Old Age and Disability in Uganda

A study of old age in Uganda using information gathered by the National Population and Housing Census 2014 shows interesting information about persons with disabilities (PWDs) over the age of 60 years. The Prevalence and correlates of disability among older Ugandans: evidence from the Uganda National Household Survey offers a deeper understanding of aging and disability.

The survey is an analysis of data collected on the answers to 6 core questions identified by the Washington Group. The answers of 2,382 older persons were analyzed in this study. 

The 6 core questions are:

1. Do you have difficulty seeing, even if wearing glasses?
2. Do you have difficulty hearing, even if using a hearing aid?
3. Do you have difficulty walking or climbing steps?
4. Do you have difficulty remembering or concentrating?
5. Do you have difficulty (with self-c are such as) washing all over or dressing?
6. Using your usual (customary) language, do you have difficulty communicating, (for example understanding or being understood by others)?

Each of the 6 questions question was analyzed into 4 categories: No impairment, mild impairment, severe impairment or unable to perform. 

It is important to build social support networks in old age

This survey looked for common threads for those with severe impairment in any one functional area or unable to perform any one function, or those who have some difficulty with any 2 of the functional areas.

These are some of the conclusions the survey made:

• As might be expected getting older is associated with greater disability but it is not dependent on gender. Getting older is also associated with decrease in function of body organs and systems. Their decline in function leads to non communicable diseases (NCDs) like high blood pressure, heart disease and diabetes. So getting older is associated with a high risk of disability and more NCDs. NCDs further increase the chances of becoming disabled or more disabled. These results agree with studies done in Nigeria, Ghana, Tanzania, rural South Africa, the United States, Malaysia and Brasil.
• Rural residents had a higher risk of disability with rural women having a  disproportionately higher risk of disability.
• Living alone was associated with disability among all older persons. This is because older persons living alone are deprived of emotional and physical support from their adult children and the social support of marriage. 
• Divorced/separated/widowed marital status was associated with disability among men and women. Having no spouse leads to loneliness and depression which increase the risk of disability among older people. Depression resulting from the presence of NCDs, in the absence of emotional support from a partner, can lead to disability.
• Dependence on remittances was associated with disability. Those who depend on remittances are disabled and unable to fend for themselves, requiring their relatives to send them assistance to survive. In contrast, older people who are engaged in farming or who receive wages, are still physically fit and hence do not need remittances. 
• Disability was significantly associated with ill health and NCDs. Older persons find difficulties in accessing healthcare and are therefore, more likely to be sick. NCDs such as diabetes, heart disease, and high blood pressure are strongly associated with disability among older persons.

Disability in old age in Uganda is a complex interaction of social, economic and health factors. The most vulnerable people over 60 years old are those without adequate social support networks. The most important social support being marriage partner and family.

The study also noted that special attention should be paid to those people living alone and dependent on remittances because they were the most vulnerable. Further to this, the study advocated the need to implement the Social Assistance Grantsfor Empowerment (SAGE) programme throughout Uganda, I will write about the SAGE programme in my next post.