Despite modernism challenges, the elderly must be given opportunities and support to live a dignified life. Sub-Saharan Africa's elderly population is projected to expand from 43 million in 2010 to 67 million by 2025 and 200 million by 2050. The study investigated how stakeholders' assistance affects Makueni County's elderly. The study was descriptive and targeted the elderly where 12 senior citizens and 30 community stakeholders from Makueni County's six sub-counties were chosen through purposive sampling. The researcher examined and interpreted the data in tables. The study found that family gave the highest support followed by the cash transfer program assistance. Further, the study found that the church and community also gave some form of assistance to the elderly. In conclusion, there is need to enhance this support through policy adjustments advocacy and community education to create awareness on this social issue.

Background information

The 2030 Agenda for Sustainable Development calls for leaving no one behind and emphasizes on ensuring that the set goals are met for all segments of society with a particular focus on the most vulnerable which includes elderly persons. Globally, the population aged 65 and over is growing faster than all other age groups. According to data from World Population Prospects: the 2019 Revision report,¹ by 2050, one in six people in the world will be over age 65 (16%), up from one to eleven in 2019 (9%). By 2050, one in four persons living in Europe and Northern America could be aged 65 or over. In 2018, for the first time in history, persons aged 65 and above outnumbered children under five years of age globally. The number of persons aged 80 years and over is projected to triple, from 143 million in 2019 to 426 million in 2050.¹

It is projected that by the year 2050, the number of people over 60 years living in Africa will have increased from 50 million to 200 million.² In Kenya, the census report of 2019 indicates that the elderly population (65 years and above) was recorded at 1,870,493 persons accounting for 3.9% of the total population. Compared to the census report of 2009, the elderly population has increased by 538,220 from 2009 when they were recorded at 1,332,273. The report also shows that there are more women in the 65 years plus group than men accounting for 55.8 percent in 2019 compared to 54.8 percent in 2009.

In Makueni County, the census report of 2019 informed that the number of those aged 65 years and above was at 2.4 % of the total population in the County. This was a remarkable increase from 50,548 in the 2009 census to 66,691. Out of this total, women were 38791, translating to 58% compared to men’s 27900, accounting for 42% of the total 66691 older persons.³ The growing number of older persons raises questions about their well-being in terms of economic security in old age, social support, healthcare, and living conditions.⁴

Across the globe, there is a growing focus on research and policy for the elderly with special attention to the changing demography marked especially by increasing life expectancy, population aging, and ensuing public health and healthcare challenges in limited-resource settings.⁵ Wang and colleagues’ research findings pointed to the influence of socio-demographic factors on health and quality of life outcomes among the elderly in South Africa. A similar study among the elderly in sub-Saharan Africa by Berthe et al points out four main reasons for elderly abuse, which include: systemic reasons, ethical/humanitarian reasons, developmental reasons, and/or the interests and future of youth and adults. In addition, they state that while improving the living conditions of children, youth, and women, efforts to promote development in Africa must also take into account the needs of the elderly.⁶ For example, the Southern African Development Community (SADC) Regional Indicative Strategic Development Plan (RISDP) 2020-230 sets out a comprehensive 10-year development agenda for addressing social, economic, political, and governance issues in the region.⁷ The plan is an ambitious attempt of laying out SADC Vision 2050 over the next 10 years. The 2050 vision is grounded on SADC’s original vision of a common future in a regional community that will ensure economic well-being, and improvement of the standards of living and quality of life.⁷

In a study on the effect of cash transfer programme on older person’s well-being in Garissa County, the respondents indicated that they did not receive cash in a timely fashion and this hampered their capacity to meet their household needs.⁸ The Cash Transfer program is one of the interventions by the National Government of Kenya meant to improve the livelihoods of the elderly in Kenya. The impact of cash transfers begins with the recipient and then expands to the household, wider community, and eventually the country, meaning that many more people can actually be said to be beneficiaries of cash transfers than just those people who receive them.⁸

The Makueni County Vision 2025 in its social pillar aims at having an all-inclusive and cohesive society that enjoys equitable social development in a clean and secure environment. The Vision aims to, by 2025, have in place programs to cushion the vulnerable and the most at-risk populations to build their capacity to effectively contribute towards sustainable socio-economic development.⁹ Further, as per the County Integrated Development Plan 2018-2022 over the medium term, the county government planned to invest in socio-economic empowerment programs for the youth, women, persons with disability, the elderly and all other vulnerable groups.⁹

To contribute to the body of knowledge in this field, the study sought to promote research that examines the lived experiences of twelve elderly persons in Makueni County. This study examined the support towards elderly persons and how it impacted their living conditions. Further, the researcher aimed at recommending an advocacy strategy to help in addressing the issues on elder support as per the study findings.

