Groundwork for Building a Gerontological Education Program in Kenya

The growth rate of the aging population in Kenya highlights the needs for educational training for care of the aging population. Current universal social pensions address the financial needs of some adults aged 60 and older. However, changes in the landscape of family dynamics have negatively impacted informal social support. Therefore, education is often at the apex when addressing the gerontological needs of a social support system. This brief discusses the introduction of gerontology to a group of Kenyan students, in Spring 2024, and the reasoning for a gerontological program at KCA University in Nairobi.

Keywords:Kenya; Older Adults; Education

The United Nations and the African Union define older adults as those 60 and older [1]. In 2020, Kenya’s expected median population age was 18.7 years; yet the continuous climb at nearly 5% annually makes the country’s population aged 60 and older set for a significant increase from 2.8 million in 2020 to 10.7 million in 2050 [2-4]. Understanding the growth rate of the aging population highlights the need for support of older adults. Those in rural Kenya with a decreased physical capacity to work often utilize an informal economy because they were left out of formal savings schemes. Thus, in 2006, the Older Person’s Cash Transfer (OPCT) was established to provide regular cash to older adults (65+) identified as poor and vulnerable [5]. The Constitution of Kenya of 2010 underlined the states’ obligation to protect older persons, address their needs, promote, and safeguard equality of non-discrimination based on age, and provide appropriate social security to those considered in need [6].

In 2018, the Kenyan government started providing universal social pensions (marked at 2000 KES (~ $15.00 USD) each month, through the Inua Jamii Senior Citizens’ Scheme for those older adults who reached 70 years of age [7]. Most recently (May 2024), an expansion of monthly assistance was provided to those living in Gucha subcounty, Kisii County. This was especially welcomed among older women who have a lifetime of barriers and discriminatory treatment who struggle to afford food and household items [8]. The social pension expansion comes at the heels of the most recent changes to Kenya’s National Health Insurance fund which will secure publicly funded primary health care, universal health insurance, and equitable access to quality health services through the Social Health Insurance Act [9] to achieve the country’s goal of Vision 2030, “to improve the overall livelihood of Kenyans,” [6]. In consideration of health improvement, the global issue of ageism often plays a role in health care and can permeate into societies that practice health-care rationing [9]. When health care practice is not updated and/or recorded properly, reliable data on older adults disables interventionists and researchers from being able to identify areas of need, monitor what is working, and assess the impact of created policies [10]. Beyond government support, traditional patterns of family support have been eroding, for several decades, due to urbanization. And as younger generations of Kenyans move to the cities, many older rural Kenyans are left to care for themselves, often not having the same level of familial support [2]. A recent study demonstrated that provision of social support across emotional, instrumental, and informational support was found to be significantly associated with higher levels of satisfaction with social well-being [3].

The landscape for support is changing and it is time to consider what additional resources may further assist older adults. The cornerstone to effectively combat this need is gerontological education which is scant in the country of Kenya thus leaving the country in a crippling state. The country is aging without a robust workforce educationally prepared to care for the older adults who may not have a family or friend network. The brief will provide a description of the journey, thus far, to create a gerontological program to assist the needs of the aging people in Kenya.

Education is often the first place to consider when addressing the gerontological needs of a social support system. Kenya Medical Training College has aging courses and offers a relatively new higher Diploma in Geriatric Nursing. Genetics nurses perform risk assessment, analyze the genetic contribution to disease risk, and discuss the impact of risk on health care management for individuals and families. They also provide genetics education, nursing care to patients and families, and conduct research in genetics. Kenyatta University, located in Nairobi, Kenya had an associate degree option available, but it was suspended for lack of interest (i.e. <5 applicants with a minimum of 15). The university was able to successfully mount the program as a short course to practitioners with the Centre for Capacity Building (S. Munanu, personal communication, May 22, 2024).

