Conditions de vie, santé et soutien aux personnes âgées en milieu rural africain : cas de Nouna, Burkina Faso

Population ageing is not yet an important issue in sub-Saharan countries. However, while the proportion of the older population remains low, their numbers are growing rapidly in a context of largely absent social security. Assuring adequate care for the older segments of the population constitutes a future challenge for sub-Saharan countries. The development of effective public interventions for these people requires a thorough knowledge of their living conditions. The main objective of this thesis is to contribute to the production of evidence regarding the living conditions of older people in sub-Saharan Africa, in order to provide the information necessary for policy and interventions. More specifically, this thesis aims to provide a better understanding of: (1) the characteristics of the older people in a West African rural context, (2) the conditions that predispose older people to live alone, (3) the health status of older men and women and its association with their residential arrangements, and finally, 4) the epidemiological situation and changes that have occurred over a 20-year period with regard to these people. Four articles on these topics have been written, using the data from the longitudinal Nouna population observatory in Burkina Faso. The first article shows that the reality of ageing differs considerably by gender. Older men are more likely to live with their spouse(s) than their female counterparts. Older women report having worse health conditions than older men. Moreover, there appears to have been a decline over time in the propensity of “other” households welcoming older people to live in their homes, as well as an increase in the proportion of households in which older people live alone. The second article further confirms the growing likelihood of older people living alone over the 20-year study period. For the older population as a whole, the results do not reveal significant differences between older men and women in terms of the determinants of living along, although among those who are currently unmarried, men are more likely to live alone than women. The third article shows that the health of older people in this population varies by residential arrangement, with those living as couples presenting generally better health conditions. Men living alone or with dependent youth report having more chronic diseases than their female counterparts. On the other hand, men living with their spouse(s) report being healthier than women in the same category. In addition, widowers living with non-dependent children exhibit a higher risk of death compared to widows of the same group. In the fourth and final article, the results indicate that older people in Nouna suffer from both communicable diseases (malaria and respiratory diseases) and non-communicable diseases (cardiovascular diseases and tumors). While the most important category of causes of death remains communicable diseases, there has been a rapid rise in the importance of non-communicable diseases over the past two decades in this population.

Keyphrases: Nouna, Burkina Faso, Ageing, Living arrangements, Households, Health, Elderly, Dual epidemiological burden, Mortality, Africa