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HOUSING FACILITIES AND REALITIES OF HEALTH
OF THE ELDERLY IN NIGERIAN CITIES
Kabiru Salami
Department of Sociology, University of Ibadan
ABST RAC T
Most studies on u rb an housing in Nigeria n cities have intrinsica lly
addressed its locational ad van tage to soc ia l am enities and its influe nce
on socia l capita l and the well-being of its inhabitants, inclu ding the
grow ing populat io n o f th e elderly. Limite d studies p rofile how housing
quality has influe nc ed the he alth of the e lderly in Nige ria. An alys is of
populatio n and housing ce nsus priority data of the UN Habita t 20 14 an d
Na tion al Po pula tion Com m ission 2010 rev eale d that more than half
(55.4% ) of the houses in Lagos city have one room exc lusiv ely for
sle epin g, almost fo ur (7 6.9%) in five ho us eho ld s in Abuja have a
ma xim um of two bedr oo m s and abo ut half (50.3 % ) of househ olds in
Ka no city did not h ave any bed ro om . A lm ost one-quarter (24 .1% ) of
houses in Onitsh a have po or sour ces of water for dom estic use , w hile
slightly b elow h alf (48 .4 % ) of househ olds in Ibadan city and more tha n
half (55.4% ) of households in I lorin, K w ara State dispo se d so lid waste
ind iscrim in ately a ro und the ir ho uses. Th is im balance in th e d istribu tion
of housing and housing facilities ev id en t am ong households in Nigerian
cities re qu ires accelerated efforts in th e era of growing population of the
eld erly in N igeria. Th is study co nclu de s that housing structure an d how
room s and their facilitie s are shared have great potential for in fluencing
the hea lth of the e ld er ly, wh o are a v ulne ra ble group.
JEL classification: I1 2, I31, J14, O19, R 21, R31
1. In trod uction
GL OBALLY, housing rem ains one of the basic needs of ma n and it is also the
main economic asset in every nation (Am ao and Ilesanm i, 2013; Olotuah, 2010;
Volume 58, No 1 (2016) 53
54 Nigerian J ou rn al of E conom ic and Soc ia l S tudies
Coley, L eventhal, Lynch and Kull, 2013). It provides space for economic
production and creates access to incom e earning opportunities (O latubara, 2012).
While housing is an important factor influencing he althy living, a determinant of
well-being, and a predictor of psychosocial balance of mental reasoning, it could
also be the source of a wide range of hazards. Housing is generally classified as
being of good quality or poor quality (Coley et al., 2013). Good-quality housing
is not only indispensable to healthy living and a pleasant hom e environment, but
is also a foundation for stable comm unities and social inclusion (O ladapo, 2006;
Jiboye, 2011; Lanrewaju, 2012). Decent housing is often attributed to a more
productive individual, while a good housing scheme has less adverse social effects
on the occupants which in turn produces higher gross national product figures for
the country (M ortgage Banking Association of Nigeria, 2004). Conversely, poor
housing qualities affect the health of vulnerable g roups (Coley et al., 2013) such
as small children, pregnant women and the elderly, especially in times of disasters
(Salami et al., 2014; W HO, 2007; Centre for Disease Control and Prevention
(CDC), 2006).
Furthermore, housing quality reflects the physical condition of a building with
other facilities that make living conducive in a particular location or area (A mao,
2012). Invaria bly, good quality housing in any neighbourhood must satisfy
minimum health and good living standards (Okewole and Ar ibigbola, 2006).
Basically, four major criteria such as objective criteria, scientific/technical criteria,
social and cultural criteria, and management criteria produce a meaningful housing
quality indicator (M eng and Hall, 2006). One major condition common to all of
these indicators is the availability of sufficient space in a dwelling house.
However, space problem is described as overcrow din g rate , w hich is defined by
the numbers of roo ms available to a household and the household size (Gray,
2001). In England and W ales for instance, basic requirem ents m ust b e met before
people can move into homes (CIE H , 2008). Such requirements entail that the
dwelling should: be structurally safe a nd robust; satisfy fire safety regulations; be
well ventilated; have adequate sanitation facilities such as toilets; have adequate
drainage and waste disposal system (Shelter, 2007). Such criteria of health
indicators produce a strong relationship between housing and health. A healthy and
standard home should have a solid structure, visual impact; possess adequate
facilities for sleeping, own an environment comfortable for relaxation, be free of
hazards, p rovide facility for social exchange with family, friends and neighbours,
Ho usin g Fa cilities and the H ealth of th e Elde rly in Nigerian C ities 55
and be safe and convenient for everyone, including elderly people (CIEH, 2008).
In contrast, Nigeria more than 75 percent of housing in urban cities are
substandard and of poor quality (Ahianba, Dimuna and Okogun, 2008; Jiboye,
2011). Olatubara (2012) observes that N igerians are confronted with a m yriad of
housing problems, which are essentially connected w ith the increasing hardships
they face in securing and retaining a residence.
