The Dangers of Being Old in Rural Tanzania: A Call for Interventions for Strengthening Palliative Care in Low-Income Communities

Tanzania is currently implementing political reforms that, with time, are expected to improve quality of life among individuals regardless of their age. This improvement in quality of life, consequently prolonged life expectancy implies that the aging population will significantly increase in a few years to come. Research projects that the number of people aged 60 years and above will increase from the current 4- percent to 10-percent of the total population by 2050 (United Republic of Tanzania, 2003; Kivelia and Kirway, 2011; Morrissette andWane, 2012). The projected increase suggests that the older population will be at a disadvantage because majority of older people in Tanzania resides in rural areas where financial support and access to social services including Primary Health Care (PHC) services is often limited (Kivelia and Kirway, 2011; Morrissette and Wane, 2012; Sanga, 2013; Musa, 2016). The older population in Tanzania continues to form a significant percentage of people seeking care for chronic diseases in PHC facilities. Reports indicate that older patients (aged 60 years and above) contribute significantly to aging related diseases, for instance, cardiovascular diseases (United Republic of Tanzania, 2007; UNFPA, 2009; Isangula andMeda, 2017). The prevalence of hypertension in Tanzania for example, is much higher among older people as compared to much younger population (Isangula andMeda, 2017).This calls for strong policies that seek to ensure that the older population are well cared for within rural PHC facilities in their final years of life. While aged care institutions are the cornerstone of Western care, similar institutions are lacking in low-income rural African communities. Consequently, older people in rural settings, mostly uneducated, uninsured, unable to work and often charged with the care of grandchildren, continue to rely on sons and daughters (if any) and neighbors to meet their daily socioeconomic needs (Sanga, 2013; Musa, 2016; United Republic of Tanzania, 2007; UNFPA, 2009). This dependency often contributes to persistent limited access to quality nutrition and medical care among the older population when family members lack the financial capacity to support them. This brings us the question of how better we can, as a country, care for our aging population as part of ensuring they enjoy their final years of life. This paper examines the challenges faced by the older population in a low-income rural community of Shinyanga in relation to access to the much-needed palliative care