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In sub-Saharan Africa, the system of maintaining older persons (60 years or more) in functional autonomy has been little studied. This thesis was conducted in Bobo-Dioulasso (Burkina Faso) to describe/analyze this system through a 12 months longitudinal study (2011-2012). Quantitative data were collected from a representative sample of the elderly population (362 people) using questionnaires PRISMA and SMAF. These data were analyzed using Stata software. Qualitative data were collected from 15 elderly people and 43 (1 month) or 19 (12 or 13 months) family members during individual interviews and group interviews. These data were analyzed using NVivo software. The study protocol received the favorable opinion of the Ethics Committee for Health Research of Burkina Faso. The results were restituted to the interviewees and stakeholders. Scientific communications were presented at international or local conferences; articles were published in journals with peer reviewers. The results showed that in Bobo-Dioulasso in 2011, 32% ([26.79 to 36.77] CI 95%) of older persons were living with moderate to severe disabilities. In other words, in this city, two third of older persons (68%) were in a position to live autonomously... In cases of moderate to severe disabilities (32% of cases), the family intervened and kept older persons in functional autonomy. The proportion of moderate to severe disabilities varied according to the activities. All older persons who needed help received it. The family was their quasi-stable human resources who brought their aid. The family positioned itself in second place of maintaining older persons in functional autonomy at home. When the family system of maintaining older persons in functional autonomy was weak/frail (did not provide care/support of quality or be almost absent), no other actors (public, religious or community) were regularly intervening at home. The system for maintaining older persons in functional autonomy was incomplete because of the absence of a third actor or group of actors who supported families and the elderly. Therefore, in case of functional handicap (moderate to severe disabilities without human resources for help) the elderly were likely to die. Because of the specificity of this city, the different proportions of functional disabilities are difficult to extrapolate to other localities in Burkina Faso and elsewhere. However, the proportion of older persons in functional handicap (0%) can be easily extrapolated to all localities of Burkina Faso, sub-Saharan Africa, where it does not exist: 1) formal stakeholders (community, confessional, public or private) that offer services to maintain older persons in functional autonomy at home and/or 2) structures who reinforce the capacities and competences of families to better maintain their elderly members in functional autonomy. It is therefore necessary to provide a third level of intervention and help to the families and/or to the elderly who are vulnerable to functional handicap by taking into account their real needs/ interests. Improving the quality of life of older people, the quality of biomedical and social care is also essential.

anthropologie and développement

Le système burkinabè de maintien des personnes âgées en autonomie fonctionnelle à domicile. Analyse centrée sur les acteurs de la ville de Bobo-Dioulasso