Poor housing quality can result in numerous health problems such as infectious
and communicable diseases, stress and depression. Cram ped and overcrowded
conditions of house s can equally promote poor hygiene and create conducive
places for virus to live (CDC , 2006). There is also the possibility for poor
household conditions to lead to food and water contam ination, as well as
respiratory and eyesight problems (CDC, 2006; WHO , 2008). Th ere is a
detrimental impact of urban decay on survival of urban dwellers in Nigeria (WHO,
2005; World Bank, 2005), Osuide and Dim una (2005) therefore advise that formal
urbanization should possess basic infrastructural amenities, standard housing,
adequate accom modation, good ventilation and sanitation. How ever, studies
(Trace, 2005; Doumani, 2005; Ahianba, Dim una and Okogun, 2008) have
confirm ed that overcrowding, inadequate basic amenities and unapproved sites of
solid w aste disposal around living areas characterize Nigerian urban cities,
creating negative effects on the health of vulnerable groups like the elderly.
The w orld is expected to have more older adults than children b y 2050, as the
glo bal elde rly population is projected to reach tw o billion that year (UNFPA ,
2012; WHO, 2012). The World Health Assembly (WHA) considers elderly people
as vulnerable with a high risk of mental health problem s (W H A , 2013). The
benchm ark set by the United Nations (UNFPA , 2012) for elderly people to benefit
from old-age social security is 60 years and 65 years in many high-income
countries (U N FPA, 2012; W HO, 2012). However, this benchmark is
inappropriate to sub-Saharan Africa where life expectancy is often low er than in
high-income countries (W H O, 2007). It is expected for a boy born in a high-
incom e country to live up to 76 years which is 16 years more than a boy born in
a low-income country. The life expectancy for a girl in a high-income country (82
years) is 19 years more than for a girl from a low-income country (63 years)
(W orld H ealth Statistics, 2014).
Older adults face peculiar health challenges among which is the inability to live
independently because they face limited mobility, frailty or other physical or
56 Nigerian J ou rn al of E conom ic and Soc ia l S tudies
mental health problem s w hich necessitate long-term care (WHA, 2013 ). At the
beginning of this millennium, it was docum ented that about 20 percent of adults
aged 55 and above suffered ill-health conditions in the USA (Administration on
Ageing, 2001), and global statistics reported sim ilar experience among the elderly
worldwide (Administration on A geing, 2001). The health of the elderly is
important in public health management, yet their health conditions are often less
considered in national allocation of health resources. W orse still, in Nig eria, the
health system gives little priority to their care perhaps due to meagre national
allocation on health resources, and the elderly people are also reluctant to seek
assistance (W H O, 2008). As N igerians are confronted with a myriad of housing
problem s (Olatubara, 2012) and poor housing affects the health of vulnerable
groups (C oley et al., 2013) such as the elderly, this review paper examines the
potential influence of housing quality on the health status of the elderly, holding
constant the housing-related hazards in Nigerian cities.
2. Materials and M ethods
The multi-stage sampling technique was adopted for this study. Stage one was an
extraction of all cities of Nigeria in sequential order as established by UN-Habitat
2014, w hile the second stage was a purposive selection of catchm ent local
government areas (C LGAs) of each city. Priority was given to any CLG A with
proximity to the state seat of government secretariat com plex in the selected city,
if the city is the state capital. For cities w hic h are not the state capitals, all the
LG As in such cities were considered adequate for analysis. Proportio nally, a
population of up to 7 50,000 but below 1 m illion inhabitants was considered as the
bench population for each city in this study.
The bench population was in line w ith UN-H abitat 2014 on population
dynamics for W est African cities. If an L GA in a city could satisfy the p opulation
range for this study, only such an LGA was considered as adequate for analysis
for that city , o therw ise, m ore than one LGA was used for such a city. Google
online m ap and Microsoft Encarta Prem ium map 2009 were used to determine the
nearest LGA. Invariably, the LGA in which the state secretariat is located was
first selected in that city before any other close LGA s were considered. Stage three
was the calculation of all regular households in the selected LG A s as released by
NP C (2010). Stage four invo lved the addition of the population of all elderly
people aged 6 0 and above in the L GAs that represented each city according to
Ho usin g Fa cilities and the H ealth of th e Elde rly in Nigerian C ities 57
NP C (2010). T he elderly proportional rate per city was derived by dividing the
elderly population figure for each city in table 1 by its CLGAs. However, five
LG As w ere used for Ogbomosho city to obtain the minimum population range for
this study. Basically, the Priority Tables Volum e II was used to determine housing
characteristics and regular household; Volume III determined the population
distribution for each C LGA and the elderly population w as derived from Volume
IV as shown in table 1. All the ta bles only revealed inform ation that pertained to
the C L G As for each city as presented in table 1. The major variables examined
in this study are: household and exclusive bedrooms; household and water supply
for domestic use; household and toilet facilities; and household and m ethods of
solid waste disposal. Each of the major variables has sub-variables of which
figures are divided by the total households to arrive at a percentage for each city.
