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Background and Objectives Policy and program interventions for older adults 60 years or older in Africa have consistently been undermined by a lack of vital data as they are usually excluded from nationally representative population surveys. The Health and Wellbeing of Older Persons in Kenya (HWOPs-1) study developed a standardized assessment questionnaire that can be used for periodic data generation. This study presents how the questionnaire was developed and examines its internal consistency and psychometric properties of the health module. Research Design and Methods The development and validation of the HWOPs-1 questionnaire was a 3-step process. Step 1 was a review of 19 panel studies and 2 national level surveys followed by a wide consultation with key experts and stakeholders on aging. The 3rd step was validation of the questionnaire with a cross-section of a representative sample to test its applicability and adaptability in a mix of rural and semi-urban settings. The internal consistency and psychometric properties of the 3 subscales: functionality, disability, and quality of life were assessed using Cronbach's (α) alpha and exploratory factor analysis, respectively. Results Three subscales of functionality, disability, and quality of life showed high internal consistency with α = 0.94, 0.97, and 0.87, respectively. There were also consistent factor loadings above 0.3 across all the factors. Gender differences across the 3 scales from the results of t test were observed. Finally, weak but statistically significant correlations between the measures of well-being and risk factors for noncommunicable diseases were also observed from the analyses. Discussion and Implications The indicators assessed have been used in settings outside Africa to measure health and well-being of older adults are adaptable and reliable enabling comparability across space and across studies. The questionnaire provides a framework for examining disease and disability burden and their determinants among older adults in Kenya or similar settings. [ABSTRACT FROM AUTHOR]

In resource poor environments, identifying those most in need of limited available resources is challenging. Kenya's older persons cash transfer programme (OPCT) targeted at the most poor used a 2-stage targeting process to identify beneficiaries, combining community-based selection with a proxy means-test. This paper investigates whether the process "correctly" identified targeted vulnerable older people in Nairobi's informal settlements and whether receipt of the OPCT resulted in an improvement in perceived financial wellbeing. Regression results show that individuals with greater need were covered under the OPCT. Using propensity score matching, the paper evidences that the OPCT improved subjective financial wellbeing among beneficiaries. [ABSTRACT FROM AUTHOR]

ABSTRACT Building on African migration as a household survival strategy; urban-rural linkages as critical for migrants' continued engagement with origin communities; reintegration in case of return; and safety net for supplementing precarious urban incomes; we examine the role of family ties in rural origin linkages among 1,693 older migrants living in Nairobi informal settlements. Despite the grim of slum residence, 80% of older migrants in Nairobi slums maintained contact with their rural origin homes during a full year of observation. Family-related factors, especially members of the nuclear family residing in rural origin, explained 45% of explained linkages. Religion, ethnicity, land ownership at origin, and current health and economic statuses are other key predictors. The patterns and reasons of linkages are consistent with migrants' positive contributions to the upkeep of rural origin households. Our findings are well-anchored in the larger continental literature that has shown the urban migrant as not a 'disembedded individual' but instead part of rural origin collectives. Against the weakness of state safety net system, the study sheds crucial light on the enduring importance of sociocultural networks in people's everyday lives, particularly the importance of family ties for older migrants. To the extent that poor health status, being aged 60 years or older, and long duration of residence in the slums, which are predictors of low propensities to maintain contacts with rural origin, are also indicators of diminished social engagement, policy interventions among the urban poor may need to include efforts to enhance rural origin reintegration of the most-aged individuals. Copyright © 2012 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

It is evident that sexual activity tends to decrease with age. Nonetheless, it is still prevalent enough to be considered a risk factor for the spread of HIV among older people. This paper uses quantitative data for 2053 individuals to examine HIV risk perception and correlates of perceived risk among older people aged 50 years and older living in Nairobi slums. It emerged that a majority of older people did not consider themselves at risk of infection. Of those who felt at risk, a greater proportion sensed only a small chance of contracting HIV. Women cited ‘no sexual activity’ while men mentioned ‘having only one and/or a faithful sexual partner’ as the primary reasons for perceiving minimal risk of HIV infection. There were no differences by sex in the basis for perceiving moderate-to-great risk of infection. Religion is a key factor in risk perception with Muslims perceiving higher levels of risk and, conversely, devotees irrespective of faith perceiving lower levels of risk. Older people willing to be tested for HIV had a decreased likelihood of perceived risk compared with those unwilling to be tested. This paper recommends evaluation of older people's perception of risk in order to better inform interventions aimed at minimizing their vulnerability to HIV infection. [ABSTRACT FROM PUBLISHER]