Statement of the problem

Various Goals under the Sustainable Development Goals (SDGs) single out Social Protection as a key component in achieving sustainable development. For instance, Target 1.3 under SDG 1 on ending poverty in all its forms everywhere states that, “by 2030 nations will implement appropriate social protection measures for all to achieve substantial coverage of the poor and the vulnerable based on gender sensitive development strategies”.¹⁰ Other goals also speak to issues of reducing inequality, building the resilience of the poor and vulnerable together with addressing issues of decent work. Further, Kimamo and Kariuki in their work on Taking care of the aged in Kenya: the Changing Trends state that social values regarding the care of the elderly in a family are changing in Kenya and more households are focusing on the nuclear family which has led to the neglect of the elderly.¹¹ They add that this has given birth to destitute elderly persons who, if no intervention is put in place, will die of neglect. In Makueni County, the case is no different as documented by the Department of Gender, Children, and Social Services which is charged with the responsibility of provision of social assistance to the elderly in collaboration with other stakeholders.

Although the County Government has put in place various interventions to offer support to the elderly in Makueni County, there is still need to address their deteriorating living conditions. The researcher who is an employee of the county government has experienced disturbing cases of elderly persons who have been neglected by their families and the community leading to very poor living conditions. Some of the elderly persons that the researcher has encountered live in dilapidated structures, lack beds and bedding. In addition, those neglected lack food, clothing and medical care and they have been left to live in conditions that are not fit for human beings.

Walsh and colleagues have criticized the current available status of global research on elderly persons for failure to incorporate diverse samples in the studies from various parts of the world and for relying heavily on quantitative methods than the lived experiences of the elderly persons.¹² Further, there still remains a gap in establishing research on various thematic issues pertinent to elderly support, particularly the form of support given and by whom, frequency of the support, and strategies needed for an effective advocacy campaign aimed at improving their living conditions.

Rationale for the study

The living conditions of elderly persons present multiple issues that can be studied from different perspectives including development, social work, and psychology. Available Kenyan literature gives limited data on the forms and types of support that the elderly are receiving, the frequency, and from whom. In addition, the researcher did not find any evidence-based advocacy strategy aimed at improving the living conditions of the elderly. Kabole and colleagues argue that a coordinated community response to elderly people’s abuse is vital. This should include institutionalized policies coordinated by all levels of the community including healthcare providers, community-based elderly abuse advocacy groups, elderly welfare and protective service agencies, and the civil and criminal justice systems.¹³ The study therefore aimed at improving the living conditions of the elderly persons in Makueni County through the enhancement of the support given to them. This will be done through awareness creation and lobbying for policy change.

General objective

The general objective of the study was to gain insights on the living conditions of the elderly in Makueni County with a purpose of increasing understanding of the overall impact of the support given by the various stakeholders and the strategies that can be adopted to enhance their living conditions. The study focused on documenting the types and forms of support provided to the elderly, who provided the support, the impact of the support on their living conditions, and the measures that could be implemented to increase support for better living conditions.

Specific objectives

The specific objectives of the study where:

1. Establishment of the form of support the elderly persons are receiving and from whom.
2. Investigating the frequency of the support per year.
3. Establishment of the gaps that need to be addressed to enhance support.
4. Formulating the strategies needed to develop an effective advocacy campaign.

Research questions

To address the research objectives the research was guided by a central question: What is the support given to the elderly persons and its impact on their living conditions in Makueni County? Pertinent to this primary research question where the following secondary questions:

1. What are the forms and types of support given to the elderly and by whom?
2. What is the frequency of the support per year?
3. What are the gaps that need to be addressed to enhance support?
4. What strategies need to be developed to deliver an effective advocacy campaign?

Significance of the study

This study is significant in creating an understanding of the lived conditions of the elderly and the impact of the support they receive from the different sector players. The study also provides insights towards transforming the living conditions of the elderly in the context of Makueni County and shall promote knowledge applicable in the field of community development, social work, education and policy development. Additionally, the study findings will guide government, non-governmental organizations, community and faith-based organizations in their engagement and programing for elderly persons and lastly the findings can be used for further research.

Scope of the study

This study focused on describing and interpreting the lived experiences of 12 elderly persons in Makueni County. Further, the study describes the interpretation of the issue by 30 stakeholders within the community drawn from the national administration, county government and development committees under the county.