3. Results
Table 1 shows that the population of each city ranged between 750,000 and below
1 m illion inhabitants. The regular household sizes of these CLGA s are calculated
based on Census 2006 Priority Tables Volume II as released in 2010 by the
Nigerian Population Com mission (NP C), as depicted under Regular Household
Total of CLG As in table 1. R egular household in this study, as defined by NPC,
consists of a person or a group of persons living together under the same roof or
in the same build ing or com pound who share the same source of food and
recognize themselves as a social unit w ith a household head (N PC, 2010). Table
1 provides information on the selected Nigerian cities, the catchment local
government areas, their population figures and regular total number of households.
Table 1. Nigerian Cities and their Catchment Local Government Areas
Ci tie s Geo -
Po lit ica l
Zo nes
Ca tc hm e nt Loc al
Go v ernm ent Area s (C L GAs )
Po pula tion
of C LG As
Re gula r
Ho u se ho ld
of C LG As
Elde rly
Ho u se ho ld
Po pu la tio n
(60+ y ea rs )
Elde rly
Ra te pe r
CL G As
(% )
La go s SW Ikeja a nd A g eg e 77 4, 35 7 19 0, 98 6 27 ,5 46 3.6
Ka no NW Ka no M unic ip al C ou n cil and
Na sara w a
967,654 154,424 38,336 4.0
Ibad an SW Ibad an N o rth , Ib ad an N orth
Ea st, a nd I ba dan N orth W est
793, 592 197,737 45,693 5.8
Ab u ja N C Ab uj a M unicip al C oun cil
(A M AC )
776,298 179,674 13,807 1.8
58 Nigerian J ou rn al of E conom ic and Soc ia l S tudies
Ci tie s Geo -
Po lit ica l
Zo nes
Ca tc hm e nt Loc al
Go v ernm ent Area s (C L GAs )
Po pula tion
of C LG As
Re gula r
Ho u se ho ld
of C LG As
Elde rly
Ho u se ho ld
Po pu la tio n
(60+ y ea rs )
Elde rly
Ra te pe r
CL G As
(% )
Po rt H ar co ur t SS Port H a rco u rt an d Okrika 76 0, 84 3 17 2, 30 5 32 ,3 30 4.2
Ka dun a NW Ka dun a No rt h an d Kad un a
So ut h
767,306 152,976 26,362 3.4
Be nin C ity SS Ore do a nd E gor 71 4, 80 2 16 5, 97 5 37 ,3 09 5.2
Og b om o sh o SW
Og b om o sh o N or th ,
Og b om o sh o Sou th , S u ru ler e,
Or i-I re and O go O lu w a
654,183 130,129 41,234 5.7
On itsh a SE O ni tsh a N or th , O nitsh a
So ut h an d Id em il i N orth
694,114 154,506 35,297 5.1
Ab a SE A ba N orth, A b a S o ut h an d
Os is ioma N g wa
754,927 166,312 35,457 4.7
M aidu gu ri NE M aidu gu ri and J ere 7 49 ,1 2 3 1 4 5, 98 3 3 0 ,8 98 4.1
Ilo rin NC Ilorin East, Ilo ri n So ut h an d
Ilo rin W es t
781,934 168,068 41,446 5.3
En ug u S E Enu gu E ast, E nu gu N orth
and Enugu South
717,291 169,422 34,497 4.8
Jo s NC Jos E as t, Jo s N orth an d Jo s
So ut h
679,843 165,216 34,697 5.1
Ke y : S W -So uth Wes t; NW-N or th W e st; N C -N orth C en tral; S S- So u th So u th ; S E -S ou th E as t; N E- N or th E as t
So ur ce : Com p ut ed from UN -H abita t, 201 4; N P C, 2 010 P rio ri ty T ab les V olum e II , I II an d IV
4. Household an d Exclusiv e Bedroom s
Table 2 highlights regular households with and without exclusive bedrooms in
Nigerian cities. As indicated in the table, Lagos has the highest (10.3% + 55.4%
= 65.7 %) number of regular households w ith prevalent inadequate bedrooms in
Nigeria. Slightly m ore than half (55.4% ) of the regular households in Lagos city
have one room exclusively, while about one-tenth (10.3%) have no bedroom at all.
Similarly, almost four out of five (9.5% + 46.8% + 20.6% = 76.9% ) regular
households in Abuja city have insufficient bedrooms; the majority (16.3% +
31.6% + 18.1% = 66.0% ) of the households in B enin C ity have overcrowded
bedrooms; and about one-seventh (16.3% ) have no bedroom . In the same vein,
seven out of ten (19.7% + 33.0% + 22.0% = 74.7%) households in Enugu city
have very lim ited rooms meant exclusively for sleeping; almost one-fifth (19.7% )
have no bedroom while one-third (33.0%) have only one bedroom for their
members.