Outside academia, the Visiting Angels Nursing Agency offers a geriatric care training program to build capacity for the care of older adults. The center, started in 2002, aims to offer nursing services in the country for aging adults, by offering training of in-service nurses and nurse assistants. The 6-month full time course incorporates gerontological theory and practice to attend to the needs of older adults who live at home. The nursing center addresses a gap in the medical profession handling stressful and emotionally draining experiences that are most often expected of family members to manage. In addition, the center supports terminally ill clients who need palliative care, and their families to assist in their coping needs and demands of their ailing loved ones. This may be by way of resident (live-in) nursing care, escort to the doctor’s appointment or other trips, supervision of medication, nutritional advice, spiritual support, end - of-life support, etc. The course ensures staff members are well equipped with modern knowledge on palliative care, pain management, communication in difficult situations, and end- of-life support [11].

After a visit to Kenya in 2022, the idea to create a joint gerontology focused course for students from the United States and Kenya was discussed. The development of a gerontology course focused on humanities and arts would expand the scope of the UNC Charlotte Gerontology program and introduce Kenyan students, within the School of Education, Arts, and Social Sciences to the discipline [12]. Objectives of the 7-week short course were guided by the AGHE Humanities and Aging foundational competencies to: a) understand diverse aging populations from a global perspective; and b) discuss how humanities and arts from distinct cultures affect the aging process [13]. The 7-week course included students communicating in small groups via Slack, reading articles on humanities and arts, completing weekly reflections and completing a team project that would integrate what students learned. The coordination of teaching the course was challenging, including the 8-hour time difference. The course was advertised to students in Fall 2023 and was subsequently cancelled when no UNC Charlotte students registered. In January 2024, during a second visit to Kenya, students and faculty mentioned their resolve to continue moving towards the creation of a gerontological program. Thus, Brown and Gachigi agreed to pivot and have a lecture series in Spring 2024 to introduce post-graduate students enrolled in the Master Degree Certificate Program in Counselling Psychology, to gerontology.

In February 2024, the lecture, “Introduction to Gerontology,” laid the foundation of the discipline for 20 students (15 women, 5 men) highlighting both global and country trends of aging. The next month, “Trends of aging in Kenya” focused on the demographics, public health, and sociological statistics of the country. This lecture also provided a wider breadth of how Kenya compared to the world. The last lecture, “Research in Kenya” introduced the different types of research (e.g. quantitative, qualitative) and historical accounts of gerontological research in the country to those which are more recent, including the most recent Longitudinal Study of Health and Ageing in Kenya (LOSHAK) [14]. Students engaged in conversations during the lectures providing their points of view based on personal familial experiences. Two students, who previously had a unit in gerontology, created a respite space for older adults in their community. They provide a space for older adults who need information for their personal, health, and medical well-being.

KCA University offers psychological courses and graduate students are eager to have new short courses, that focus on gerontology. Currently, KCA offers gerontology as a unit in the Bachelor’s degree and Diploma Education programs. Questions were asked among the students (N =20) who attended the spring lectures. Their answers to questions that asked about their gerontological experience inside/outside of classroom, their observational or personal experience with aging networks in the place where they reside; and, what they thought older Kenyan adults needed, demonstrated an interest in learning about emerging issues. They expressed their desire to learn more about gerontological studies in terms of psychosocial support for older adults with subjects ranging from ageism, palliative care, career preparedness, retirement and aging, counselling for the aged, changes in body systems as you age, bridging the inter-generational gap, and residential assisted living and care. Therefore, we are proposing KCA offer Gerontological Studies as a special program in the form of a short course, certificate, or diploma for caregivers, medical professionals, psychologists and other professionals or non-professionals.

The program development has been necessitated by the recognized need to increase knowledge among professionals in their emotional and psychological care of older adults [15]. In addition, there is guidance in integrating this care with nonprofessionals for family support, health support, etc. With the support of one of the university chancellors, the Department of Psychological and Educational Studies will present a proposal to the University Senate to approve the creation of the courses. This will enable KCA to advertise and market the courses related to the Gerontological Studies program.

The proposed program is timely because of an ongoing need to support the growing older adult population in Kenya. A Gerontological Studies program is plausible for caregivers, idle retirees, older adults, and medical professionals (outside of nursing) who want to learn how to care for themselves and others. This is a relatively new area in the country and based on the students who participated in the spring 2024 lecture series, the likelihood of its popularity is quite high. KCA university is an ideal space for a gerontological program due to its location in Nairobi, the existing Psychology department that can house the program, and the preliminary course development completed in spring 2024 with the University of North Carolina, Charlotte.

None.

No conflict of interest.