impact of ageing is even more significant, forecasting that 2050 the number of older adults in South Africa will escalate to 15.4% of the total population.

Ageing, morbidity, and health expenditure

Based on the results from a data analysis conducted, which were extracted from the medical claims and member records stored in the data warehouse of NMG Consultants and Actuaries, these trends were identified:

Increasing age correlates with a rise in the proportion of individuals with chronic conditions.
The prevalence of co-morbidities (more than one chronic condition) increases with age.
Older adults are over twice as likely as those under 60 to develop a single chronic condition.
Older adults are 7.6 times more likely to develop multiple chronic conditions compared to their younger counterparts.
Overall, older adults are nearly five times more likely to develop a chronic condition.

Challenges and required steps.

As mentioned earlier, research on the ageing population in South Africa is limited. Thus, immediate attention is required for research, policy development, and planning to tackle the challenges of an ageing population effectively.

Research Areas:

Further research is needed in the following areas:

Policy development and implementation

The South African Policy for Older Persons originated in 2005 after the Madrid International Plan of Action on Ageing was signed in 2002. However, limited progress has been made, with no significant policy or legislation development beyond the Older Persons Act of 2006 and minimal implementation of the original plan.

Following are the growing concerns with South African policy development and implementation:

1. Health and Mental Health Legislation:

Existing health and mental health legislation lacks sufficient acknowledgement or provisions for the unique needs of older individuals.

2. National Development Plan 2030:

The National Development Plan aims to increase life expectancy. Still, it lacks clear strategies from the Department of Health or the Department of Social Development to meet the health needs of the ageing population.

3. Non-Communicable Diseases Strategy:

The Strategic Plan for the Prevention and Control of Non-Communicable Diseases focuses on general population health. Still, it lacks a specific focus on ageing as a risk factor or the unique needs of older individuals.

4. Implementation Challenges:

Despite theoretical benefits, poor implementation of plans and related policies has been observed.

5. Urgent Action Needed:

There is an urgent call to implement the South African Plan of Action on Ageing, aligning with commitments in the Madrid Declaration.

Commitment to establishing a framework for healthy ageing based on the WHO Global Strategy and Action Plan on Ageing and Health.

6. Call for Simple and Low-Cost Solutions:

Emphasises the need for straightforward and cost-effective solutions to promote healthy ageing, provide quality health and social care for the growing older population, and address the impending health and social welfare burden in resource-poor settings.

Ageing poses a challenge to the economic stability of South Africa.

The global wave of ageing, previously prominent in Europe and East Asia, is now reaching the shores of countries in the Global South. Over the next 25 years, South Africa is expected to become the fourth country in sub-Saharan Africa, after Mauritius, Seychelles, and Cape Verde, to transition into an ageing society. While tackling poverty is a priority, the rising demographic dependency associated with this shift can yield adverse effects.

By 2045, the proportion of South Africa’s population aged 60 and above (the qualifying age for an older person’s grant) is expected to double from 8% to 16%.
Thus, the number of older adults is projected to increase from approximately 4.5 million to 10.6 million, exhibiting an average annual growth rate of just below 3% compared to the overall population’s 0.6%.
This demographic shift requires careful consideration for effective policy and planning to address the evolving needs of an ageing society.

Further known issues to consider:

Firstly, Economic vulnerability emerges as a primary concern.
According to the Organisation for Economic Co-operation and Development, South Africans face minimal savings, with an expected retirement income of only 16% compared to 69.5% in Brazil and 87.4% in India.
This emphasises a reliance on family support in retirement or the potential risk of falling into poverty.
Secondly, the country’s dual burden of communicable and non-communicable diseases contributes to elevated levels of unhealthy ageing.
Thirdly, at a macro level, population ageing poses economic risks.
The associated slowdown in economic growth, coupled with a growing proportion of older adults, elevates the economically vulnerable population and the demand for social grants.
These trends present challenges to the country’s fiscal stability and the goal to eradicate poverty. (MARKLE, 2019).

Conclusion

As South Africa stands at the threshold of becoming the fourth sub-Saharan African country to embrace the challenges of an ageing society, the need for comprehensive strategies becomes increasingly evident. The rise in an ageing population brings challenges and things we need to consider. By 2045, the number of people over 60 will double, which might cause further economic challenges. It’s thus essential to implement sufficient policies. With minimal savings and a dependence on family support, there’s a risk of retirees falling into poverty. Despite existing policies, health legislation and implementation gaps persist, requiring urgent attention. To make things better, we need to re-evaluate our policies, ensure clearer planning, and implement them in a timely manner. Simple and affordable solutions are also required to ensure the wellbeing of the older population.

This blog post is for informational purposes only and should not be considered medical/financial advice. Please consult with a healthcare/financial professional for personalised guidance.

References

MARKLE, A. (2019, November 25). Ageing: another barrier to South Africa’s economic stability. Retrieved from Institute for Security Studies:
https://issafrica.org/iss-today/ageing-another-barrier-to-south-africas-economic-stability

Solanki, G., Kelly, G., Cornell, J., Daviaud, E., & Geffen, L. (2019). Population ageing in South Africa: trends, impact, and challenges for the health sector. Retrieved from HST:
https://www.hst.org.za/publications/South%20African%20Health%20Reviews/16%20SAHR_2019_Population%20ageing%20in%20South%20Africa.pdf

Stats SA. (2023, April 25). SA’S elderly population increasing steadily. Retrieved from Stats SA:
https://www.statssa.gov.za/?p=16280#:~:text=The%20ageing%20index%20in%20SA,highest%20elderly%20population%20in%202022.

Worldometer. (2024). South Africa Population (LIVE). Retrieved from Worldometer:
https://www.worldometers.info/world-population/south-africa-population/