Ho usin g Fa cilities and the H ealth of th e Elde rly in Nigerian C ities 59
The data from table 2 also reveal that most of the households in the cities do
not have more than two bedrooms, while in fact, more than half (55.4% ) of
households in Lagos and almost half (46.8%) of households in Abuja have only
one room each. Significantly, about eleven people slee p in a room in almost half
(46.8% ) of households in Abuja and about eight people sleep in a room in many
(33.7% ) households in Ibadan. Although, as show n in this study, the size of
households exclusively sleeping in a room in Ibadan is higher than the aggregate
of six people per room observed in a n earlier study by C oker et al. (2007) in the
sam e city, their study agrees w ith the present study on overcrow ded rooms.
Table 2. Regular Households (HH) Distribution by Number of Exclusive Bedrooms
Ci tie s No R o om (%) One R oo m (% ) Two R oo m s (% ) Th re e Ro o ms a nd
ab ov e (% )
To ta l ( %)
Lagos 19735 (10.3) 105741 (55.4) 27780 (14.5) 37730 (19.8) 190986 (100.0)
Kano 77700 (50.3) 12642 (8.2) 16806 (10.9) 47276 (30.6) 154424 (100.0)
Ibadan 26041 (15.3) 57120 (33.7) 27765 (16.4) 58737 (34.6) 169663 (100.0)
Abuja 17114 (9.5) 84015 (46.8) 36971 (20.6) 41574 (23.1) 179674 (100.0)
Port Harcourt 20926 (12.1) 62466 (36.3) 39536 (22.9) 49377 (28.7) 172305 (100.0)
Kaduna 23890 (15.6) 43618 (28.5) 40174 (26.3) 45294 (29.6) 152976 (100.0)
Benin City 27108 (16.3) 52443 (31.6) 29967 (18.1) 56457 (34.0) 165975 (100.0)
Ogbomosho 12262 (9.7) 21420 (16.8) 21806 (17.2) 71442 (56.3) 126930 (100.0)
Onitsha 50290 (32.5) 15762 (10.2) 21115 (13.7) 67339 (43.6) 154506(100.0)
Aba 19424 (12.3) 28429 (18.4) 42526 (27.4) 65096 (41.9) 155475 (100.0)
MaidugurI 29673 (20.3) 31666 (21.7) 35431 (24.3) 49213 (33.7) 145983 (100.0)
Ilorin 20174 (12.0) 48401 (28.7) 37965 (22.5) 61528 (36.6) 168068 (100.0)
Enugu 33310 (19.7) 56001 (33.0) 37217 (22.0) 42894 (25.3) 169422 (100.0)
Jos 16064 (10.1) 43423 (27.3) 36287 (22.8) 63188 (39.8) 158962 (100.0)
So ur ce : Com p ut ed from UN -H abita t, 201 4; N P C, 2 010 P rio ri ty T ab les V olum e II .
Population influx in the cities m ay account for overcrow ding (Gray, 20 01)
while overcrow ding is a major factor in the spread of m easles, meningococcal
disease, tuberculosis infections and diarrhoeal diseases (Global P latform, 2011).
The elderly are particularly vulnerable to ill-health conditions associated with
overcrow ding (Olotuah, 2010). Where fourteen people sleep in a room, there is
congestion and the sleeping condition is overcrowded with lim ited ventilation,
which often poses significant risks to health and quality of life. For instance,
60 Nigerian J ou rn al of E conom ic and Soc ia l S tudies
Lagos city, which is one of the fastest growing cities in the world, has about
fourteen people sleeping in one room as indicated by data in this study. This
physical overcrowding condition is one of the determinants of health hazards and
harmful social behaviour (Olotuah, 2010). Overcrow ding is also one of the m ajor
characteristics of defining slum s (U N -Habitat, 2003). Invariably, most urban
cities in N igeria have the attributes of slums.
In spite of the poor conditions such as overcrowding, and slum s challenges in
Nigeria cities, there is high influx of people to cities from rural areas due to pull-
push factors such as urbanization in cities and lack of economic opportunities in
rural areas (Amao, 2012). Egunjobi (1999) observes that the rate of housing
demand, w hich is consequent upon the movem ent of rural migrants into the cities,
is far higher than the rate of housing construction. The attendant effect of this is
homelessness and very poor and degrading shelters for the not-too-poor; yet these
cities continue to receive m ore rural-urban migrants (A worem i et al., 2011). A s
the population of cities continue to grow, the chronological age of the people also
continues to grow with the result that more elderly people are likely to populate
the cities. How ever, there are many poor quality houses in major cities in N igeria
(Amao and Ilesanmi, 2013), which are expected to have good quality housing.
