Understanding resilience in later life in a low resource setting

Lead Research Organisation: University of Southampton
Department Name: School of Social Sciences

Abstract

It is estimated that close to 60 percent of the urban population in Kenya live in slums and informal settlements and the number of slum dwellers continues to grow at a fast pace. One of the key development goals is to reduce urban poverty and improve the lives of slum dwellers. The majority of the population in urban areas in sub-Saharan Africa including Nairobi are of working age. However recent research highlights that a growing number of migrants are choosing to age 'in situ', resulting in an increase in the number of older people living in slum areas.

Ageing in urban areas of developing countries can be challenging particularly given the lack of formal social support systems for the aged coupled with employability in the urban economy which is notably problematic for older people. Furthermore, the capacity of the family to contribute to the wellbeing of older persons may be weakened both by migratory moves and the daily challenge of life in the slum. Given this context, it is crucial to understand how older people in low-resource settings adapt, their resourcefulness in maximising on the available social capital and how this translates to better health and socio-economic outcomes and overall wellbeing.

The proposed study will use recently available panel data to investigate the health and socio-economic trajectories of a cohort of people aged 50 and over living in two Nairobi slums to shed light on the factors that are associated with successful ageing in such a setting. The study will apply mixed methodology and advanced statistical approaches to understand the interplay between individual inherent characteristics and external protective factors such as social or family networks, household attributes, and how these interact with shocks, stressors and adverse life-course events to influence individuals' vulnerability or resilience in experiencing negative outcomes. In-depth cross-case analysis using qualitative techniques will be used to triangulate the findings from the statistical analysis and provide comprehensive understanding of the processes through which older people navigate risks, opportunities and [lack of] choices in mitigating shocks and adverse life events.

This research provides the basis for understanding resilience factors among older people and how they might be supported to maximise on existing opportunities and social capital amidst shocks or stresses as well as other life-course events that would potentially impact negatively on their health and socio-economic wellbeing. Findings from the study will be valuable in informing developmental policies designed to alleviate poverty and improve the lives of poor people. In particular, the study will highlight the situation of older people living in urban slums in sub-Saharan Africa, a group that is largely invisible in the development discourse and research focusing on the region.

Planned Impact

The non-academic audiences who will benefit from this research are international, bilateral and intergovernmental agencies and civil society groups that seek to improve the wellbeing of poor people. The research will also be directly beneficial to government ministries and departments providing social and health services. The findings from this research will inform third sector organizations that are primarily involved with vulnerable and marginalised populations such as slum dwellers and older people by providing evidence-based recommendation to inform their policies and interventions. One such key stakeholder particularly relevant to this study is HelpAge International, whose primary mandate is advocating for the rights of older people nationally and internationally as well as service delivery to improve the wellbeing of older people. HelpAge works directly with older people through targeted initiatives seeking to help older people overcome poverty and improve their wellbeing. It is envisaged that the findings from this study will inform their programs that seek to empower and improve the capacities of older people. This research will raise the profile of older people living in urban areas as a group in need of attention.

At the national level, one of the government agencies targeted as a beneficiary for this research is the National Coordinating Agency for Population and Development of Kenya (NCAPD) whose mandate is to 'provide leadership in formulating, coordinating and implementing appropriate population policies and programmes for sustainable development'. This agency has facilitated a number of social and health programs aimed at targeting the poor and the most vulnerable in society. Therefore, findings from the proposed study would be particularly relevant to NCAPD as it would provide the agency with strategic methodology for classification of the vulnerable people in society and highlight areas to be targeted for interventions in order to strengthen the capacity of individuals to utilize available opportunities and increase their abilities. Another initiative that will benefit directly from findings from this research is the newly introduced cash transfer scheme. The government of Kenya through the Ministry of Gender, Children and Social Development has allocated funds in the fiscal budget to be dispersed to destitute older people. Findings from the study will therefore be beneficial to the government of Kenya in the identification of older people who are potentially vulnerable and in highlighting this segment of older people living in urban areas given that the current focus for the cash transfer scheme are older people living in rural areas.

The non-academic beneficiaries mentioned above will be involved throughout the phase of the project and concerted efforts will be put in place to engage with them through various forums. The research findings will be disseminated through a number of channels including consultative meetings with the stakeholders at key stages of the projects. In order to improve on the likelihood of the findings of this research being absorbed by the intended beneficiaries, the stakeholders' communication channels will be utilised. This includes using the existing newsletters and other Information, Education and Communication (IEC) materials which have an already established circulation to disseminate the research findings. Electronic publications of the research findings in the investigators and partners' websites will facilitate easy retrieval by the wider public through popular search engines.

