Reframing Healthy Ageing and Long-Term Care Systems in Africa: Strengthening Informal, Home-Based and Community Care through Integrated Systems Approaches

Pan-Africa Dialogue Series on Ageing and Development: Session 5

Africa is experiencing one of the fastest demographic transitions globally. While the continent remains relatively young, the absolute number of older persons is increasing rapidly, often in contexts where health, social protection and care systems are under-resourced and fragmented. At the same time, Africa faces an urgent employment challenge, particularly for women and youth, alongside widening gender inequalities in unpaid and informal work.

Long-term care (LTC) needs are already rising due to increased longevity, non-communicable diseases, disability, functional decline and dementia, yet remain largely invisible within national development, health and financing frameworks. Across Africa, long-term care is predominantly provided by families, communities and informal caregivers, most of whom are women, often without recognition, skills certification, income security or social protection. This invisibility masks both the economic burden of unpaid care and the missed opportunity to build a skilled care workforce and care economy.

Global and regional frameworks, including the Madrid International Plan of Action on Ageing (MIPAA), the Doha Political Declaration, the UN Decade of Healthy Ageing (2021–2030), and the African Union Common Position on Long-Term Care and Framework on Family provide a strong policy foundation. However, many countries lack the tools, governance models, financing pathways and implementation guidance to translate these commitments into integrated long-term care systems that simultaneously advance healthy ageing, gender equality and job creation.