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Review

Reconfiguration of Informal Social Protection Systems of Older Adults in Sub-Saharan Africa Amid the COVID-19 Pandemic: A Narrative Review

by
Phoene Mesa Oware
1,*,
Yanga Zembe
2,3 and
Wanga Zembe-Mkabile
3
1
School of Public Health, University of the Western Cape, Bellville, Cape Town 7535, South Africa
2
School of Built Environment & Development Studies, University of KwaZulu-Natal, Durban 4041, South Africa
3
South African Medical Research Council (SAMRC), P.O. Box 19070, Cape Town 7505, South Africa
*
Author to whom correspondence should be addressed.
Soc. Sci. 2025, 14(4), 200; https://doi.org/10.3390/socsci14040200
Submission received: 18 December 2024 / Revised: 12 March 2025 / Accepted: 18 March 2025 / Published: 24 March 2025
(This article belongs to the Section Social Policy and Welfare)
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Abstract

:
The COVID-19 pandemic and associated lockdowns in sub-Saharan Africa led to significant social, economic, and health shocks, raising the need for social protection. While the adaptation of formal systems of social protection in response to these shocks has been investigated, gaps remain in understanding how informal social protection (ISP) systems were reconfigured. Taking the ISP systems of older adults as an entry point, and through the lens of ubuntu, an African moral philosophy that underpins ISP systems, this paper synthesises evidence on the ISP systems of older adults prior to and during the COVID-19 pandemic (2019–2024). It highlights shifts that were experienced within these systems amid the COVID-19 pandemic. Evidence reveals pre-existing barriers for older adults to engage in ISP networks prior to the pandemic. The pandemic context enabled older adults to re-integrate and participate in reciprocal exchanges within kinship and community networks. However, the unique pandemic circumstances revealed the additional vulnerabilities of ISP systems, highlighting the need to strengthen state-led interventions to reduce reliance on ISP systems. Opportunities and social policy considerations to reimagine care for older adults in a post-COVID-19 world are discussed.

1. Introduction

The COVID-19 pandemic and varying degrees of lockdown measures that were implemented across sub-Saharan Africa (SSA) to contain the spread of the virus caused significant health, social and economic shocks, raising the need for social protection. Across SSA countries, formal social protection systems were reconfigured in response to these shocks (Devereux 2021). Expanding formal social protection programmes in SSA contexts without pre-existing infrastructure was, however, slow and challenging (Devereux 2021). SSA is characterised by inadequate state-sponsored social welfare provision. Welfare regimes in southern African countries have historically been rights-based, tax-financed, and means-tested, with categorically universal social assistance programmes (Niño-Zarazúa et al. 2012). In contrast, ad hoc, donor-financed, and poverty-targeted programmes are more prominent in East and West African countries (Niño-Zarazúa et al. 2012). Deficiencies in formal welfare systems in both contexts, however, mean that in many SSA settings, informal social protection (ISP) systems fill gaps in state welfare provision (Oduro 2010). Consequently, much like in the pre-pandemic context (Awortwi 2018), many individuals excluded from formal social protection interventions may have been forced to rely on ISP systems.
Considerable attention has been paid to understanding how formal social protection systems in SSA were adapted amid the COVID-19 crisis, highlighting valuable lessons and policy options to strengthen future shock preparedness and responses in a post-pandemic era (Devereux 2021; International Labour Organization 2022; Segona et al. 2021). However, gaps remain in understanding shifts that were experienced within ISP systems. Taking the ISP systems of older adults as an entry point, and through the lens of Ubuntu—an African moral philosophy that underpins ISP systems—this paper synthesises evidence on the ISP systems of older adults prior to and during the COVID-19 pandemic. In so doing, it shines light on how the ISP systems of older adults were reconfigured during the COVID-19 pandemic. This paper expands upon the existing body of evidence on how ISP systems respond to or are affected by covariate shocks. Such understanding can enable the development of comprehensive, shock-responsive, social protection systems in a post-COVID-19 world that considers the dynamics of ISP systems.

2. Capacity of ISP Systems to Respond to Covariate Shocks

ISP systems which comprise kinship and community-based risk management associations such as self-help groups, burial societies, etc., mitigate covariate shocks to varying degrees (Bhattamishra and Barrett 2010; Calder et al. 2014). Due to their reliance on individual members’ resources which are often constrained during crises, ISP systems have a limited capacity to respond to covariate shocks (Walcott et al. 2023). However, interventions by ISP systems that improve income and food security or housing conditions before shocks such as droughts or floods occur, can enhance members’ resilience and mitigate the impact of these shocks (Enworo 2023). ISP systems, specifically kinship networks, implement coping strategies such as providing food and shelter accommodation to affected family and/or community members during floods (Enworo 2023). Additionally, post-shock strategies, such as donating herds or farm inputs to those affected by shocks such as floods, aid in recovery (Ouma et al. 2012). The effectiveness of these strategies, however, varies based on the severity of shocks and the magnitude of the ISP efforts. ISP systems can falter when shocks are unpredictable and widespread (Walcott et al. 2023), as was the case with COVID-19.

