Mawuko Anani Afangnibo EKUHOHO

Anani is putting in place a nationwide system of Senior Clubs, the aim of which is to improve the health and well-being of its 60+ population by putting the emphasis on seniors leading active lives, offering the gift of their giving through extended networks in their communities. The approach has garnered the attention of the Health Ministries in Burkina Faso, Ivory Coast, Mali and Guinee Conakry.

Building upon his successful efforts to design the systems that undergird Togo’s health care program, previously available only for civil servants and now extended to all citizens, Anani has worked in the same close collaboration with several Togolese Ministries and Agencies to create a new Draft Law and implementing regulations for Seniors aged 60 and above. With the Draft Law’s expected passage later this year or in early 2025, and with the active cooperation of the Togolese Government, Anani is pilot testing elements of the Senior Club system.

Anani's vision with Anavi (his organization), centers on the creation of Senior Clubs, which are localized hubs or community centers specifically designed to cater to the needs of elderly citizens at the commune level. These clubs serve as government-approved programs aimed at promoting social interaction, providing support services, and fostering a sense of community among older individuals. The goal is for the Senior Clubs to become hubs of broadly conceived community health services, taking advantage of new ways for seniors and young people to collaborate in serving their communities. The popularity with which this idea has been received, even before its full implementation, is rooted in Togo’s near past, before the civil war in Togo, when families in both urban and rural areas, ranging from the wealthy to families with modest incomes, congregated in compounds - fluid networks of generations of people connected through kinship or “extended kinship” - if, in some instances, a family in a rural area had moved from that area to an urban area that contained a compound including members from that rural community.

Countries in the Sahelian Francophony have lagged behind their Anglophone counterparts in the region in creating programs to serve their elderly populations. This is in part due to the fact that only Senegal has attempted to put in place a national health insurance program, which has enrolled more than 3 million people who are not enrolled in other public or private health care plans and cannot afford to pay for medical services. None of the Sahelian countries have a Senior Club system at the grassroots level that, in addition to creating opportunities for seniors to volunteer and serve their communities, is also integrated with the nation’s newly expanded health care system.

In terms of demand for senior services, while in Togo, the population over 60+ is currently 5.5% (low if compared to the EU’s 24%), only 1% of the population of Togo benefits from social security or retirement pensions. This leaves the vast majority of the elderly vulnerable to poverty, and this percentage of the elderly population is projected to more than double by 2050.

The problem of inadequate support systems and limited access to essential services has a significant material impact on the senior population, affecting various aspects of their well-being and quality of life. One of the primary consequences is loneliness and social isolation, as many elderly individuals lack opportunities for social interaction and meaningful connections. This isolation can lead to adverse effects on mental health, including depression, anxiety, and cognitive decline. Additionally, without adequate support, seniors may struggle to meet their basic needs, such as accessing healthcare services, transportation, and affordable housing. This can result in poorer health outcomes, reduced mobility, and increased vulnerability to exploitation or neglect. Overall, the lack of comprehensive support systems exacerbates the challenges faced by the senior population, hindering their overall well-being and diminishing their quality of life.

Senior Clubs are community-based organizations established to cater to the specific needs of elderly individuals within their local communities. These clubs serve as hubs for social interaction, engagement, and access to essential services for seniors. Because the activities of the Clubs revolve around the needs and resources of their proximate communities, the supervision of the Senior Clubs takes place at a level of jurisdiction of “commune leader,” (a commune in Togo is a regional subdivision, and nationally there are 117 in total) each of whom oversees the provision of public services in an area spanning an area comprising 4-5 quartiers/villages, which is the effective operating radius of each Senior Club.

