Health, health care and ageing in Africa: challenges and opportunities

New health-care policies in South Africa have been targeted primarily towards women, children and the youth, and the elderly are not regarded as a priority. However, older persons are especially heavy consumers of health-care resources generally. Although the improvement of community-based care for older clients, together with improved detection and control of risk factors and chronic disease at the primary level were identified as two principal health priorities in the health reconstmction plan (African National Congress, 1994), there is scant evidence of any implementation of this policy goal. With the dismantling of former apartheid government healthcare structures in the transformation process, to effect a shift from tertiary and secondary care with their curative focus, to primary health care with a preventive focus, dedicated geriatric services have fallen by the wayside. The preventive, curative and rehabilitative needs of older clients have for the main part been integrated into general sessions at community clinics, at the primary care level. Numerous community nurses have been redeployed from geriatric services, for example, to assist with immunization programmes for children. The current geriatric health service dilemma in the country needs to be urgently addressed, and for this there is a need for information on effective service delivery models. However, would the reinstatement of equitable geriatric services for all older South Africans be no more than a pipe dream