Nigerian cities are thus inform al urbanized system s devoid of social engineering
approaches (Obono, 2007). A lthough housing is a prerequisite to optim al utility
of man and the state, unfortunately, the justiciability of the right to housing is not
enforceable in Nigeria, unlike civil and political rights (Otubu, 2011). B y
implication, no one can judicially compel the Nigerian government to realize
socio-economic rights under Chapter II of the C onstitution (Diala, 2012).
As noted earlier, one of the determinan ts of good health is good housing
(Dahlgren and W h itehead, 1991). S tudies have show n the relationship between
peoples’ housing conditions and their health status (Page, 2002; Harker, 2006;
Olukolajo et al., 2013) and concluded that while good quality housing increases
people’s well-being, poor quality housing negatively affects people’s health (Page,
2002; Harker, 2006; Chartered Institute of Environmental Health, 2008; Olukolajo
et al., 2013). Poor quality housing is also associated with negative health
conditions among the elderly. Such health conditions are: respiratory diseases,
depression and anxiety, arthritis, diarrhoea, increased heat mortality, decreased
mental well-being, dem entia, falls and accidents (Tanaka et al., 1996; Pollack et
al., 2008). The elderly may experience more of these health conditions due to
Ho usin g Fa cilities and the H ealth of th e Elde rly in Nigerian C ities 61
limited number of room s exclusive for bedrooms as older people spend m ost of
their time at home.
The right to adequate shelter is universally recognized and enshrined in various
constitutions across the globe. T he 1999 Constitution of the F ederal Republic of
Nigeria is not left out, thus, it is acknowledged under Chapter 2 as “Fundamental
Objectives and Dir ective P rinciples of State Policy”. It provides that states shall
direct its policy tow ards ensuring that suitable and adequate shelter, suitable and
adequate food, reasonable national minimum living w age, old age care and
pensions, amongst other things, are provided for its citizenry. Nigeria’s National
Housing Policy was introduced in February 1991 with the goal of ensuring that
every Nigerian owned or had access to decent housing at affordable cost by the
year 2000 (Orji 2011). T his policy was spurred by the United Nations Declaration
on “Housing for all by the year 2000”. At its inception, the basic goal of the
policy was to provide affordable housing to accom m odate Nigerian households in
a conducive environm ent. In addition, the fundamental principles of freedom,
justice, equity, and public interest were taken into consideration in the form ulation
of the policy.
However, m any years after th e pro mulgation of the policy, many N igerians
are still homeless while several others live in indecent houses (Ibimilua and
Ibitoye, 2015). A s O latubara (2012) observes, Nigerians are confronted with a
myriad of housing problems, which are essentially connected with the increasing
hardships they face in securing and retaining a residence. Although cities in
Nigeria derive fast-grow th opportunity for sometim e being state capitals, the slow
rate of development m ay not influence positive living standards unlike cities in
other parts of the world. For instance, Lagos is the first mega-city in Nigeria and
the second fastest grow ing city in Africa (Vanguard News, 2013), yet, it was
described as a ‘bloated slum ’ with the vast majority living in appalling housing
conditions beleaguered by disease and environmental deprivation (Obono, 2007).
This is the same city w here the elderly rate per CLGA is 3.6 percent.
As noted earlier, poor housing is known to have detrimental effects on
residents’ health (Page, 2002). T he data derived for this study and its an alysis of
housing-related facilities in Nigerian cities show how the availability of facilities
can facilitate good housing and hence prom ote good living for the people. A lso,
this study shows that the proportion of the elderly is significant and they could be
an unfortunate group in the effect of poor housing conditions in the cities. The
62 Nigerian J ou rn al of E conom ic and Soc ia l S tudies
elderly spend an average of 80 percent of their time daily at hom e (Shelter Fact
Sheet, 2007) and are more vulnerable to various illnesses associated with quality
of housing conditions. Hence, the housing condition determines the health of the
elderly either positively or negatively.
Culturally, ow nership of a personal house indicates high status. For instance,
Lagos residents often rebuke retaine rship of tenancy in old age when they say
“Oluwa m a se m i ni Baba Eko l’aye” (literally, May God not m ake m e a L agos
daddy in life). The translation of this is that L agos life without good housing is
a life without old age security. Life without good housing for the elderly in
Nigeria becomes severe w hen formal social supports are not available (Salami,
2014). By im plication, the aging conditions of the elderly compounded by ‘bloated
slums’ living (Obono, 2007) predispose them to increased blood pressure,
diabetes, malaria , che st and heart pain and falls (Odaman and Ibiezugbe, 2014;
Stevens et al., 2012). Clearly, forceful sustenance of landlord status by the elderly
in low density areas has the tendency to generate overcrowding, which is a
determinant factor for dam aging social behaviour, and cause of irritation and
fatigue (O lotuah, 2010).