3. Ubuntu—An African Ethic That Undergirds ISP Systems

Ubuntu is a moral/ethical philosophy which is associated with the people of SSA (Ewuoso and Hall 2019). It prescribes standards and principles that should govern interpersonal and communal relationships (Gade 2012; Metz 2007). Ubuntu roughly translates to mean ‘humanness’ (Gade 2012, p. 323). Someone who possesses Ubuntu, or humanness, embodies a specific set of values. These include solidarity, that is, empathy for the plight of others and a willingness to offer help for altruistic reasons (Ewuoso and Hall 2019). Interdependence and interconnectedness, rather than individualism, are other key principles of Ubuntu (Ewuoso and Hall 2019). These values are often captured in the Zulu maxim ‘umuntu ngumuntu ngabantu’, which implies that a person’s humanity is intrinsically connected to that of others (Ewuoso and Hall 2019; Gade 2012; Metz 2007). Consequently, embracing Ubuntu involves actively engaging in community life, demonstrating reciprocal compassion and mutual care among members of the community (Ewuoso and Hall 2019).
Ubuntu principles are fundamental pillars of ISP systems (Dekker 2008). In most African societies, care for older adults which is provided out of a sense of duty or as part of a reciprocal exchange, reflects the core values of Ubuntu. Some scholars view the principles of Ubuntu as relics of a utopian past, in decline within modern society (Matolino and Kwindingwi 2013). Nevertheless, others contend that Ubuntu remains dynamic and adaptable across various social and political contexts (Gade 2012). Taking both views into consideration, this paper explores how the pre-pandemic context shaped the values of Ubuntu as practiced in the ISP systems of older adults, and how they were reconfigured amid the pandemic.

4. Materials and Methods

This review analyses and synthesises existing qualitative evidence from SSA on how older adults experience and engage in ISP systems, focusing on two time periods: pre-COVID-19 pandemic and during the pandemic. Pre-pandemic literature highlights ways that older adults accessed care and support from ISP systems. During the pandemic, much of the evidence described how older adults were affected by lockdown measures, shedding light on ways that older adults engaged in ISP systems during this period. There is yet to be a synthesis of evidence from these two time periods to identify shifts that were experienced in ISP systems of older adults because of the pandemic. A narrative review which allows for the analysis of existing evidence from a different perspective to construct new insights is well suited for this task (Sukhera 2022). By analysing and synthesising evidence from the pre- and mid-pandemic periods, such a review can generate new insights on how the ISP systems of older adults are reconfigured during covariate shocks such as the COVID-19 pandemic, drawing implications for social policy in a post-pandemic world.
A systematic search on Google Scholar was performed in April 2024. The search on how older adults engaged in ISP systems before the pandemic period was performed using the following search terms: (“older adults” OR aged OR old OR elderly) AND (“sub-Saharan Africa”) AND (“community-based risk management” OR “self-help” OR “mutual aid” OR kinship OR family OR community). This search, which was limited to studies published from 2015 onwards, yielded over 200,000 results many of which were not relevant to the review topic in its entirety. In a second round, the search was refined to ‘Informal social protection systems of the elderly in Africa’ (2015–2024). This produced approximately 17,000 results.
To identify studies on the impact of COVID-19 context on the ISP systems of older adults, the following search that comprised pandemic-related keywords was performed: (“older adults” OR aged OR old OR elderly) AND (“sub-Saharan Africa”) AND (“community-based risk management” OR “self-help” OR “mutual aid” OR kinship OR family OR community) AND (COVID OR pandemic). This search was limited to studies published from 2020 onwards. It yielded approximately 32,000 results. A refined query using “older adults” OR “elderly” AND “COVID” AND “Africa” (2020–2024) returned approximately 22,000 results.
For each category, pre- and mid-pandemic, the results obtained from the refined query were sorted by relevance as ranked by Google Scholar. Only the first 200 most relevant results were considered for further screening as beyond this threshold, many were irrelevant. Titles were screened to exclude studies that did not focus on informal social protection systems of older adults or COVID-19. Studies that focused on the ‘elderly’, ‘older adults’, or ‘aged’ people regardless of the specific age group were included. However, in this paper, the term ‘older adults’ was used, as it is considered more respectful (Avers et al. 2011). In total, 106 articles were downloaded for further assessment. Their abstracts were reviewed to determine relevance based on the following inclusion criteria: focus on SSA, published between 2019 and 2024 to ensure contemporary insights into ISP systems before and during the pandemic, pre-pandemic studies must have discussed intergenerational care arrangements, community support networks, or mutual aid arrangements of older adults in SSA, and pandemic period studies (2020–2024) must have examined the impact of the pandemic on ways that older adults engaged in ISP systems. It was noted that some studies published during the pandemic period on older adults’ engagement with ISP systems did not address the pandemic conditions; these were classified under the pre-pandemic period. The reference lists of selected articles were also examined to identify additional relevant materials. This process is presented in Figure 1 below.
In total, 34 sources comprising 30 journal articles, 1 book chapter, 3 research reports and 1 PhD thesis, were included in this review. Table S1 (Supplementary File) presents each of the reviewed sources that was included in the narrative review, including the authors, the country where the research was conducted and the purpose of source. As this study is a review of secondary literature, no ethical approval was required.

