When we think of sexual and reproductive health (SRH), the image that often comes to mind is that of young adults navigating relationships, family planning, or pregnancy. But what happens when the conversation shifts to older adults? That’s a question still left hanging in many corners. In sub-Saharan Africa where cultural taboos, stigma, and systemic healthcare gaps silence this subject, the SRH needs of our aging population are dangerously overlooked.
The overlooked demographic
Africa has the lowest population of older adults aged 60 and above but this population is expected to triple between 2020 and 2050. This an indication that in the future, there will be more older adults in many African countries. Yet, most discussions around healthy aging in African remain cantered on physical strength, disease prevention, and economic dependency. Invariably, discussions around SRH needs of older adults have been missing.
Aging is more than a biological process. It affects the body, the mind, and one’s place in society. It brings emotional shifts, psychological changes, and raises sexual health concerns. Aging gracefully is not just about remaining active or looking youthful, it is also about living with dignity, and enjoying intimacy when desired, and maintaining overall well-being.
Sexual and reproductive health needs of older adults
There is a widespread assumption that older people no longer have sexual desires or reproductive health concerns. This myth is particularly deep-rooted in rural communities, and places where cultural beliefs frame aging as the end of intimacy. But research and lived experience suggest otherwise. Older adults do have sexual needs and face unique SRH challenges. In fact, some people enjoy greater sexual satisfaction at older age than when they were younger. Then there is the obvious fact that older adults are not shielded from contracting sexually transmitted disease (STDs). Thus, ignoring the SRH needs of older adults could be dangerous.
Furthermore, gender disparities exist; older men may experience SRH issues like prostate enlargement, reduced libido, or erectile dysfunction while older women may go through menopause-related conditions like hot flashes, incontinence, and vaginal dryness. These changes are natural but could spark psychological and emotional distress for them.
Several structural and cultural barriers continue to deny older adults their right to SRH care:
- Cultural Silence: Older adults are frequently seen as “asexual” and are discouraged from discussing their SRH needs. Talking about it often invites shame and ridicule, particularly for widowed or single women. This could have serious mental and emotional consequences.
- Healthcare Gaps: Many healthcare providers lack training in age-appropriate SRH care. Older patients are either dismissed or misdiagnosed. Clinics rarely offer services that meet their needs, leaving many to suffer alone.
- Policy Neglect: Many African countries national SRH policies are primarily youth-focused, often excluding the elderly entirely. Programmatic efforts and funding largely go to maternal and adolescent health. Older adults are rendered invisible in both documents and services.
What Needs to Change?
It is time we rethink our approach and include older adults in SRH policies, programs, and practices. Here’s how we can start:
- Community engagement: Promote open, intergenerational conversations about aging and sexuality. This should involve religious leaders, traditional rulers, and local influencers to help dismantle myths and encourage respectful dialogue.
- Healthcare worker training: Equip healthcare providers with skills to understand and treat common age-related SRH concerns. Training should cover menopause, prostate health, urinary incontinence, and STI prevention among older adults.
- Public awareness campaigns: Launch national and community-based campaigns to reduce stigma and normalize SRH discussions for older people.
- Age-inclusive services at PHCs: Integrate SRH services for older adults into existing primary healthcare centres. These should be accessible, confidential, and respectful of older people’s unique needs.
- Policy Reform: National health and aging policies must explicitly include the SRH rights of older people.
Our InSiGHt
At InSiGHt, we are positioned to lead the change in meeting the SRH needs of older adults in sub-Saharan Africa. We have a proven track record of developing and implementing evidence-based interventions in multiple countries and communities. Our expertise can help bring both visibility and impact to this neglected area in multiple ways:
- Research and data generation: we can support studies that highlight the SRH needs and experiences of older adults across rural and urban contexts. Such data is crucial for informing policy, programming, and advocacy.
- Community-centered interventions: we have experience running social and behavioural change communication (SBCC) that is culturally sensitive and can dispel myths about aging and sexuality.
- Training and capacity building: We have the capacity to strengthen health workers and institutions through modules focused on age-inclusive SRH care.
- Policy advocacy and technical assistance: InSiGHt can support government stakeholders to revise national SRH policies to be inclusive for the elderly. This includes offering technical assistance to integrate older adults into programmatic frameworks, monitoring indicators, and budget allocations.
Conclusion
Aging gracefully should not mean aging invisibly. We must recognize that SRH is a right for all, regardless of age. The time to act is now. Let us break the silence, challenge the stigma, and build a system that cares for all Nigerians across the life course.