In Nigeria, there exists the culture of passing down houses from one
generation to another through inheritance. In most cases, such houses are
inhabitable (C oker et al., 2007), yet the occupants try to maintain landlord status
holding on to the belief that ‘Eniti ko ni ile asiri re kobo’ (W hoever does not own
a house is exposed to shame). Hence, people who could not build a house in low-
density areas while they were actively engaged in work life m ay retire to their
generational homes. For instance, in Ibadan city, areas such as Mapo, Beere, Oke-
Padre are high-density areas with 300 persons per hectare (Coker et al., 2007).
High-density areas are prone to high incidence of cholera, dysentery, infectious
diseases (Sangodoyin, 1995; Coker et al., 2007), guinea worm, typhoid,
hookworm (A gbo et al., 2012), and natural disasters like flooding (Salami et al.,
2014). The perspective of concentric circles on urban social structures by the
sociologist, Ernest Burgess, describe perfectly the distribution of social groups in
Nigerian cities. Despite the high population influx into Nigerian cities and the
continued change in the distribution of their social groups (Ajala, 2006), residents
(especially the elderly) who share the cultural inclination that the family com pound
and properties should not be exterminated or abandoned still remain. The culture
of passing down hom es from one generation to another through inheritance in fact
has the potential of amplifying the high incidence of infectious diseases
Ho usin g Fa cilities and the H ealth of th e Elde rly in Nigerian C ities 63
(Sangodoyin, 1995; Coker et al., 2007), increased blood pressure, diabetes,
malaria, chest and heart pain, and falls among the elderly (Odaman and Ibiezugbe,
2014; Stevens et al., 2012).
However, one possible implication of housing facilities deficit is the possibility
of becom ing elderly in destitution which has great negative impact on, not only the
well-being of the elderly but also the health of the public in N igeria (Fajemilehin
et al., 2007). Invariably, destitution has contributed to a rise of elderly abuse
globally and it is more intense in developing countries where more than 80 percent
of these abuses occur (W HO, 2002; W H O , 2009). The elderly, especially among
the Yoruba ethnic group of southwestern N igeria, play vital roles in sustaining
social relations and harmony in society (A jala, 2006), however, their perform ance
of these roles can nosedive if they are unwell or living in unhealthy conditions
(Salami, 2014). It may lead agbalagba (the noble aged) to becom e agbalangba
(the ignoble aged) as observed by Om obowale (2014).
5. Households and Main Source of Water Supply for Dom estic Use
The im portance of w ater goes beyond its being essential for human consum ption
to include its usefulness in maintaining solid ground for social stability, food
security and economic growth of the society (UN -Habitat, 2014). The negative
impact of unsafe sources of water for dom estic use will be more pronounced on
the health of the elderly and m ay inadvertently increase poverty among them .
Analysis of data on the m ain source of water supply for domestic use in N igerian
cities show s that Maiduguri has the highest (36.0 % ) demand for water tanker or
water vendor supply for home use. Almost one -third (30.9% ) of the households
in Abuja patronize water tanker suppliers or water vendors, while one in five
(21.0% ) households in Enugu patronize water vendors. How ever, one in four
(26.8% ) households in Ogbomosho depends on river/stream /spring as their
primary source of water supply for dom estic use. This same pattern is shared by
Onitsha where one in five (22.2%) households uses stream water for house chores.
Overall, the majority of households in K ano (47.5 % ), A buja (42.2%) and Enugu
(43.2% ) do not have access to safe water for domestic purposes. Conversely, two
out of five (39.3% ) households in Kaduna have pipe-borne water inside their
dwellings, while alm ost two-thirds of households in Ibadan (61.9% ) and more than
half of households in Jos (54.7%) depend on wells as their major source of w ater
(see table 3).