5. Results

Guided by Ubuntu as a theoretical lens, a thematic analysis (Braun and Clarke 2006) of the selected articles was performed. The following themes were identified: for the pre-pandemic period, reciprocity failures and alienation from ISP networks were key features that characterised the ISP systems of older adults. Amid the pandemic, the following shifts were identified in the ISP systems of older adults: access to resources for participation in reciprocal exchanges, further alienation from social networks, and re-integration into social networks. These themes are presented in Table 1 below and further elaborated on in the following sections.

5.1. Features of the ISP Systems of Older Adults Pre-Pandemic

5.1.1. Reciprocity

In the absence of adequate state-sponsored social welfare, family members played a crucial role in providing care for older adults in many SSA contexts (World Health Organization [WHO] 2017). Both young people and older adults perceived the provision of kinship care for older adults to be rooted in a sense of duty towards older generations (Curreri et al. 2023). Older adults are regarded as a ‘deserving’ population by virtue of their vulnerability due to old age, and also the contribution to society they would have made in life before reaching old age (Curreri et al. 2023). In many communities in SSA, it is believed that older adults have wisdom and are thus to be accorded respect (Mligo 2022). Mutual obligations between generations, grounded in the values of Ubuntu, also underpin kinship care. For example, in Ethiopia, in exchange for their wisdom, older adults contributed towards problem solving within their families and communities (Mefteh and Shenkute 2022). Within multigenerational families, they assisted with childcare, which allows younger adults to engage in other responsibilities (Mefteh and Shenkute 2022). Young people were also expected to care for older adults as they too will be cared for by future generations (Mligo 2022). In addition, the obligation to care for older adults also stemmed from a need to reciprocate the care that younger adults received as children from older generations (Mligo 2022). In theory, these reciprocal exchanges that are grounded on Ubuntu ought to strengthen intergenerational bonds. In reality, however, various dynamics resulted in reciprocity failures and alienation of older adults from ISP networks, as discussed below.

5.1.2. Reciprocity Failures

Prior to the pandemic, many older adults perceived a shift in societal values that sustain kinship obligations. Older adults in Ethiopia reported a weakening sense of obligation among younger generations to care for them (Zelalem et al. 2021). Family caregivers in Ethiopia noted that caregiving for older adults was not only driven by duty as prescribed by Ubuntu, but was also contingent upon ‘good behaviour’ on the part of older adults (Mefteh and Shenkute 2022, p. 2477). This suggests a decline in values of Ubuntu which underpin care and support for older adults that is provided via kinship and community networks.
This decline was further compounded by social-economic factors. Poverty and resource constraints mediate reciprocal kinship care relations. In South Africa, where poverty is widespread and the old age grant is the main source of income for many rural families, especially black Africans, older adults were forced to use the grant to support multiple younger generations (Dubbeld 2021). In so doing, however, they never got to experience the reward of being cared for by younger generations as per the values of Ubuntu. On the other hand, relying on family members who had limited resources, without offering anything in return, engendered negative emotions among older adults, such as feelings of guilt for being burdens to their loved ones (Granlund and Hochfeld 2020; Samuels and Stavropoulou 2016; Tran et al. 2019).
Older adults in South African black communities described providing payments to their adult children who looked after them (Brear et al. 2024). This is in acknowledgment that in providing non-material care, family members set aside their goals and other responsibilities (Brear et al. 2024). Although not explicitly acknowledged by young people in the same setting, their provision of non-material care is contingent upon their employment prospects, evidenced by their willingness to migrate upon securing employment opportunities (Brear et al. 2024). In Ethiopia, older adults who possessed resources such as land or herds, but lacked the energy to cultivate or tend to them, described bestowing such resources upon younger family members to secure long-term care (Mefteh and Shenkute 2022). Meanwhile, younger people provided care with the expectation of receiving inheritance (Mefteh and Shenkute 2022). Reciprocity that is driven by altruism and a sense of obligation is a core value of Ubuntu. However, the above evidence suggests that in the context of poverty and vulnerability, kinship care was not only provided as part of reciprocal and altruistic values of Ubuntu, but was necessitated by limited economic opportunities for young people and an absence of long-term care services for older adults. Reciprocal exchanges under these circumstances are fragile (Brear et al. 2024). In South Africa, Button and Ncapai (2019) found that acts of generosity by black older adults could fail to be reciprocated, resulting in a loss of both resources and kinship support. Moreover, in the context of poverty resulting in low-paid precarious employment for young people, adult children experienced the expectations to provide kinship care and support for their older adult parents as burdensome and difficult to balance with their own material needs (Brear et al. 2024).
Gendered power imbalances that contribute to differences in accessing resources by men and women also mediated reciprocal exchanges. In Ethiopia and South Africa among black Africans, some women reported feeling obligated to provide care for ageing spouses in exchange for residence (Brear et al. 2024; Mefteh and Shenkute 2022). This dynamic arose in situations where women depended on their husbands for housing and were viewed as men’s property. Failure to provide the expected care could result in a loss of residence (Brear et al. 2024).

