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Towards effective protection of Nigeria’s older population 21 Jul 2023

One of the bills that former President Muhammadu Buhari did not sign into law is the Older Persons (Rights and Privileges) Bill. The bill had been passed by both chambers of the National Assembly in 2021 but did not receive presidential assent. There is a lot of focus on Nigeria’s teeming youthful population with admonitions to the country to unlock the genius of its human capital. The aging portion of the population mostly seems ignored in policy development and implementation.

Although sub-Saharan Africa (SSA) has a smaller proportion of the aged in its population compared to developed regions, it is projected that this segment of the population would grow over the coming years. According to statistics from the National Population Commission, the population of older persons in Nigeria rose from about 4.6 million in 1991 to 6.9 million in 2006. This population is projected to reach almost 28 million by 2050.

Care for the aged in Nigeria and in other parts of the SSA region has mostly been carried out by the traditional family and other informal support systems. The absence of publicly funded social security systems in the region makes this segment of the population even more vulnerable.

However, the Nigerian population demographics have been changing, arising from rural-to-urban migration within the country and the increasing numbers of the ‘youthful’ population emigrating to other countries. Given these trends, the traditional family support systems for the aging population are fast disappearing. This presents increasing challenges in meeting the economic, healthcare, and social needs of the aging population.

High level of poverty, which is driven by equally high unemployment rate, is one of Nigeria’s major challenges. As such, one can reasonably expect that the aged, who have either retired from formal work or are less productive, are quite vulnerable to economic shocks. The impacts of the helplessness include fast deteriorating health due to lack of access to quality healthcare, recourse to working after formal retirement, and social isolation.

The aged group tends to need more healthcare services. In the circumstance of Nigeria’s deteriorating socioeconomic and healthcare conditions, access to quality healthcare – especially geriatric care – by this demographic has become even more limited.

Under Section 16(2) (d) of the 1999 Constitution (as amended), state policy is mandated at ensuring “that suitable and adequate shelter, suitable and adequate food, reasonable national minimum living wage, old age care and pensions, and unemployment, sick benefits and welfare of the disabled are provided for all citizens.” Nigeria has signed both regional and international instruments relating to care of its aged population, including the African Union (AU) Policy Framework and Plan of Action on Ageing, and the United Nations (UN) International Plan of Action on Ageing, which was adopted by the General Assembly in December 1991.

Under the UN plan, member states are encouraged to develop and integrate policies for ensuring that older persons have access to adequate food, water, shelter, clothing and healthcare; opportunity to work or other income-generating opportunities; autonomy over withdrawal from the labour force; appropriate educational and training programmes; safe, effective and preferred environments; continued social integration and participation in social and communal life including access to the educational, cultural, spiritual and recreational resources of society; continued protection of their rights to freedom of associations; family and communal care;  institutional health, social and legal care; protection of their fundamental rights while residing in shelters or similar facilities; security; and equal and fair treatment.

Nigeria enacted the National Senior Citizens Centre Act 2017, which established the National Senior Citizens Centre (NSCC), headquartered in Abuja. The objective of the centre is to identify the different needs of the aging population and develop and implement programmes and schemes to address these needs. Unsurprisingly, however, the NSCC has not been delivering its objectives. Not much was done in implementing the legislative enactment until 2021 when former President Buhari approved a N2.5 billion take-off grant for it.

The Older Persons (Rights and Privileges) Bill is a more holistic legislation that provides for the rights and privileges of older persons, in terms of healthcare, housing, economic benefits, and adequate standard of living. The bill provides for the rights of older persons to freedom from discrimination; to express their wishes and preferences regarding future health and long-term care-related decisions and to have those expressions respected; to social protection, including income security without discrimination on the basis of age, gender, or health status; and equality. The bill expressly provides for the inclusion of older persons in every national programme on income generation of the state or federal government.

The bill also makes significant provisions for public healthcare services for older persons. The proposed law makes it mandatory for public hospitals to establish geriatric wards for the exclusive use of older persons. Even where the wards are used for other purposes in emergency situations, they will be reverted exclusively for geriatric use thereafter. The bill also provides that primary healthcare centres will be modified to serve the geriatric population and further makes provisions for mobile “hospital on wheel” healthcare facilities to serve physically challenged older persons.

While the reputation of the public healthcare system in Nigeria is poor, implementation of these provisions in public hospitals will alleviate some of the challenges our older people are facing, especially in rural areas where the lack of formal healthcare is more pronounced. The creation of the ‘specialised’ wards and services will also encourage development of skills and investment in that area of healthcare. The bill expressly provides that the federal and state Ministries of Health shall train community-based health workers among older persons and health personnel to specialise in the geriatric care and health problems of older persons. The government is also to provide an enabling environment for private institutions to train same as approved by the Federal Ministry of Health. Furthermore, the government is to encourage and create an enabling environment for the establishment of day care centres, nursing/respite homes, and hospices throughout the country, which shall be approved by the relevant government agencies.

In addition to these provisions, the Older Persons (Rights and Privileges) Bill also makes provisions for health insurance and costs. It expressly states that the National Health Insurance Scheme shall cover all indigent older persons, and that the NHIS shall design insurance product for coverage of the elderly with sustainable funding options. It further states that older persons shall be entitled to the grant of 50 percent discount and exemption from VAT on medical and dental services, pharmaceutical services, diagnostic and laboratory fees in all private hospitals, medical facilities, outpatient clinic, and home healthcare services, as determined by the NHIS.

The bill also provides for the provisions of social safety assistance for older persons during disasters, calamities, or economic shocks. The assistance includes food, medicines, house repairs, and they are to be sourced from National Emergency Management Agency (NEMA)/State Emergency Management Agency (SEMA)/Local Government Emergency Management Agency (LGEMA) and the National Commission for Refugees and Internally Displaced Persons (IDPs).

Regarding economic protection for the older persons, the bill provides for the monthly payment of a stipend amounting to not less than 50 percent of the national minimum wage, subject to the review every five years by the National Assembly, to every indigent older person. This payment is the responsibility of the social welfare units of local governments. The bill also makes provisions for some rebates for older persons such as 50 percent of actual fare for all modes of transportation; utilities such as electricity, water, telephone; and fees charged by theatres, cinema houses, and other leisure houses.

A piece of legislation to adequately cater for the need of the aged population is important, but even more important is the will to implement the right policies that benefit them. Some of the provisions of the bill actually do not require legislation before they can be implemented by the organs responsible for implementation including the various ministries of health as well as social and welfare ministries. Some of the provisions such as right to first consideration in queues and emergencies, reserved parking spaces, express lanes, and assistive service for all modes of transportation are social conventions. They mainly require social re-orientation to implement.

The three arms of government have their roles to play in protecting Nigeria’s elderly. While the federal government can develop and implement a holistic policy in this regard, it is the government closest to the communities – the state and local governments – that can provide effective and practical care to the older population.

Despite the many economic challenges that the new administration of President Bola Ahmed Tinubu is faced with, attending to the needs of the elderly is important. This makes a consideration and passage of the Older Persons (Rights and Privileges) Bill by the 10th National Assembly as well as presidential assent quite imperative.

Funmilayo Odude is a Partner at Commercial and Energy Law Practice (CANDELP).