Publications

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Bennett R (2016) Gender differentials and old age survival in the Nairobi slums, Kenya. in Social science & medicine (1982)

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Bennett R (2017) Gender differentials and old age survival in the Nairobi slums, Kenya in Social Science and Medicine

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Chepngeno-Langat G (2012) Concern about HIV and AIDS among older people in the slums of Nairobi, Kenya. in Risk analysis : an official publication of the Society for Risk Analysis

 
Description This study uses a mixed methods approach to better understand resilience among older people. It combines in-depth qualitative research with quantitative analysis of unique longitudinal data of 2,000 older people aged 50 and over living in two Nairobi slums.
The project has generated new knowledge on the nature and experience of resilience in older age on two broad levels. First by providing rare emic (from the perspectives of older persons themselves) understandings of the issue. Second by providing novel insights from non-Western low resource - specifically sub-Saharan African - settings.
The most important specific new empirical insights generated by the study are:
(i) The major 'adversity' faced by older slum dwellers centres not on the 'multiple losses' (to health, function, social roles and relationships (through bereavement) that are considered as key in the Western debate - but rather on three interlinked domains that are not captured in the extant literature, namely a) a perceived inability to meet basic needs at present and to secure their future b) a perceived lack of prospects for their offspring and c) resultant anxiety and stress.
(ii) A resilience 'resource' for older adults commonly considered key in the Western debate - namely close, supportive friendships and family ties and attendant emotional social support - plays little or no role in supporting the 'coping' of older slum dwellers. Qualitative research highlighted that social relationships are marked by a generalized lack of trust; frequently in the case of spouses or close younger generation kin, by conflict and strain; and a broad lack of rapport with youth within the community). However, older slum residents do draw on other forms of engagement with the social network as key coping resources. This was confirmed in the quantitative analysis, which demonstrated that maintaining or increasing formal local networks reduced the detrimental effects of the post-election violence for older people's wellbeing, whilst household environment and informal local and non-local networks did not influence the relationship.
(iii) Mobility is a pivotal determinant of the extent to which older individuals can pursue such a coping strategy. A further determinant is the extent to which their peers engage in the same coping strategies - highlighting the interdependence of resilience within the slum-dwelling older population
(iv) In a low resource, subsistence setting, older people's level of access to material resources and economic opportunities plays a central role in shaping both the level of adversity they experience, and the level of 'coping' they are able to attain. Women have poorer health and socio-economic status and contrasting social networks to men, underscoring the importance of structural inequalities in resilience.
The findings have opened up important new research questions about what appropriate, effective and gender sensitive policy responses could be designed to enhance older slum dwellers' resilience. In particular, what will:
i) enhance mobility among this population?
ii) address and bridge intergenerational tensions and divides within families and communities?
iii) enhance the effectiveness and inclusivity of savings groups for older adults?
iv) enhance the scope and reach of old age social protection provision?
Exploitation Route Findings from the study will be beneficial to national and international agencies that seek to reduce vulnerability through improved understanding of both income and non-income components of poverty among the poorest in society.
During the project, new connections have been forged with key policy role players at national and sub-national levels, who are seeking to build on the findings in advancing their respective strategic agendas. National-level partners include the Kenya Ministry of Health and the Kenya Ministry of Labour, Social Services and Security who are working, respectively, on finalizing a national strategy on ageing and health and on the implementation of the Kenya national policy on older persons and ageing. At the sub-national level, the Nairobi county government departments of education, youth and social services are utilising the findings to inform policy design and practice.
In addition, the findings will inform academic scholarship in the field of resilience. The study has highlighted that existing conceptions of later life 'adversity' and 'resilience' in the literature - which are derived overwhelmingly from empirical work in the Global North - are highly context dependent and the nature of salient 'adversities' and resilience resources in such SSA settings is not captured in existing constructs.
Sectors Communities and Social Services/Policy,Education,Healthcare,Government, Democracy and Justice

 
Description The project findings have been disseminated to a range of audiences and informed decision making and policy design at community, local and national levels. On 27 July 2015, a Community Dissemination workshop was held in the 'Chief's Hall' in Korogocho in order to present the findings to the local community where the research was conducted. A key aim of the workshop was to involve local community members in discussion around the implications of the research findings and to identify local actions that could help address the issues raised. A key outcome of the meeting was recognition of the need for local community space for older men and women to meet, strengthening involvement in social networks. Intergenerational relations and conflict were also openly discussed, providing the basis for future discussions and local interventions. The event was chaired by the Korogocho Chief, ensuring the 'buy-in' of local community leadership. On 28 July 2015, a high-level dissemination forum was held at the Hilton Hotel, Nairobi, bringing together around 80 national- and county-level policy makers from relevant sectors, and key representatives from civil society and academia. Opening remarks were provided by the Hon. Christopher Khaemba, Nairobi County Government Minister in charge of Education, Youth Affairs, Children, Culture and Social Services and Ms Cecilia Mbaka, Head, Older Persons and Social Welfare Division, Ministry of Labour, Social Security and Services. Following presentations of the key results, the participants discussed the implications of the research findings, with the discussion facilitated by Elijah Agevi, CEO, Research Triangle Africa. The timing of the meeting was opportune as the discussions were able to inform the Nairobi County Strategic Plan (2015-2025), highlighting the need to address specific vulnerabilities of those older people living in slums. Subsequent to the dissemination forum, members of the research team have held a number of meetings with the Kenyan Ministry of Labour, Social Services and Security. The project findings have resulted in a new collaborative research project between the research team and the Kenyan Ministry of Labour, Social Services and Security to investigate the role that old age social pension may play in reducing pension poverty and also in either ameliorating or augmenting intergenerational tensions and divides within families and communities. This ESRC-DFID funded project starts in September 2016 (ES/N014510/1).
First Year Of Impact 2015
Sector Communities and Social Services/Policy
Impact Types Societal,Policy & public services