5.1.3. Alienation from ISP Networks

Access to care and support from non-kin community members was tenuous at best. Evidence from Nigeria suggested that older adults received minimal support from community members who were unrelated to them (Ebimgbo et al. 2022). In cases where such support was available, older adults felt obligated to carefully navigate relationships to avoid conflicts that could result in the loss of support as has been observed in Kenya (Oware 2023). Moreover, while ageing elevated the social status of some older adults, and their increased capacity to access ISP networks, poorer older adults found themselves marginalised in society and at risk of abuse and victimisation, for example, facing accusations of witchcraft (Awortwe et al. 2023; Onzaberigu et al. 2024).
Participation in mutual aid arrangements such as self-help groups and burial societies can facilitate access to psychosocial support and access to financial resources to respond to various risks and shocks (Dafuleya 2018; Oware 2023). However, such groups mobilise resources through member contributions (Calder et al. 2014). Evidence from Kenya indicates that this contributory nature of mutual aid arrangements made it difficult for older adults, who are often neither employable nor economically active, to make regular contributions in such ISP systems (Oware 2023). Thus, mutual obligations within ISP systems, such as self-help groups that are grounded on Ubuntu, simultaneously exclude vulnerable demographics such as older adults. Functional limitations and poor health further hindered the ability of older adults to participate in livelihood and social activities within their communities in both Ghana (Braimah and Rosenberg 2021) and Kenya (Oware 2023). Indeed, demographic data on community-based risk management associations such as self-help groups primarily reported the participation of younger rather than older members (Fafchamps and La Ferrara 2012; La Ferrara 2002). Older adults in Nigeria reported participation in less demanding social activities such as attending church services and funerals (Ekoh et al. 2022). Even then, in Ethiopia, older adults described being deprived of social roles, such as bestowing blessings to children, which used to be their prerogative (Zelalem et al. 2021).
Modern realities such as migration, which often result in the separation of family members, further impacted reciprocal exchanges that benefited older adults within communities. While multigenerational living arrangements are still prevalent in Africa compared to other regions around the world (Kamiya and Hertog 2020), single and skipped generation households are on the rise, driven by the economic migration of younger adults or death due to HIV/AIDS or war (He et al. 2020; Sadruddin 2020). In Nigeria, kin that had migrated were forced to prioritise the provision of monetary support over emotional support for older adults (Akinrolie et al. 2020). Migration in search of economic opportunities and rapid urbanisation also contributed to a growing population of adults’ ageing in urban areas where they experienced higher levels of isolation (Braimah and Rosenberg 2021; Ezeh et al. 2006). For older women, ageing in urban areas and alienation from families in rural areas was partly underpinned by patriarchal structures, such as being disinherited or fleeing domestic violence, as seen in Kenya (Oware 2023). Failure to participate in community activities, such as attending funerals or weddings, during periods of separation from kinship and community networks weakened ties that undergirded reciprocal exchanges (Oware 2023).
Overall, the above evidence reveals the significant barriers among older adults to access and tap into kinship and community networks of care in the pre-COVID-19 context. This was not only as a result of evolving values and norms, but was also because of widespread and intergenerational poverty and vulnerability and stigma, as well as dynamics such as migration.

5.2. Shifts in ISP Systems Amid the Pandemic

Literature suggests the reconfiguration of the ISP systems of older adults amid the COVID-19 pandemic in three major ways, namely access to resources for participation in reciprocal exchanges, further alienation from social networks, and re-integration into social networks. These are depicted in Figure 2 below and further elaborated on in the following sections.