Table 3. Main Source of Water Supply for Domestic Use
Ci tie s
Ta n ke r su p ply/
W at er v en d or
No . (% )
Ri ve r/ St re am /
Sp r in g
No . (% )
Du g ou t/
Po n d/ L ak e /
Da m /P o ol
No ( % )
Ra in W ater
No . (% )
Pi pe -b o rn e
in sid e
dw e lling
No . (% )
Pi pe -b o rn e
ou ts id e
dw e lling
No . (% )
W ell
No . (% )
Bo reh ol e
No . (% )
To ta l
No . (% )
Lagos 37070 (19.6) 1529 (0.9) 248 (0.1) 1565 (0.8) 24330 (12.9) 42186 (22.3) 31995 (16.9) 50041(26.5) 188964 (100.0)
Kano 33827 (22.0) 16715 (10.8) 1169 (0.8) 21413 (13.9) 13851 (9.0) 7722 (5.0) 26377 (17.2) 32675 (21.3) 153749 (100.0)
Ibadan 6447 (3.5) 4735 (2.5) 614 (0.3) 14929 (8.0) 11899 (6.4) 16335 (8.8) 115160 (61.9) 16073 (8.6) 186187 (100.0)
Abuja 55528 (30.9) 17240 (9.6) 398 (0.2) 2769 (1.5) 34394 (19.5) 9516 (5.5) 30595 (17.3) 27293 (15.5) 177733 (100.0)
Port Harcourt 18574 (10.8) 4661 (2.7) 329 (0.2) 2567 (1.5) 14692 (8.6) 29875 (17.4) 17303 (10.1) 83497 (48.7) 171498 (100.0)
Kaduna 11749 (7.7) 1294 (0.8) 401 (0.2) 8968 (5.9) 59695 (39.3) 13810 (9.1) 53511 (35.2) 2559 (1.8) 151987 (100.0)
Benin City 16714 (10.1) 9912 (6.0) 497 (0.3) 2973 (1.8) 23822 (14.5) 30367 (18.5) 8396 (5.1) 71777 (43.7) 164458 (100.0)
Ogbomosho 3344 (2.6) 33700 (26.8) 921 (0.7) 8669 (6.7) 1518 (1.2) 1896 (1.5) 62440 (50.0) 13168 (10.5) 125656 (100.0)
Onitsha 15018 (9.9) 33512 (22.2) 2856 (1.9) 10013(6.6) 6423 (4.2) 10685 (7.1) 15318 (10.1) 57399 (38.0) 151224 (100.0)
Aba 6861 (4.1) 12331 (7.5) 627 (0.5) 5985 (3.6) 6159 (3.9) 19365 (11.7) 4459 (2.4) 109616 (66.3) 165403 (100.0)
Maiduguri 51896 (36.0) 5653 (3.8) 2859 (2.0) 2520 (1.7) 19565 (13.6) 15587 (10.8) 14289 (9.9) 32022 (22.2) 144391 (100.0)
Ilorin 20048 (11.1) 6437 (3.6) 501 (0.3) 14540(8.0) 18430 (10.2) 20048 (11.1) 75193 (41.6) 25564 (14.1) 180761 (100.0)
Enugu 34361 (21.0) 20784 (12.7) 1112 (0.7) 14393(8.8) 17747 (10.9) 15685 (9.6) 49037 (30.0) 10199 (6.3) 163318 (100.0)
Jos 11808 (7.6) 5502 (3.6) 382 (0.2) 6149 (4.0) 24910 (16.1) 16688 (10.8) 84441 (54.7) 4534 (3.0) 154414 (100.0)
So ur ce : Com p ut ed from UN -H abita t, 201 4; N P C, 2 010 P rio ri ty T ab les V ol. I I
64
Ho usin g Fa cilities and the H ealth of th e Elde rly in Nigerian C ities 65
Provision of safe water for the populace is one w ay to improve the health of
the public as well as the elderly. This is because water-borne diseases such as
cholera and other diarrhoeal diseases, which result in about two million deaths
each year (W HO, 2008; UN -Habitat, 2014), can easily spread due to lack of clean
water for drinking and cleaning. The physical characteristics of a household’s
environment are im portant determinants of the socio-economic and health status
of household mem bers, and incre asing access to improved drinking water and
water for domestic use is part of Goal 6 (Clean water and sanitation) of the
Sustainable Development G oals (SDGs) (U N DP, 2015). N igeria’s target was that
77 percent of the country’s residents would have access to an im proved drinking
water source by 2015 (U N DP, 2013). H owever, data for this study show that one
in ten (11.6% ) households in K ano city and almost half (42.3%) of households in
Abuja have poor sources of water for dom estic use. This is consistent with data
from the Nigeria Demographic and Health Survey (NDH S), which shows that only
3 in 10 households in B enue, Bauchi, Taraba, and Zam fara states and only 2 in 10
households in Kebbi State have access to an improved source of drinking w ater
(NPC and ICF Internatio nal, 2014). The coverage of this study does not include
unprotected wells since there is no demarcation between protected and unprotected
wells in the census information.
6.Households w itho ut Improv ed Toilet Facility
The sustainable development goals 3 and 6 promote the need for ensuring adequate
sanitation facilities. Improved toilets and a method of waste disposal that separates
waste from human contact form the com ponent of sanitation at the household level.
A household is classified as having an improved toilet if household m embers do
not share the toilet with another household; and as having a method of waste
disposal if the facility used by the household separates w aste from human contact
(W HO and UNIC EF, 2010). Regular households without toilet facilities account
for almost one in seven (14.6% ) in Kano, while about a quarter (21.6% ) of
households in Onitsha use a bucket or pan as their toilet facility. More than one-
tenth (13.3% ) of households in Abuja use a nearby bush/beach/field to defecate;
slightly above half (56.8%) of the households in O gbomosho also used nearby
bushes, while tw o in five (40.0%) households in Ilorin, three in ten (30.0% )
households in Onitsha, and one in five (22.2% ) h ous eholds in Jos, are w ithout
toilet facilities as show n in table 4.