ABSTRACT Circular and return migrations between rural and urban areas in sub-Saharan Africa have persisted over time, driven by a combination of socio-cultural, economic, and structural forces. Much of the literature on migration in Africa focuses on labour migration. However, old age also marks a stage in the life course often associated with migration. This paper examined the determinants of out-migration among older people living in the slums of Nairobi. The paper used a prospective population study of 2,270 older people, followed up over a 3-year period. The annual rate of out-migration was 4%. Cox proportional hazard analysis was used to model the effect of ties to place and to socio-economic capital on propensity to out-migrate. The presence of adult children outside the city was a significant pull factor for both men and women. The propensity to out-migrate decreased with length of residence in the slum. Attachment to the slum through participation in voluntary communal activities was also negatively associated with out-migration, particularly for men. The poorest older people were more likely to leave the city, highlighting the effect of deprivation in triggering return migration. Looking at future migration intentions, only one in five older people reported that they intend to relocate from the slums, highlighting that, in the future, there will be a growing number of people ageing 'in situ' in poor urban areas. This has implications for policy makers concerned with the provision of services to vulnerable older people who may be unable to engage in livelihood strategies as health deteriorates with age. Copyright © 2011 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

This article seeks to investigate the association between caregiving to someone with an HIV-related illness and the socioeconomic status of the caregiver using a population-based survey of 1,587 older people living in Nairobi slums. Findings indicate significant differences in living arrangements, wealth, income, and expenditure between HIV caregivers and noncaregivers. HIV caregivers lived in larger households and were also more likely to live in households with a large number of children younger than the age of 15 years. Whereas a high proportion of HIV caregivers were ranked highly in terms of wealth status, differences in per capita income and expenditure were not significant when household size and other confounders were accounted for . The financial costs associated with caring for someone with a chronic illness and the reliance on family members with financial ability for material support, a common feature of African extended family systems, may account for the relative economic advantage of HIV caregivers. [ABSTRACT FROM AUTHOR]

Background and Objectives: Policy and program interventions for older adults 60 years or older in Africa have consistently been undermined by a lack of vital data as they are usually excluded from nationally representative population surveys. The Health and Wellbeing of Older Persons in Kenya (HWOPs-1) study developed a standardized assessment questionnaire that can be used for periodic data generation. This study presents how the questionnaire was developed and examines its internal consistency and psychometric properties of the health module., Research Design and Methods: The development and validation of the HWOPs-1 questionnaire was a 3-step process. Step 1 was a review of 19 panel studies and 2 national level surveys followed by a wide consultation with key experts and stakeholders on aging. The 3rd step was validation of the questionnaire with a cross-section of a representative sample to test its applicability and adaptability in a mix of rural and semi-urban settings. The internal consistency and psychometric properties of the 3 subscales: functionality, disability, and quality of life were assessed using Cronbach's (α) alpha and exploratory factor analysis, respectively., Results: Three subscales of functionality, disability, and quality of life showed high internal consistency with α = 0.94, 0.97, and 0.87, respectively. There were also consistent factor loadings above 0.3 across all the factors. Gender differences across the 3 scales from the results of t test were observed. Finally, weak but statistically significant correlations between the measures of well-being and risk factors for noncommunicable diseases were also observed from the analyses., Discussion and Implications: The indicators assessed have been used in settings outside Africa to measure health and well-being of older adults are adaptable and reliable enabling comparability across space and across studies. The questionnaire provides a framework for examining disease and disability burden and their determinants among older adults in Kenya or similar settings., Competing Interests: None., (© The Author(s) 2023. Published by Oxford University Press on behalf of The Gerontological Society of America.)