5.2.1. Access to Resources for Participation in Reciprocal Exchanges

Amid the pandemic, despite the enduring sense of obligation among kin to support older adults (Maviza and Nzima 2022), the provision of such support in the context of COVID-19 containment measures was challenging. Reduced physical contact between older adults and their kin, and a loss of means of livelihood among adults, further constrained the ability to provide physical and material support for older adults (Ekoh et al. 2022; Maviza and Nzima 2022). Thus, for older adults who were relying on remittances, a loss of employment for adult children meant that some faced sudden loss of economic support and increased vulnerability.
The economic fallout from the pandemic resulting in loss of employment for some adult children, however, facilitated some forms of reciprocal exchanges within kinship networks. It prompted some young adults to return to live with their older parents and provide non-material care (Manyaapelo et al. 2022). In contexts such as South Africa where the old age pension was topped up during the pandemic (Devereux 2021), such resources supported intergenerational families. This dynamic resonates with the pre-pandemic period during which access to resources such as grants enabled black older adults to engage in reciprocal exchanges within kinship networks (Du Toit and Neves 2009). However, formal social protection measures, such as social grants in the global South, and particularly in Africa, are usually minimalist, dispersing small amounts of money (Niño-Zarazúa et al. 2012). Thus, they are not designed to respond to more than the most basic needs of the recipient. Because the top-ups were minuscule in value, and given the increased rates of unemployment experienced during the pandemic, this meant that the old age pension was more stretched than ever before.
Reliance on older persons’ pensions by younger adults highlights the failures of social welfare systems in SSA, which do not meet the needs of some vulnerable demographics, such as the youth. On the part of older adults, the practice of trading on the grant to access kinship care can have negative consequences: not only depreciating the value of the grant (Zembe-Mkabile et al. 2018), but also contributing to intergenerational conflicts that further worsen beneficiaries’ well-being (Button and Ncapai 2019; Kelly 2019). These are consequences that may have been exacerbated by the additional economic pressures brought about by the COVID-19 pandemic (Arthur-Holmes and Gyasi 2021).
The closure of schools and unavailability of childcare services also presented a unique context in which time, a resource that older adults possessed in abundance, could be leveraged in reciprocal exchanges. A study that was conducted in Mauritius illustrated this by demonstrating how older adults cared for their grandchildren and facilitated homeschooling, allowing adults to work from home (Chemen and Gopalla 2021). Similarly in Ghana, Dovie (2021) found that upon the closure of schools, working mothers brought in their children to the homes of some older adults and financially compensated them for child care services. In fulfilling the roles that would otherwise be performed by schools or day care centres, older adults enabled working mothers to perform other duties. Dovie describes this restoration of the social roles of older adults as ‘pearls in the pandemic’ which enabled older adults to actively contribute towards family life and society and therefore not being perceived as burdens (Chemen and Gopalla 2021; Dovie 2021, p. 48). In turn, older adults accessed companionship, which mitigated loneliness. The provision of childcare by older adults is not unique to the pandemic context. Prior to the pandemic, this was necessitated by skipped generations due to the HIV epidemic or economic migration of young people (Dubbeld 2021). The pandemic circumstances therefore led to an increased role of older adults in childcare. On the one hand, this dynamic fostered a sense of mutual interdependence—a core value of Ubuntu—among generations and addressed the need for companionship among some older persons. On the other hand, it highlights a heightening of the risk of overburdening older persons with childcare responsibilities in contexts where such services are limited or unavailable.

5.2.2. Further Alienation from Social Networks

Studies from urban and rural contexts in Ghana, South Africa (black African communities) and Nigeria indicate that COVID-19 containment measures which restricted movement and social gatherings, as well as fear of being infected and infecting others, further alienated older adults from kin and community networks (Asante et al. 2021; Ekoh et al. 2020; Manyaapelo et al. 2022). The ban on social gatherings also meant that older adults were neither able to participate in communal activities such as church services and funerals nor perform rituals that are typically reserved for them (Ekoh et al. 2022; Manyaapelo et al. 2022). Moreover, in Ghana, studies found that older adults, who were at a higher risk of infection, faced stigma and prejudices as people were reluctant to associate with them, even when they did not display COVID-19-like symptoms (Arthur-Holmes and Gyasi 2021; Gyasi 2020). These findings indicate a further loss of opportunities to consolidate social networks that are predicated on physical interaction during the pandemic.

5.2.3. Re-Integration into Social Networks

Experiences of isolation, marginalisation, and stigma towards older adults, however, varied across different contexts. In Ghana and Mauritius, the slowing down of economic activities and the closure of schools resulted in strengthened social bonds among family members. Parents, grandparents and grandchildren, no longer bound by work or school obligations, found themselves spending more time together, fostering closer relationships (Chemen and Gopalla 2021; Dovie 2021). Notably, these outcomes were realised in unique contexts, such as the small island state in Mauritius in which family structures were already skewed towards extended or modified extended families (Chemen and Gopalla 2021). Conversely, in rural Nigeria, older adults faced heightened isolation as COVID-19 movement restrictions made visits by their urban-dwelling relatives more infrequent (Ekoh et al. 2022). These disparities underscore that multigenerational living arrangements effectively mitigated the social isolation of older adults during crises such as COVID-19. However, such arrangements were perceived to be unsustainable. In Mauritius, concerns were raised by participants regarding the eventual return to normalcy after the lockdown period which threatened to disrupt the newfound familial closeness and support networks enjoyed during the crisis (Chemen and Gopalla 2021).