 
Description Global Ageing and Long-Term Care Network
Amount £126,781 (GBP)
Funding ID ES/P006779/1 
Organisation Economic and Social Research Council 
Sector Public
Country United Kingdom
Start 01/2017 
End 11/2018
 
Description Impacts of pensions on multiple dimensions of poverty, subjective wellbeing and solidarity across generations
Amount £404,130 (GBP)
Funding ID ES/N014510/1 
Organisation Economic and Social Research Council 
Department ESRC-DFID Joint Fund
Sector Public
Country United Kingdom
Start 01/2017 
End 06/2019
 
Description Africa Population & Health Research Centre, Nairobi 
Organisation African Population and Health Research Center
Country Kenya 
Sector Academic/University 
PI Contribution We have a long-standing collaboration with APHRC, one the leading demographic research centres in Africa, and are currently partnered with APHRC on an ESRC-DFID grant and also on an ESRC GCRF grant, where CPC members are the PIs and provide the intellectual leadership to the projects. We have also previously worked with APHRC on earlier grants and have hosted APHRC members in Southampton on various fellowships, including training and capacity development. We have also provide expert advice on questionnaire design and advanced statistical analysis in relation to the DSS (see below).
Collaborator Contribution APHRC run a Demographic Surveillance System (DSS) in two slums in Nairobi, generating unique longitudinal data on individuals living in low income settings. Our collaboration has involved the analysis of this data, especially that relating to the health & well-being of older people.
Impact The ESRC-DFID projects have generated academic outputs in peer review journals as well as briefing papers. We have also been involved in policy discussions with the Ministry of Labour & Social Protection in Kenya and are currently working with APHRC and the Ministry on an evaluation of the roll out of the social pension in Kenya.
Start Year 2010
 
Description British Society of Gerontology 2014 Conference 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact A paper entitled "Resilience in the face of post-election violence in Kenya: the mediating role of social networks on wellbeing among older people in the Korogocho informal settlement, Nairobi" was delivered at this conference, it was attended by about 40 persons and it produced a debate in the audience about the role of social networks in older people's wellbeing.
Year(s) Of Engagement Activity 2014
URL http://www.southampton.ac.uk/bsg2014/index.page
 
Description British Society of Population Studies 2014 conference 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Postgraduate students
Results and Impact A presentation entitled "A gendered analysis of protective factors for old age mortality in the Nairobi slums, Kenya" was delivered as part of this conference, it was attended by about 20 persons and it created a debate about the role of gender in the analysis of mortality, which contributes to how academics and students engage with this topic.
Year(s) Of Engagement Activity 2014
URL http://www.lse.ac.uk/socialPolicy/Researchcentresandgroups/BSPS/annualConference/2014-Conference/BSP...
 
Description Community Dissemination Workshop, Chief's Hall, Korogocho, Nairobi, 27 July 2015 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact On 27 July 2015, a Community Dissemination workshop was held in the 'Chief's Hall' in Korogocho in order to present the findings to the local community where the research was conducted. A key aim of the workshop was to involve local community members in discussion around the implications of the research findings and to identify local actions that could help address the issues raised. A key outcome of the meeting was recognition of the need for local community space for older men and women to meet, strengthening involvement in social networks. Intergenerational relations and conflict were also openly discussed, providing the basis for future discussions and local interventions. The event was chaired by the Korogocho Chief, ensuring the 'buy-in' of local community leadership.
Year(s) Of Engagement Activity 2015
 
Description Resilence in Later Life in Low Resource Settings, Policy Dissemination Forum, Hilton Hotel, Nairobi, 28 July 2015 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Policymakers/politicians
Results and Impact On 28 July 2015, a high-level dissemination forum was held at the Hilton Hotel, Nairobi, bringing together around 80 national- and county-level policy makers from relevant sectors, and key representatives from civil society and academia. Opening remarks were provided by the Hon. Christopher Khaemba, Nairobi County Government Minister in charge of Education, Youth Affairs, Children, Culture and Social Services and Ms Cecilia Mbaka, Head, Older Persons and Social Welfare Division, Ministry of Labour, Social Security and Services. Following presentations of the key results, the participants discussed the implications of the research findings, with the discussion facilitated by Elijah Agevi, CEO, Research Triangle Africa. The timing of the meeting was opportune as the discussions were able to inform the Nairobi County Strategic Plan (2015-2025), highlighting the need to address specific vulnerabilities of those older people living in slums.
Year(s) Of Engagement Activity 2015