Description of the study area

Makueni County is one of the forty seven counties of Kenya, pursuant to schedule one of the Constitution of Kenya, 2010. The county is situated in the South Eastern part of the country bordering Machakos County to the North, Kitui County to the East, Kajiado County to the West and Taita Taveta County to the South. The county has a population of 987,653 persons with 497,942 being female and 489,691 being male. The number of those aged 65 years and above was at 2.4 % of the total population in the County. This was a remarkable increase from 50,548 in the 2009 census to 66,691. The estimated poverty rate is 34.8 % and majority of the poor are the elderly. Agriculture is the key driver of growth in the county economy recording a 47.2% contribution towards the Gross County Product (GCP).

The study adopted a descriptive research design. Lived experiences are the subject of qualitative research methods. Further, a phenomenology approach was used which was helpful in studying the living conditions of the elderly with a view of gathering rich accounts and detailed descriptions of the experiences of the elderly persons and that of selected duty bearers within the communities. Phenomenology describes and interprets key aspects of phenomenon such as perceptions, attitudes, beliefs, feelings and emotions experienced by people. It assumes that people observe, define, interpret and construct meanings to events that have value in their lives.¹⁴ It focuses on exploring the deep seated cultural, situational and social contexts of an experience.¹⁵

Purposive sampling was applied in selecting the research respondents among whom were 12 elderly persons from the six sub-counties and 30 stakeholders from the community drawn from the national administration, county government and the county development committees. The selected 12 respondents were adults aged 65 years and above and from vulnerable households. In-depth interviews, observation and focus group discussions where used as the research data collection methods. Data collection began with the profiles of participants, followed by an interview of the participants concerning their backgrounds as a basis for creating smooth conditions to proceed to the rest of the interview. The main interviews where in the form of questions that explored the living conditions, form and types of support received, the concerns of study participants and their responses to the frequency and adequacy of the support. As the interviewees shared their experiences, the researcher probed through emerging questions to enable the capturing of further explanations and meanings of issues of importance to the research raised by the participants.

The study focused on four areas themed around the research questions as presented below.

1. The forms and types of support given to the elderly and by whom.
2. The frequency of the support.
3. The gaps that need to be addressed to enhance this support.
4. The strategies that need to be developed to deliver an effective advocacy campaign.

Question 1: The forms and types of support given to the elderly and by whom

All the 12 respondents were interviewed and they indicated the following as the forms of support that they get (Figure 1 & Table 1).

Figure 1 Form of support.

Further, the respondents indicated the following as their source of support (Figure 2, Table 2).

Figure 2 Source of support.

Out of the 12 respondents, 5 were receiving cash transfers from the Kenya National Government. This represented only 41.7 percent of the sampled elderly persons meaning that a large number of the elderly who are vulnerable were not receiving support from the government. Further, only 2 (16.7%) of the respondents had received support from the County Government of Makueni. Data from the Makueni County Department of Gender, Culture and Social services indicated that the county in the financial year 2019/2020 supported only 2100 elderly persons with food stuff out of a population of more than 66,000.¹⁶ 25% of the interviewees had received support from relatives, while 16.7% reported that they had received support from mixed sources. Further analysis of the data showed that 60% of the respondents were registered under the County Government’s Universal Health Care programme while the rest (40%) relied on relatives and community for medical care. On housing, 50% were housed by their relatives either by sharing a common structure or in their own structures constructed for them by their relatives. 30% of the respondents were found to be living in houses that they had put up themselves and 20% were in houses constructed for them by the community members. In addition, those who were receiving support from relatives and the national government were found to be living in better conditions. In a research conducted in Western Kenya focusing on Old Age security, the researcher found out that indeed children are a source of age old security through transfer of good and money which is an important component of their elderly parents’ income.¹⁷ In another research on the role of reciprocity between older parents and adult children on intergenerational support in Northern Nigeria, the researchers found that the perception of reciprocity remains strong among Nigerians and plays a vital role in promoting intergenerational support between older parents and adult children.¹⁸ The two studies agree with the finding that support from relatives has a significant impact on the lived experiences of the elderly.

Question 2: The frequency of the support per year (Figure 3 & Table 3)

Figure 3 Number of times support is received.

