The Constitution of Kenya 2010, Article 57, mandates the state to take steps to make sure that the rights of older people are protected (Government of Kenya, 2010). Kenya’s Vision 2030 also aims to establish a Consolidated Social Protection Fund which is relevant to the care and protection of older persons through cash transfer programmes. Other vulnerable groups will also be a beneficiary to these funds (discussed under overall country context – social protection schemes) (Kenya vision 2030, 2019). The disbursement of funds to these groups is ongoing.

The care and protection of older members of society bill, 2018 part III provides for the care of older members of society, defined as those who have attained the age of 60 years. Specifically, it provides the establishment and implementation of community and home-based care programmes for older members by the government and prohibits their abuse (Republic of Kenya, 2018b).

At the moment, Kenya is developing a universal health coverage policy but older people have not been adequately factored into it (“Kenya Trends in ageing and health,” n.d.). The care of older people living with disabilities and chronic health problems is mainly undertaken by unpaid family members. Older people are expected to receive health care from public general hospitals, as there is only one geriatrician based in the national government (policy level) in Kenya. By 2017, 16 residential care homes that are run by religious organizations and mostly located in urban or peri-urban areas were unaffordable to family members. As a result, some homes become underutilized. For example, during a 2016 audit of residential institutions, the Fatima Home with a capacity of 20 persons had only housed three older persons (National Gender and Equality Commission, 2016). It is not clear from literature the current average bed capacity of residential homes in Kenya. In addition, so far no long-term care public insurance scheme is available in Kenya as of yet, limiting access to costly private health insurance to those who can afford it (L. Maina, 2017).

High levels of poverty, distantly located health facilities, poor attitude of health workers and a lack of confidence in the services provided in health facilities are some of the factors deterring older persons from accessing services in public health care settings (Waweru et al., 2003). Furthermore, older people are expected to receive the same public health services provided for all life cohorts, there are no specific arrangements in place for older people. This has resulted to increase in confidence in spiritual care (Waweru et al., 2003). In future, strategic attention should be paid  to geriatric health requirements or the ability to tackle one or more chronic illnesses at health facilities (Wairiuko et al., 2017).

The Focus Area of The IX Session of the Open-Ended Working Group on Ageing, established by the General Assembly on 21^st December, 2010  for the purpose of strengthening the protection of the human rights of older persons identified the following challenges facing older people in accessing Long Term Care (Republic of Kenya, 2016b), page 3-4:

• “Prohibitive medical costs and limited Human Resource and health center capacities” – page 3
• “Communities and family members have very little (indigenous) knowledge on how to manage long-term care” – page 3
• “Facilities available do not meet the required standards” – page 3.
• “The private institutions are very expensive to be afforded by many” – page 3.
• “High costs of diagnostic, medication and transport costs to access LTC services” – page 3
• “Assistive devices are expensive, should one need one” – page 3.
• “There are few formal centers offering long term care. Most of them depend on the social systems i.e., relatives for long term care” – page 3.
• “Non-existence of a regulatory or policy framework on long term care system”- page 3.
• “Ageism that results to stigmatization and discrimination of older people by society and policy makers” – page 3.
• “Lack of adequate resources hinder the provision for long term care and support” – page 3.
• “Lack of information and understanding on LTC and wider rights of older people by the older people themselves, community and policy makers. Manifested in lack of demand for action by the citizens and older people, which is necessary to improving the policy and programmatic change” – page 4.

The working group, considers the existing international framework for the human rights of older persons and identifies possible gaps and solutions (United Nations Department of Economic and Social Affairs (UNDESA), 2019).

References:

Government of Kenya. (2010). The Kenya Constitution, 2010. Kenya Law Reports.  http://www.kenyalaw.org/lex/actview.xql?actid=Const2010

Kenya vision 2030. (2019). Consolidated Social Protection Fund.  https://vision2030.go.ke/project/consolidated-social-protection-fund/#

Maina, L. (2017). How Kenya can ensure adequate health care for its older people. The Conversation, 25 January. https://theconversation.com/how-kenya-can-ensure-adequate-health-care-for-its-older-people-70163

National Gender and Equality Commission. (2016). Audit of Residential Institutions of Older Members of Society in Selected Counties of Kenya. Nairobi, Kenya. https://www.ngeckenya.org/Downloads/Audit%20of%20Residential%20Homes%20for%20Older%20Persons%20in%20Kenya.pdf

Republic of Kenya. (2016b). Focus Area of the IX Session of the Open-Ended Working Group on Ageing. Republic of Kenya. Nairobi, Kenya. https://social.un.org/ageing-working-group/documents/ninth/Inputs%20Member%20States/Kenya_LTC.pdf

Republic of Kenya. (2018b, June). The Care and Protection of Older Members of Society Bill, 2018. Kenya Gazette Supplement No. 73 (Senate Bills No. 17), pp. 333–363. Nairobi, Kenya. http://www.parliament.go.ke/sites/default/files/2018-08/The%20Care%20and%20Protection%20of%20Older%20Members%20of%20Society%20Bill%2C%202018.pdf

United Nations Department of Economic and Social Affairs (UNDESA). (2019). Open-ended Working Group on Ageing for the purpose of strengthening the protection of the human rights of older persons.

Wairiuko, J. M., Cheboi, S. K., Ochieng, G. O., & Oyore, J. P. (2017). Access to Healthcare Services in Informal Settlement: Perspective of the Elderly in Kibera Slum Nairobi-Kenya. Annals of Medical and Health Sciences Research, 7(1), 5–9. https://www.amhsr.org/articles/access-to-healthcare-services-in-informal-settlement-perspective-of-the-elderly-in-kibera-slum-nairobikenya.html

Waweru, L. M., Kabiru, E. W., Mbithi, J. N., & Some, E. S. (2003). Health status and health seeking behaviour of the elderly persons in Dagoretti division, Nairobi. East African Medical Journal, 80(2), 63–67. https://doi.org/10.4314/eamj.v80i2.8647