6. Discussion

This paper synthesises evidence on the ISP systems of older adults prior to and during the COVID-19 pandemic through the lens of Ubuntu, in order to highlight how ISP systems of older adults were reconfigured during the COVID-19 pandemic. In the pre-pandemic context, older adults faced barriers to participating in reciprocal exchanges within ISP networks. Modern realities such as urbanisation and migration, along with widespread intergenerational poverty made it difficult for them to honour the unspoken ethic of Ubuntu, that is, reciprocity. Older adults also faced alienation from ISP systems due to having limited resources that hindered their participation or as a result of the stigma. The slowing down of economic activities and school closures amid the pandemic yielded mixed outcomes. These included a loss of support from kin, and increased dependence on older persons’ grants and resources such as childcare due to increased unemployment rates. Some older adults were further alienated from ISP networks due to their increased vulnerability to COVID-19. However, some positive outcomes were realised. The pandemic context presented an opportunity for some older adults to contribute to a greater extent towards childcare, and to reconnect with their families, thereby alleviating feelings of isolation experienced before the pandemic. These shifts, facilitated by the uniquely exceptional circumstances of the COVID-19 pandemic, have significant implications for policy actions that are needed to reshape the context of ageing in the aftermath of COVID-19 in SSA.
Both pre- and mid-pandemic literature reviewed in this paper suggests a sense of obligation among family members to participate in intergenerational care arrangements, i.e., an enduring sense of Ubuntu. However, the ways that Ubuntu manifested in the ISP systems of older adults was influenced by the differentiated context of the pre- and mid-pandemic periods. During the pre-pandemic period, intergenerational poverty and resource constraints limited the practice of Ubuntu through the provision of material support to older adults by their working-age children. Deteriorating economic conditions during the pandemic which worsened economic hardship further limited resources to participate in intergenerational care arrangements, and worsened resource conflicts. In the pre-pandemic period, migration for economic opportunities by working-age adults constrained intergenerational living arrangements and access to proximate care for older adults. Mid-pandemic literature suggests that in some contexts, a slowing down of economic activities supported the reintegration of families and created opportunities for older adults to contribute to family activities such as through the provision of child care. This mitigated their isolation as was the case in the pre-pandemic context. However, it is possible that the pandemic context further burdened older adults with caregiving roles. Although the impact of the pandemic on ISP systems was inadvertent, both pre- and mid-pandemic literature suggests that context, shaped by social and economic policies, shapes the practice of Ubuntu in ISP systems and its impact on the well-being of older adults. Thus, social and economic policies can proactively intervene by embodying and enabling the practice of Ubuntu in ways that enhance the well-being of older adults. Essential considerations are as follows.
It is imperative to pursue social policy interventions that recognise that ISP systems cannot be the main instrument for providing social and economic liberation and inclusion for vulnerable populations, including older adults. This is because ISP systems, as demonstrated by this paper, are inherently reliant on the individuals’ ability to contribute/reciprocate. The [in]ability to contribute in low-income settings impacts on older adults’ ability to participate in the reciprocal exchanges necessary to access kin and community networks, and ultimately, ISP networks. Moreover, relying on ISP systems requires individuals and communities to have sufficient resources to be able to meet both their needs, as well as those of other vulnerable people, such as older adults. While altruism and mutual exchange are core Ubuntu values, in the context of widespread poverty, reliance on ISP systems is untenable (Matolino and Kwindingwi 2013). ISP systems and kinship and community networks, therefore, cannot replace and take over the responsibility to provide care and support to older adults, which is primarily the state’s responsibility. The World Health Organization [WHO] (2017, p. 5) in its report on the importance of home-based long-term care for older adults, emphasises that ‘national governments must take overall responsibility for the provision and functioning of long-term care systems’.
Key in designing and implementing effective social policy interventions is the need to both increase the value of existing cash transfer programs, as well as extending cash transfer programmes to overlooked demographics, i.e., vulnerable working-age populations (Segona et al. 2021). Evidence suggests that within the context of intergenerational poverty, transactional intergenerational exchanges and expectations between kin emerge, and can worsen well-being outcomes (Brear et al. 2024; Coe 2016; Mefteh and Shenkute 2022). Torn between caring for older adults and supporting their own families, young adults with limited means, prioritise the latter (Tran et al. 2019), that is unless there are significant incentives to care for older adults, such as when older adults can offer resources that young people do not possess (Brear et al. 2024; Coe 2016; Mefteh and Shenkute 2022). In the pre-pandemic period and amid the pandemic, such resources included childcare, financial compensation, or material support. In the absence of such resources for exchange, such as when an older adult is disabled or has no