The study found that 2 (16.7%) of the respondents were receiving support only once per year, 5(41.7%) were receiving support 4 times a year while the other 5(41.7%) received support many times indicating it was regular. Further, the support from the County Government was only received once per year and the beneficiaries kept on changing hence a challenge of reliability. Overall, the 41.7 percent that reported to be receiving frequent support also were found to be living in better conditions. In another study investigating the effect of cash transfer programme on older person’s wellbeing in Garissa County, the researchers found that the frequency of cash payments to beneficiaries had the second greatest influence after amount.⁹

Question 3: The gaps that need to be addressed to enhance this support

The study found that there was need for awareness creation among the communities to enhance the uptake of the universal health care by the County Government which is offered free of charge to those aged 65 years and above. Kabole, Kioli & Onkware¹⁴ observe that the elderly have no right to health because of weak affordability of medical expenses. Consequently, the elderly are more likely to experience social exclusion in medical facilities hence the need for a health policy in favor of the elderly in Kenya. In addition, the findings show that there is need to register more elderly persons under the cash transfer and for the County Government to increase the frequency of the material support offered. The family caregivers also need support to enable them to meet their own obligations and to care for their aging relatives. Further, there are elderly persons who live alone and are exposed to insecurities and suffering and there is need for the Government both National and County as well as other actors in this sector to come up with a programme to address this.

Question 4: The strategies that need to be developed to deliver an effective advocacy campaign

The 30 respondents that were drawn from the communities strongly felt the support given to the elderly was inadequate and that there is need for policy change to enhance the support by targeting more beneficiaries and increasing the frequency. In addition, the communities need to be educated on the need to take care of the elderly among them. Further, based on the findings there is need to adopt a multi-sectorial approach in addressing issues for the elderly and to develop an advocacy strategic plan to draw attention of the key stakeholders to the issues of the elderly in Makueni County.

Data analysis

The research data was analyzed through interpretative phenomenological analysis (IPA). IPA was selected to analyze data because it resonates well with the phenomenological approach used in the study.¹⁹ During data analysis the researcher listened carefully to the tape-recorded interviews repeatedly and transcribed them in English. Local terminologies contained in the tape-recorded interviews were italicized and described. Further, the researcher re-read all transcribed texts and field notes and listened to the audio-recording to ensure full comprehension of the content.

First, the researcher undertook the initial noting of the texts, recording and identified significant phrases, themes or statements related to the participant’s experience. This included writing personal thoughts and feelings of the content, making notes or coding for specific themes using descriptive words. Secondly, development of emerging themes was done through reading the transcribed texts again including listing each non-repetitive and non-overlapping statement, classifying significant statements into meaning units and clustering them into larger themes. Finally SPSS was used to get a statistical analysis of the frequency of the collected data.²⁰

In conclusion, the study found that elderly persons who receive frequent support from relatives and those that are on the cash transfer program had better living conditions than those who were receiving little or no support. This, therefore, means that there is need to lobby the government both at the national and county level to enhance their support to older citizens. In addition, the family caregivers need to be supported to be able to take care of themselves as well as the elderly persons under their care.

Based on the findings of this study, the researcher recommends an advocacy campaign focusing on the following key priority areas and strategies for improving the living conditions of the elderly in Makueni County. 

Key priority areas

1. Educating the communities on the need to take care of the elderly living among them.
2. Increased number of beneficiaries under the cash transfer program.
3. Increase of budget allocation by the County Government of Makueni towards elderly support program.
4. Capacity building of family caregivers to improve their level of income.
5. Mapping of all elderly persons in the county and establishment of a database per sub-county.

Strategies

1. Sensitization sessions during public meetings. These will be done during local administration meetings and church gatherings.
2. Lobbying the National Government to increase the number of beneficiaries under the cash transfer program in Makueni County.
3. Lobbying the County Government to increase its budget allocation for the elderly support program.
4. Mobilizing key stakeholders to develop a multi sectorial empowerment programme for the family care givers.
5. Lobbying the National and County Governments to map all the elderly persons in Makueni County.

Ethical considerations

Here, the main concern was to ensure that the research is conducted within acceptable standards and principles of research work. During the field research, the researcher ensured that all participants were informed of the nature of the study and their consent to participate in the data collection exercise was obtained. The researcher ensured that the participants understood the purpose of the study and that participation was voluntary. Further, informant’s identities were protected by the researcher and no personal information was required. Codes instead of names were used as identifiers to enhance identity protection (anonymity). The researcher shall ensure that all data is well stored with a view of furthering the participant’s confidentiality and ensuring that they are not put at risk due to poor data storage. Lastly, in the formulation of the findings, recommendations and conclusion the researcher ensured that all that is informed by the research shall be presented to stakeholders in a manner that edifies the participants. It is expected the overall objective of the research shall be met through the recommendations and solutions for elder living conditions in Makueni County and the Kenyan society at large.

I wish to thank the lecturers under the Institute of Social Transformation at Tangaza University College for their support in helping me to learn how to conduct a social research. Special appreciation goes to Dr. R. Nalugala for his guidance on how to develop an evidence based advocacy campaign strategy. Dr. Zipporah Wambua for ensuring I didn’t lose focus during the research. County Government of Makueni for making the data publicly available which has made this study possible.

The author report no conflict of interest in this work.

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