The Role of Women in A ged Care: Perspectives on Ageing and Gender in the MENA Region

1. The Role of Women in Aged Care: Perspectives on Ageing and Gender in the MENA Region Dr Shereen Hussein Senior Research Fellow King’s College London

2. Presentation structure • Overview of the MENA region: Similarities and differences • Population Ageing as a policy issue in MENA • Current aged care model in the region • Competing demands and women role in aged care provisions • Demographic and population trends focus on nuptiality, co-residency and labour participation trends • Viability of MENA current aged care model • Call for integrated age and gender social policy development Institute for Policy Research - Beyond International Security - Univeristy of Bath

3. The Middle East and North Africa: .. How similar? • Lies at the crossroads of Europe, Africa and Asia • The birthplace of civilization and the three great monotheistic religions of the world • 22 countries • Share similar language (Arabic in the majority) • Share very similar cultural norms based on religious/spiritual beliefs • governing family roles and ties- influencing both women and the aged • Some geographical coherence with sub-groups • Arab Asia (Iraq, Jordan, Lebanon, Palestine, Syria, Yemen) • Gulf Cooperation Council (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, United Arab Emirates) • North Africa (Mauritania, Morocco, Algeria, Tunisia, Libya, Egypt, Sudan, Somalia, Djibouti, Comoros) Institute for Policy Research - Beyond International Security - Univeristy of Bath

4. The Middle East and North Africa: .. How different? • Huge variability in: • Poverty and per capita income • Population size • Literacy and unemployment rates • Migration, geographical mobility, co-residency arrangements and other socio-economic and socio-demographic characteristics • While all experience some forms of demographic and nuptiality transition • Fertility: some at or near replacement levels, in others high fertility persist • At different tempo and stage Institute for Policy Research - Beyond International Security - Univeristy of Bath

5. Population Ageing in the MENA region • Population ageing is relatively a recent phenomenon in the region • traditional higher fertility rates slower pace of population ageing in other developing countries • Different degrees of population ageingbut all on the same road • More rapid population ageing is expected, by 2050 proportion of older persons projected to reach 19% • Gender life-expectancy differences Institute for Policy Research - Beyond International Security - Univeristy of Bath

6. Population Ageing as a Policy Issue in the Region • The region has historically shown a strong commitment to social welfare • Post independence • Majority linked to employment • E.g. pensions and retirement schemes, however, favouring public sector and can be regarded as gender biased • Universal health and education service • but actual delivery is relatively poor in most countries • No ‘formal’ aged policy strategic vision • However some recent attention to the phenomenon in recent policy discussions Institute for Policy Research - Beyond International Security - Univeristy of Bath

7. Ageing is not a ‘major’ policy concern for the majority of countries in the region Institute for Policy Research - Beyond International Security - Univeristy of Bath

8. Aged-care model in the region • Mainly a family-based model • Embedded within religious beliefs and duty of care to the elder • A two way beneficial model • Gender imbalance of expectations of financial, physical, emotional and personal care • Absence of formal long term care provision • With limited availability and use of residential care • Charitable (voluntary) sector is an important provider of social activities for the elderly • mainly religion based • Women play a pivotal role in sustaining this model • A model based on certain assumptions around family structure and women’s availability sustained by strong cultural and religious ideology • Challenged through another set of demographic changes Institute for Policy Research - Beyond International Security - Univeristy of Bath

9. Women competing demands • A sea of demographic and social change !! • Family formation • Age at marriage, celibacy rates, marriage dissolution, marriage patterns and types of contracts …. ‘marriage revolution’ • Spousal choice and co-residency after marriage • Migration • Geographical proximity • Married women as female-headed households: new responsibilities, financial involvements, decision making etc. • Urbanisation • Co-residency & geographical proximity • Education and labour participation • Overall women status and societal/political involvement Institute for Policy Research - Beyond International Security - Univeristy of Bath

10. Nuptiality trends: Age at first marriage Institute for Policy Research - Beyond International Security - Univeristy of Bath

11. Source: Hussein (2002) Institute for Policy Research - Beyond International Security - Univeristy of Bath

12. Nuptialitytrends: Marriage stability • Marriage stability measured by different elements • Marriage dissolution • Divorce and widowhood – unclear direction of trend • Duration of marriage – divorce usually occur in early years • Remarriage rates – very low overall, except in some countries (e.g. Morocco) • Influenced by other nuptiality elements including: • Marriage contracts • Consanguinity and polygyny • Inter-spousal age and educational gaps • Observed changes in all the above • Affect women on a number of ways • Female headed-household • Welfare • Financial and social status Institute for Policy Research - Beyond International Security - Univeristy of Bath

13. Source: El-Saadani (Undated) Institute for Policy Research - Beyond International Security - Univeristy of Bath

14. Marriage dissolution, due to divorce, working for cash and education – not a consistence relationship Example 1: Tunisia Source: Hussein (2002) Institute for Policy Research - Beyond International Security - Univeristy of Bath

15. Marriage dissolution, working for cash and education – not a consistence relationship Example 2 Morocco Source: Hussein (2002) Institute for Policy Research - Beyond International Security - Univeristy of Bath

16. Marriage dissolution, working for cash and education – not a consistence relationship Example 3 Egypt Institute for Policy Research - Beyond International Security - Univeristy of Bath

17. Husband selection and co-residency Institute for Policy Research - Beyond International Security - Univeristy of Bath

18. Women labour-force participation Institute for Policy Research - Beyond International Security - Univeristy of Bath

19. Viability of current family-based care model • Assumes a certain family and societal structure • Women are key players in providing care • Other demographic and social changes challenging such structure on a number of ways: • Family unit availability and ability to provide increasing care • Competing demands on women time, emotional strengths, and finance • Lack of vision to link with existing charitable and societal activities • Includes risk elements: • Lack of awareness of old age care needs including dementia and associated risks • Lack capacity building Institute for Policy Research - Beyond International Security - Univeristy of Bath

20. Ageing and gender issues go hand-in-hand • An opportunity to develop a policy direction that integrates both ageing and gender issues • Women over represented in the ageing population • Women main providers of aged care, and will continue to be • Need for wider policy support for women to enable their pivotal role in aged care • at different levels including employment, respite care, flexible working conditions, recognition of increased duties • Develop policy that enables the family, community and the state to support and maintain aged care in a complementary (not substitution) structure Institute for Policy Research - Beyond International Security - Univeristy of Bath

21. Thank you for listening • Shereen.hussein@kcl.ac.uk • 0207848 1669 Institute for Policy Research - Beyond International Security - Univeristy of Bath