Swansea University Partners a Community in Malawi to understand better care in rural communities

Following on from a successful visit, Dr. Chichlowska of the Centre for Innovative Ageing at Swansea University intends to apply for research funding to support research to understand the complicated issues and circumstances around the provision of formal and informal care for older people in rural communities in Sub Saharan Africa.

Population ageing is a phenomenon where the median age of a country increases – commonly due to factors such as low birth rates or increased life expectancy.  This phenomenon can be observed in Malawi, Central Africa, where community landscapes have been determined by high infant mortality, migration of young adults from rural to urban areas, the prevalence of HIV/AIDS and high ‘all-cause’ mortality.

In October 2013, Dr Chichlowska of the Centre for Innovative Ageing at Swansea University visited Malawi, as part of the Strategic Insight Programme coordinated through the Dragon Innovation Partnership. The aim of the trip was to develop a research collaboration and knowledge exchange platform around care of older people in communities in Wales and Malawi.  Hosted by Dr Mandala at the College of Medicine Research Support Centre, Blantyre, she was able to observe how communities are addressing such issues in a country with little infrastructure, limited public services and an even more limited budget.

Low- and middle-income economies such as Malawi are generally woefully under developed and have inadequate health and social care systems.  Malawi has been forced into a position of attempting to meet the intractable needs of an increasing population, an ageing demographic and a rise in the prevalence of chronic conditions and the increasing incidence of non-communicable diseases. 

Dr Chichlowska explained,

“I was privileged to observe some Malawian volunteers who have set up the Aged Project Trust.  They explained to me the system they use to facilitate health and social care in rural regions”. 

The Aged Project Trust provides care to isolated older people by using a traditional social structure.  Older people in need are identified and referred to the organisation by the headman or group village headman. A local volunteer carer is then assigned by the Aged Project Trust to support the older person.  The volunteer is then entitled to the same material benefits the older person receives such as clothes, blankets, pots etc.

Malawi cannot singularly rely on services that are supported by private donations and the generosity of volunteers giving their time.  Relying on aid based organisations to deliver care indefinitely is not a sustainable solution over the long term.  Public services need to be developed to meet the needs of changing communities.  The Aged Project Trust uses an effective model of care for older people; however, within the next decade the Governments of all Sub Saharan African countries are going to be faced with the following wider dilemmas associated with delivering care to ageing rural populations.  The rising incidence of non-communicable diseases in older populations is an unchartered public health challenge for Africa.