NAIROBI – On the second day of Nature’s “The Future of Dementia in Africa” conference, experts and caregivers focused on a key element of dementia care: community, and the unique potential strengths of African approaches to supporting patients.
The conference, the first of its kind in Africa, was co-hosted by the Davos Alzheimer’s Collaboration and the Aga Khan University and took place in Nairobi from 11-12 September.
One of the main focuses of the two-day event was the use of traditional, complementary and alternative medicine in Africa and how it can be integrated with modern healthcare practices.
Razak GyasiAn associate researcher at the African Population and Health Research Centre noted that by 2050, 2.1 billion people worldwide will be aged 60 or older, 80% of whom will live in Africa.
Ageing societies face many challenges, including economic loss, social isolation, and declining mental and cognitive abilities, including dementia.
Gyasi stressed that there is no need to rely solely on Western medicine to address mental health issues in older people: for example, physical activity improves mental health in older people, social participation promotes a sense of belonging, and good quality sleep has a positive effect on brain function.
His A study on Ghanaian perceptions of traditional medicine Gyasi showed that community members are already using a variety of alternative methods to support health care, from physical activity and social inclusion to massage therapy, herbal medicine, prayer, music and aromatherapy.
The study focused on how people in Sekele South District, Ashanti Region, Ghana, perceive traditional medicine and its role in comparison to modern medicine. It explored key factors such as the availability of traditional medicines, the conditions they treat, their safety, effectiveness and how they interact with the modern health care system.
Gyasi’s study used a descriptive cross-sectional survey to collect data at a point in time to describe the situation. The study involved 120 participants, of which 70 were traditional medicine practitioners, 30 were healthcare users, and 20 were modern medicine practitioners. Data was collected through questionnaires, interviews, and observation of practitioners’ work environments in nine communities. Both qualitative (interviews and observations) and quantitative (survey) methods were used for data analysis.
Results show that alternative medicines are effective in treating a number of medical conditions, including malaria, typhoid, arthritis, jaundice, infertility, stroke, bone fractures, boils, haemorrhoids, HIV/AIDS and mental illness. However, risks remain as there is no formal collaboration between modern and traditional health care providers.
Gyasi identified “pull factors” that draw people towards traditional medicine and “push factors” that move people away from modern medicine.
Gyasi noted that people are drawn to alternative medicine because it takes a holistic approach and treats the “whole human system.” Furthermore, traditional methods are deeply rooted in upbringing and therefore have strong cultural beliefs. As one study participant asked, “How can you be cured by a treatment you don’t understand?”
Many people believe there is a spiritual connection between the physical and mental aspects of health, which is what is driving people to alternative medicine.
Deterrents also exist within the mainstream health care system.
According to the survey, some people felt that their doctors lacked expertise or that they were embarrassed during treatment. Others cited prejudice against seeing modern doctors or “white” doctors. Furthermore, many modern treatments have side effects that people are unwilling to endure, even if the treatment is effective. Finally, the cost of treatment is often prohibitive, making modern treatments inaccessible to many.
“Traditional medical systems are ingrained in our culture and traditions,” Gyasi says. “Ask any African elder, whether in urban or rural areas, and they will tell you they grew up with it. It is not right to try to separate family traditions from Western systems. We should encourage collaboration.”
He suggested that African people should be able to benefit from both systems – for example, visiting a clinic for diagnosis but relying on traditional healers in their communities for treatment.
“We all need to come together and address these issues holistically,” he said.
Care for the caregiver
Another important aspect is the unique role of caregivers in Africa. Wambui KaranjaJonathan Mind Associates, project manager at the Aga Khan University’s Institute for Brain and Mind Research, said that in low- and middle-income countries, almost all people with dementia (96%) live at home. This places a heavy burden on caregivers and has a major impact on the global distribution of caregiving time, with women in particular accounting for 71% of global informal caregiving hours, with the highest proportion in low-income countries.
Caregivers need better tools and support to care for the people they care for.
Karanja said: Alzheimer’s Dementia Association of Kenya, It works to build capacity among caregivers at all levels and equip them with the skills to provide basic care for people with dementia.
During the COVID-19 pandemic, the organisation partnered with Alzheimer’s Ireland to provide online support from both peers and experts, and training programmes helped carers to better understand people with dementia, practise self-care and strengthen communication.
Feedback to the programme has been overwhelmingly positive – carers expressed relief that they finally had someone to listen to and support them, making them feel less alone. The programme also provided greater insight into what carers of loved ones in the early stages of dementia should expect.
Karanja stressed that other local organizations in Africa offer similar programs, but that in Kenya in particular they lack sufficient resources and partnerships to adequately support caregivers. She said more investment and collaboration is needed to provide the necessary assistance.
Digital Tools
Edem AzogheneThe Vice-Chair of the Nigeria Digital Health Initiative discussed how digital tools can support the dementia community at large.
“In low-resource continents like Africa, where the necessary investments in things like clinical trials may not be available, early diagnosis and intervention is the most prudent strategy,” Azoghene said.
In Africa, dementia diagnosis usually begins only after there is a significant decline in memory, he explained, but digital tools could change this.
With so many people now having access to smartphones, Azoghene stressed that promoting digital health is more about education than training, noting that digital tools can collect basic health information and conduct simple tests to identify early signs of dementia.
If older people have trouble getting tested, younger caregivers or relatives can help, he said.
Digital health wallets have been rolled out in 22 African countries to ensure continuity of care during the COVID-19 pandemic, with Kenya being the first country to do so.
“This platform allows us to build a lot of other things on top of it, and we’re using it for brain health,” Azoghene said.
He reiterated the widespread use of digital tools in Africa, especially in areas such as fintech and social media.
“It would be a mistake to say that health, which is a valuable aspect of our existence on this planet, does not leverage digital tools,” he concluded. “The question is… how do we create an enabling framework for health?”
Image credits: source:, Maayan Hoffman.
Fighting the health infodemic and supporting health policy reporting in the Global South. Our growing network of journalists in Africa, Asia, Geneva and New York connects local realities with bigger global debates with evidence-based, open-access news and analysis. To donate as an individual or organisation, click here via PayPal.
