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Ashoka Fellow since 2023   |   Nigeria

Philomena Anyanwu

El-Aged Care Initiative
Philomena is building a better architecture to support the needs of the elderly population in rural areas.
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This description of Philomena Anyanwu's work was prepared when Philomena Anyanwu was elected to the Ashoka Fellowship in 2023.

Introduction

Philomena is building a better architecture to support the needs of the elderly population in rural areas.

The New Idea

Philomena is helping rural communities to reimagine the lives of older persons by designing new standards of care, developing innovative care models, and engaging local communities in deploying more effectively the services needed to improve the functional and social abilities of the older persons to live dignified, independent lives and contribute to communities, and society.

Through her non-profit, El-Aged Care, she is using a mix of social care, and peer-to-peer support to cater to the older population and change mindsets about ageism. Using a strong network of family and community stakeholders, she is putting older persons in the drivers’ seat of the movement as peer support for fellow older persons and also partnering with traditional rulers who are the recognized community gatekeepers and custodians of norms and culture in rural Nigeria as partners-in-progress by getting them to designate their community halls as centers for geriatric care, and social connections for the older persons.

Philomena has recognized that independent work to support older persons is not enough to turn the curve of system-change, hence she founded a coalition of 60 organizations called, the Association of Care Service Providers to Older Persons in Nigeria (ACSPOPIN), to improve the quality of life for older persons and provide a holistic standard of care by providers. Under Philomena’s leadership, ACSPOPIN achieves this through capacity building, resource mobilization, standardization, advocacy, quality assurance, and quality control. The association has raised the bar for the standard of care by developing the first ever Aged Care Quality Standards and Regulation manual to guide quality care practices to older persons in Nigeria. By this, she is inviting existing service providers to reimagine how to deploy more effectively their services and adopt new standards.

The Problem

The older population in Nigeria is growing rapidly. In 2016, there were an estimated 9 million people aged 65 and older in Nigeria. This number is expected to more than triple to 26 million by 2050. The growing elderly population is putting a strain on Nigeria's resources. Many older persons are living in poverty and lack access to healthcare. They are also more likely to be abandoned by their families and to experience social isolation, age discrimination and ageism.

According to the World Health Organization, two-thirds of older persons will need help with everyday activities at some point. This is because age increases the risk of health problems, such as diabetes, heart disease, and cognitive decline. These problems can make it difficult to do things like eat, groom, or move around. Older persons in rural areas are especially vulnerable to these health problems and may not have access to the care they need.

Many older persons in rural communities lack understanding and the ability to follow through in most cases, with what their doctors tell them after consultation/visit. They do not also partake in decisions about their health care, due to ignorance or illiteracy and this leaves them ill equipped to make daily decisions that affect their lives and also unable to take actions that lead to good health management. On the other hand, some of the older persons are even unaware that taking an active part in managing one’s health condition can have a huge impact on how they feel and what they are able to do to help ameliorate the impact of their disease conditions.

Furthermore, the mass migration of younger family members from rural areas to urban areas is exacerbating the problem. In rural areas, older persons are traditionally cared for by their families. However, as more and more young people move to urban areas in search of work and better economic opportunities, they are less able to provide care for their older parents, leaving them at the mercy of the harsh realities of the rural environment. It is also key to mention that the priorities of these young people have evolved over the years as they are focusing more on their immediate nuclear families while relegating their aged parents and extended families to the background. An unintended consequence of this progressive neglect is that the ageing population is forced to lean more towards seeking medical help from traditional healers whose methods go against modern medicine.

The Strategy

Through the agency of her non-profit, El-Aged Care, Philomena is activating a coordinated three-pronged approach to providing care depending on the needs of specific communities. Her strategy involves -

● Engaging communities using a network effect of elder-helping-elders, friends of the elders, and partnership with traditional community leaders.
● Developing new innovations through social and community programming
● Establishing new standards for quality aged care.

In the area of engaging communities using a network effect, Philomena has recognized the importance of building partnerships with traditional rulers who are powerful entities in rural communities. Through stakeholder engagement, she is partnering with these traditional rulers and getting them to designate their community halls as adult day centers in their communities. Once this is done, Philomena and her team move to appoint a Community Liaison Officer from that community to help build trust with that community, provide information and local context to Philomena and her team and work with other local partners to implement Philomena’s strategies.