access to pensions, older adults continue to be deprived of the support and care they need. This, yet again, raises the importance of the centrality of the state in older adults’ care frameworks. The state can intervene both in terms of increasing social assistance for older adults and introducing basic income grants targeting young unemployed youth (Ferguson 2015). Cash transfers which target older adults provide them with resources to leverage in reciprocal exchanges within ISP systems (Du Toit and Neves 2009). In doing so, however, the value of the grant is diluted (Zembe-Mkabile et al. 2018), highlighting a need for a life course approach to social protection (García and Gruat 2003). Transactional exchanges also contribute to intergenerational conflicts (Button and Ncapai 2019; Kelly 2019). Thus, it is important to ensure that cash transfer programs are designed to provide adequate amounts that meet, in a more holistic and comprehensive way, the needs of older adults and those of other vulnerable demographics in households and communities.
It is also essential to explore alternative ways to address the long-term care needs of older adults beyond family care networks. This is in view of the increase in single-residence older adults’ households in SSA in the pre-pandemic context (Ezeh et al. 2006; Kamiya and Hertog 2020), and the isolation experienced by older adults who were separated from their families both before and amid the pandemic (Adedeji et al. 2023). Additionally, the state’s responsibility cannot be overstated. Allocating resources toward providing care for vulnerable older adults is thus crucial to filling gaps in kinship care and mitigating the burden of caregiving that disproportionately falls on women (Asante et al. 2021; World Health Organization [WHO] 2017). The state taking responsibility for direct care for older adults would ensure that state-paid caregivers, for instance in the form of community-based workers, are provided for all older adults with limited or no family support (Mobasseri et al. 2023). There are different models for providing such care including daily home-based care, respite care for contexts where there is some family support; and specific services including transport and home-based nursing care (Chen and Berkowitz 2012). In many SSA contexts, such systems of organised care, if available, tend to be clustered in urban contexts and are operated by non-governmental actors (Oware 2023). In these cases, the state has the responsibility of establishing national coordination mechanisms that ensure that such resources are equitably distributed (World Health Organization [WHO] 2017).
Another key consideration to address the long-term care needs of older adults is recognizing and valuing the contributions of older adults, particularly in regard to childcare. The role of older adults in providing childcare, especially in skipped-generation households due to war or HIV, was widely acknowledged even before the pandemic (Small et al. 2019). The closure of schools amid the pandemic further affirmed this by positioning older adults as important resources within their communities (Chemen and Gopalla 2021; Dovie 2021). Recognizing and valuing these contributions through policies that incorporate older adults into systems of childcare, without overburdening them with care responsibilities, can address the challenges of childcare in skipped-generation households in SSA. This has been established in Asian and Western contexts, where integrating child and older adult care institutions has been found to not only meet the growing need for childcare but also foster intergenerational ties and combat the isolation of older adults (Femia et al. 2008; Murayama et al. 2019). The establishment of such institutions would need to ensure that the inclusion of older adults in childcare systems does not transfer the care burden for small children to them, leading to overwhelm and exhaustion. In South Africa, for example, black older adults bear a disproportionate burden of childcare as a result of urban migration of working-age parents in search of economic opportunities, who are forced to leave their children with their own older adults’ mothers (Dubbeld 2013).
Finally, the persistence of strong kinship obligations even in extremely challenging circumstances, such as the COVID-19 pandemic (Maviza and Nzima 2022), is encouraging. Such intergenerational solidarity can be further supported by policymaking that integrates social and economic goals rather than treating them as separate components (Adesina 2011). A broader perspective that acknowledges the impacts of current migration regimes including the cheap migrant labour system that characterises much of Africa, on caregiving arrangements is necessary (Deshingkar 2019; Merla et al. 2020b). Increasingly restrictive migration policies undermine the provision of proximate care to family members, while separation from family has been associated with the poor mental health of migrants (Hajak et al. 2021; Merla et al. 2020a). Amid COVID-19, in contexts such as Mauritius where multigenerational communities were still intact, older adults experienced isolation to a lesser extent during the pandemic (Chemen and Gopalla 2021). The governments of both host and destination countries should, therefore, intervene to prevent the exploitation of migrant workers that undermines their capacity to provide kinship material support (United Nations University Centre for Policy Research 2023). They should also put in place less restrictive migration regimes that facilitate physical contact between migrants and their families, thus preserving kinship ties that are integral to the well-being of older adults (Merla et al. 2020a). The impact of current restrictive migration regimes on caregiving arrangements, however, further underscores the need for the state to fill gaps in care created when family caregivers migrate.

