Ethical Issues in Caring for Older Persons in Sub-Saharan Africa: A Scoping Review

Rapid population ageing in sub-Saharan Africa (SSA) is unfolding within fragile health systems, weak social protection, and limited geriatric and palliative services, creating ethical challenges in older adult care. This study critically reviews current literature and policy reports, synthesizes key themes, and proposes evidence-based recommendations for policy, practice, and research.

A comprehensive literature search examined ethical issues in caring for older adults in SSA across healthcare and social care settings. We searched biomedical, ethics, social science, and gray literature sources using population, ethics, care, and geographic terms. English-language studies from 2000 to 2025 addressing ethical dimensions of older adult care were included.

We identified multiple ethical challenges that affect older adult care in SSA, including justice, equity, autonomy, dignity, vulnerability, abuse, and ageism. Healthcare-related concerns involve unmet needs, resource allocation dilemmas, limited palliative and end-of-life care, and age-biased clinical decisions. Socially, weakening family support systems create moral tensions for caregivers. Policy analyses emphasise rights-based, culturally sensitive, and equitable approaches, highlighting the need for integrated ethical, social, and systemic care strategies.

Addressing ethical issues in older care in SSA requires legally enshrined protections, health-system investments, public campaigns to counter ageism, supportive decision-making frameworks that respect cultural contexts and individual rights and strengthened research and surveillance. A right-based, culturally sensitive approach focused on the voices of older persons is essential.