The Senior Club's goal is to recapture that notion of sharing and caring in a community in a new form. For example, in the ten pilot Senior Clubs, six in Lome and one each in the four other regions of Togo, the services are targeted at seniors, young people, pregnant women and mothers with young children. The services range from volunteer or paid work opportunities for seniors in the “commune,” with the active assistance of the commune leader. Some senior members lead tailored exercise programs, weekly discussion groups on current topics, as well as classes on nutrition and meal planning and cooking classes. Additionally, there is a range of activities targeted to members that are led by experts such as physiologists, nutrition experts, and aqua gymnastics trainers. In line with this, Anavi has introduced a senior volunteer program in collaboration with the National Volunteerism agency to enhance community engagement. This program involves engaging volunteers to actively participate in supporting seniors, contributing to the overall well-being of the community, and promoting intergenerational dialogue by providing space for young people to learn from elders and get mentorship and coaching from them.

Senior Clubs are where senior members congregate, but if they cannot take part, there is in-home supervised attention available. Anani has partnered with the National Employment Agency to create a new occupation, an accredited “home caregiver” (auxiliaire de vie in French) The Public University of Lome, located in the nation’s capital, has established an accreditation program for this new occupation.

The activities undertaken by Anavi have addressed various aspects affecting the elderly population, including medical consultations benefiting over 500 seniors annually, and providing social and legal assistance to more than 100 elderly individuals each year. Additionally, Anavi's digital presence has facilitated outreach to over 5,000 visitors annually through its website and social media platforms.

Through strategic partnerships with governmental institutions, international organizations, and civil society stakeholders, Anavi has positioned itself as a catalyst for policy change and advocacy at both national and regional levels. By engaging with decision-makers and advocating for the rights and dignity of older adults, Anavi contributes to shaping policies and frameworks that promote healthy aging and social inclusion.

One of the reasons that Anani has played a pivotal role in both the extension of the National Health Care Program and its next elaboration, the Senior Club system, is Anani’s capacity to create systems that interface smoothly, like a digital system for the Ministry of Health to work with the National Health Insurance Agency to provide a mobile app that serves as a user-friendly and accessible tool that empowers elderly individuals to take control of their health, stay connected with their communities, and access essential support services to enhance their overall well-being and independence, such as Medical Assistance, Home Care Services, Health Monitoring, Information and Resources. Another example is a mobile app for the Togolese Nurses Association that allows nurses to access a senior’s recent medical history, including the results of consultations, test results and up to date information on prescribed medication,

Looking ahead, Anavi's vision for expansion includes the establishment of specialized Medical-Social Centers in Lomé, the launch of a mobile application for elderly care services, and the proliferation of Senior Clubs across more communities. With plans to extend its presence to all eight UEMOA countries and create Senior Villages to provide alternative family environments for seniors.

Anani’s early youth years were spent in Lome, as a member of a polygamous family consisting of 17 children in all. He was one of the three last children when his father, a policeman, was approaching retirement, and was designated by family members as his father’s “indispensable child,” tasked with providing for all of his father’s requests and anticipating his needs.

The civil war began when he was 13, and his family dispersed. He fled to Ghana, went to a refugee school, and earned his living by smuggling bags of wheat flour by night from Ghana to pay for his living expenses. He returned home in 1994 and was the only one of the children to return, and he resumed his care for his now-elderly father. With financial support from sisters who had fled to London, he managed to finish schooling and was the only one of his father’s children who managed to go to university.

After graduating from university, he went to work at an insurance company selling medical insurance and as a sales representative for pharmaceutical companies. During this period, his father’s and mother’s health failed. That experience, taking care of his father and mother in their last years, changed his life trajectory. He decided to leave the private sector and launched ANAVIE, focusing at the beginning on raising money from corporate CSR programs to fund the cost of medicines for seniors who had no other sources of support. His next step was to lobby the Ministry of Health to provide services like home-based medical services for seniors. This is how he began, working with an elderly population that grew to include more than 5,000 people.

It is noteworthy that the interest being expressed by other Francophone countries in the region who are seeking to upgrade significantly their healthcare systems, including seniors, is closely linked to Anani’s proven ability to create systems designed to build upon the Francophony-based administrative infrastructure, and his successful track record for doing this in Togo.