7. Strengths and Limitations

A key strength of this narrative review is its synthesis of literature from both the pre- and mid-pandemic periods, making explicit shifts experienced in ISP systems amid the pandemic. While effort was made to include a wide range of studies that reported on ISP systems of older adults, the literature search was not as exhaustive as in a scoping or systematic review, a limitation inherent to narrative reviews (Sukhera 2022). Additionally, it is likely that the initial sorting of studies by relevance, as ranked by Google Scholar, may have excluded studies that are relevant to the topic. This is evident in the geographical skew of included studies which are mainly from countries in East, West and Southern Africa, with few studies from Central Africa. The review examines how older adults engaged in ISP systems shortly before the pandemic and during the pandemic. This short time frame means that the review neither provides a comprehensive picture of ISP systems of older adults long before the pandemic and ways they continue to be reconfigured after the pandemic. Finally, the studies reviewed considered older adults as a broad category without distinguishing age groups or life stages. As such, the policy recommendations discussed do not account for the diverse capacities, needs, and experiences of older adults.

8. Conclusions

This paper explored the ways that the informal social protection systems of older adults were reconfigured during the pandemic. It highlighted the pre-pandemic stressors and factors that shaped the ways that older adults participated and accessed ISP networks. It also established that the pandemic context enabled older adults to participate in reciprocal exchanges within kinship and community networks. However, the unique pandemic circumstances revealed additional vulnerabilities of ISP systems, highlighting the need to strengthen state-led interventions to reduce reliance on ISP systems. To this end, key considerations are discussed, which include expanding social protection programs such as cash transfers to vulnerable working-age demographics, investing in state-led systems of long-term care for older adults, and adopting social and economic policies, particularly in the context of international migration that are supportive of caregiving arrangements, while filling gaps in care created by the migration of younger family members.

Supplementary Materials

The following supporting information can be downloaded at: https://www.mdpi.com/article/10.3390/socsci14040200/s1, Table S1: Sources included in the review.

Author Contributions

Conceptualization, P.M.O.; methodology, P.M.O., W.Z.-M. and Y.Z.; formal analysis, P.M.O.; writing—original draft preparation, P.M.O.; writing—review and editing, Y.Z. and W.Z.-M.; supervision, Y.Z. and W.Z.-M. All authors have read and agreed to the published version of the manuscript.

Funding

This work is based on the research supported by the South African Research Chairs Initiative of the Department of Science and Technology and National Research Foundation of South Africa (Grant No. 82769).

Institutional Review Board Statement

Not applicable.

Informed Consent Statement

Not applicable.

Data Availability Statement

All studies reviewed in this narrative review are included in the Supplementary Table S1. No primary data were analyzed for this study.

Conflicts of Interest

The authors declare no conflicts of interest.

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Figure 1. Literature search process.
Figure 1. Literature search process.
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Figure 2. Shifts in the ISP systems of older adults during the COVID-19 pandemic.
Figure 2. Shifts in the ISP systems of older adults during the COVID-19 pandemic.
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Table 1. Themes identified.
Table 1. Themes identified.
ThemeFeatures of the ISP Systems of Older Adults Pre-PandemicShifts in the ISP Systems of Older Adults During the COVID-19 Pandemic
Sub-theme
a.
Reciprocity
a.
Access to resources for participation in reciprocal exchanges
b.
Reciprocity failures
b.
Further alienation from ISP networks
c.
Alienation from ISP networks
c.
Re-integration into ISP networks
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Oware, P.M.; Zembe, Y.; Zembe-Mkabile, W. Reconfiguration of Informal Social Protection Systems of Older Adults in Sub-Saharan Africa Amid the COVID-19 Pandemic: A Narrative Review. Soc. Sci. 2025, 14, 200. https://doi.org/10.3390/socsci14040200

AMA Style

Oware PM, Zembe Y, Zembe-Mkabile W. Reconfiguration of Informal Social Protection Systems of Older Adults in Sub-Saharan Africa Amid the COVID-19 Pandemic: A Narrative Review. Social Sciences. 2025; 14(4):200. https://doi.org/10.3390/socsci14040200

Chicago/Turabian Style

Oware, Phoene Mesa, Yanga Zembe, and Wanga Zembe-Mkabile. 2025. "Reconfiguration of Informal Social Protection Systems of Older Adults in Sub-Saharan Africa Amid the COVID-19 Pandemic: A Narrative Review" Social Sciences 14, no. 4: 200. https://doi.org/10.3390/socsci14040200

APA Style

Oware, P. M., Zembe, Y., & Zembe-Mkabile, W. (2025). Reconfiguration of Informal Social Protection Systems of Older Adults in Sub-Saharan Africa Amid the COVID-19 Pandemic: A Narrative Review. Social Sciences, 14(4), 200. https://doi.org/10.3390/socsci14040200

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