In addition to her work with traditional rulers and other community members, Philomena is also working to strengthen family connections among the older persons. She is doing this by engaging young people as "Friends of the Elderly". These young people are trained and equipped with empathy skills and knowledge to understand the needs of older persons in their communities. They are then positioned to willingly provide care and support to their immediate older family members, and other older persons within their communities. Philomena is also partnering with older persons to create a network of "Elders-Helping-Elders." These older persons are stronger and healthier than others in their community, and they are willing to commit some of their time to help take care of older persons in need. They report back to Philomena and her team on their progress, and Philomena uses this information to galvanize whole communities and make them custodians of the older persons.

Secondly, for her Social and Community Programming, the Adult Day Care Center is the most visible and innovative aspect of her strategy. It is community-based and designed to help older persons stay active and engaged in the community, while also providing them with the support they need to maintain their independence.

The center offers a variety of services, including:

● Personal care where staff and volunteers can help with the bathing, dressing, grooming, and other personal care needs of the older persons.
● Social work services: Through this, Philomena’s social workers provide counseling and support to help older persons cope with challenges such as loneliness, isolation, and grief.
● Health monitoring: As a part of this strategy, Philomena and her team monitor older persons' health and provide them with referrals to medical professionals as needed. They also carry out minor surgeries at the center periodically.
● Therapeutic care: Her in-house therapists lead weekly therapeutic activities such as physical therapy, occupational therapy, and music therapy.
● Social activities: The center offers a variety of social activities, such as games, crafts, and outings to the older persons in a safe and secure environment.

In addition to the adult day care center, Philomena’s organization also offers home care support designed for older people who want to stay in their own homes but need some assistance with everyday tasks. They provide help with personal care, such as bathing, dressing, and grooming through volunteers. They also provide help with household chores, such as cleaning, laundry, and cooking. Lastly, they provide social and psychological support, as well as respite care for caregivers.

Thirdly, in the area of developing new standards, Philomena is leading a coalition of 60 organizations under the agency of Association of Care Service Providers to Older Persons in Nigeria to develop the first ever Aged Care Quality Standards and Regulation manual of caring for the aged in Nigeria. The manual has been submitted and it is currently being reviewed for possible adoption by the National Senior Citizen Center of Nigeria, the body responsible for designing and implementing programs that offer as much comfort and care as possible to senior citizens to make the rest of their lives easy. In addition to this, she is partnering with the National Directorate of Employment (NDE) to provide small grants to older persons who desire to engage in small-scale enterprises as a way to keep themselves busy. She has been able to support them to start small scale groceries shop, small scale local soap making, livestock rearing, and vegetable farming.

So far, Philomena’s work has directly impacted over 100,000 older persons in more than 200 communities across five states in Nigeria, and she is currently leveraging her position as the National President of ACSPOPIN (a coalition of 60 organizations) to spread towards the north and other states in Nigeria.

The Person

As a child, growing up during the Nigerian Civil War, Philomena always empathized with the plight of older persons in her community, particularly those with little or no social support. This empathy would make her sneak out of her home to help these lonely older persons wash their dishes, and help them prepare dinner, things she usually didn’t like doing for her own mother. She eventually learnt how to cook and do household chores just by observing and helping them. Because she was so empathetic to older persons, she naturally wanted to become a nun and devote her time to helping them. However, her father prevented her from joining the convent.

After her Higher National Diploma studies, she got into Ajaokuta Steel Complex as a staff and eventually rose to contest for the position of Social Secretary for the entire staff association of the steel complex, a position normally reserved for men. She faced incredible opposition, but forged on, and had a landslide victory against the popular candidates who were all men and had more chances than she did of clinching the position. Subsequently, she went back to school for a bachelor's degree in computer science which positioned her to get into the oil and gas sector, specifically, Shell-Nigeria and Shell Africa Region where she had a long and successful career rising to eventually lead the IT Computing Infrastructure project management team, and helping the organization eliminate the cost of flying in expat technical staff from Netherlands by building and reinforcing the internal capacity of her team.

In spite of her well-paying job and the accompanying perks, her heart was still set on helping older persons in a more strategic way. She eventually resigned from Shell-Nigeria and went back to school in Canada for another bachelor's degree in social work with a minor in Ageing. After the bachelors, she enrolled immediately for a master’s degree in Gerontology to equip herself to fulfill her life’s assignment of helping older persons with enhancing their quality of life. She relocated back to Nigeria and started her non-profit, “El-Aged Care” to fulfill her lifelong goal. Today, Philomena has been recognized and honored by the UN-WHO as one of the 50 global leaders who have contributed to fostering healthy aging.