Double Burden, Single Response: The Irony of Ageing with Disability in Ghana

Ghana faces a demographic paradox: a rapidly ageing population, projected to reach nearly 10% by 2050, collides with systemic unpreparedness to address the intersecting vulnerabilities of ageing and disability. Through a narrative review of literature anchored in the lived experience of Alima, a 68-year-old grandmother with arthritis and post-stroke disability, this paper examines the “double burden” of health decline and socio-economic precarity exacerbated by fragmented policies and cultural dissonance. Findings reveal stark regional disparities; mobility impairments are notably more prevalent in poorer northern regions than in urban areas. Environmental factors, such as coastal flooding and entrenched social norms in patrilineal northern communities further isolate elders with disabilities. Cultural ideals that emphasize family reciprocity stand in sharp contrast to policy inaction. National health schemes often omit rehabilitative care, and public investment in older adult health remains marginal. Women, especially in rural areas, experience intensified caregiving burdens and economic strain, while widowed urban women face increased health risks. To avert a looming public health and social care crisis affecting millions of older adults by mid-century, this paper proposes actionable reforms: expanding national health coverage to include geriatric services, institutionalizing gerontology training, and prioritizing rural community-based rehabilitation. Aligning these strategies with international development goals on health and equality is vital to transforming cultural respect for elders into concrete, rights-based support systems.