Table 4. Distribution of Regular Households with Toilet Facility
S/n Ci tie s Bu ck et/P an
(% )
To ile t i n
anothe r
(diff eren t)
dw el lin g
(% )
Pu blic to ile t
(% )
Ne ar by
(bus h/ be ac h/
fie ld )
(% )
Pit L at rin e
(% )
W ate r Cl os et
(W C )
(% )
To ta l
(% )
1 Lagos 2371 (1.2) 630 (0.3) 2096(1.1) 1000 (0.5) 106304 (55.7) 78342 (41.2) 190743 (100.0)
2 Kano 22557 (14.6) 4658(3.0) 4930(3.2) 623 (0.4) 83411 (54.4) 37238 (24.4) 153417 (100.0)
3 Ib ad an 464 3 (2 .4 ) 11 49 ( 0. 6) 359 2 (1.9) 1 291 6 (6 .8 ) 1 040 38 ( 54 .6 ) 6 4 18 1 (3 3.7 ) 1 905 19 ( 10 0 .0 )
4 Abu ja 322 2 (1.8 ) 1 15 2 (0 .6 ) 7 00 4 (3 .9 ) 2381 1 (1 3. 3) 511 51 ( 28 .5 ) 9293 9 (5 1. 9) 17 92 7 9 (100 .0 )
5 Po rt H arco u rt 568 7 (3 .4 ) 3 35 7 (1 .9 ) 5 340 5 (3 1. 6) 1 47 3 9 (8 .6 ) 1 47 5 6 (8 .7 ) 77 5 66 ( 45 .8 ) 169 510 (1 0 0. 0)
6 Kad un a 26 29 ( 1. 7) 1635 ( 1. 1) 6559 ( 4. 3) 1892 (1.2 ) 837 91 ( 55 .0 ) 55 84 9 (3 6.7 ) 1 523 55 ( 10 0 .0 )
7 Be nin City 11 48 0 (6 .9 ) 11 95 (0 .8 ) 14 78 ( 0. 9) 113 4 (0 .7 ) 647 37 ( 39 .1 ) 8542 8 (5 1. 6) 1 65 4 52 ( 10 0.0)
8 Ogb om osho 338 5 (2 .6 ) 1521 (1 .2 ) 86 08 ( 6. 6) 736 65 ( 56.8 ) 28 1 47 (21 .7 ) 143 0 7 (1 1. 1) 12 96 33 ( 100 .0 )
9 Onit sh a 3337 8 (2 1. 6) 386 9 (2 .5 ) 7 464 (4.8 ) 168 7 (1 .1 ) 3720 0 (2 4 .2 ) 706 82 ( 45.8) 1542 80 ( 10 0.0 )
10 Ab a 13 46 5 (8 .1 ) 14 13 (0 .8 ) 90 17 ( 5. 4) 131 8 (0 .8 ) 391 83 ( 23 .6 ) 1014 84 ( 61 .3) 1 65 8 80 (10 0. 0)
11 M aidu gu ri 9 559 (6 .5) 24 92 (1.7 ) 86 97 ( 6. 0) 374 8 (2 .7 ) 907 19 ( 62 .5 ) 2995 9 (2 0. 6) 1 45 1 74 ( 10 0.0)
12 Ilo rin 66 60 ( 4. 0) 22 34 ( 1. 3) 14 1 01 (8 .4 ) 414 25 (2 4.7) 620 1 5 (37. 2) 40 864 (24 .4 ) 167 29 9 (1 00. 0)
13 Enugu 3417 (2.1) 1942 (1.1) 17811(10.5) 17117(10.1) 36230 (21.5) 92455 (54.7) 168972 (100.0)
14 Jo s 15 35 ( 0. 9) 10 89 ( 0. 7) 45 7 9 (2.8) 2 921 6( 17 .8 ) 86 411 (5 2 .3 ) 419 3 4 (25. 5) 1647 64 ( 10 0 .0 )
So ur ce : C omp ut ed fr om UN -H abita t, 20 1 4; N P C, 2 010 P riority T ab le s Vo l. II
66
Ho usin g Fa cilities and the H ealth of th e Elde rly in Nigerian C ities 67
Clearly, this study reveals that 3 in 5 households in Ogbomosho, 2 in 5
households in Abuja and Port H arcourt, and 3 in 10 households in Ibadan use an
unimproved toilet facility. This lack of commensurate toilet facilities to the
household sharing capacity is peculiar to all cities in Nigeria, with the exception
of Lagos where only 3.1 percent of households are without an improved toilet
facility (table 4). T his finding confirm s the report by the WHO /UN ICEF Joint
Monitoring Programme for W ater Supply and Sanitation in which 6 out of 10
Africans are reportedly witho ut access to a proper toilet facility, making them
vulne rab le to a range of health risks (WHO, 2008; W H O/U N ICE F, 2010), the
elderly being particularly vulnerable. The NDHS established that less than 10
percent of households in Zamfara and Ogun states have access to an im proved, not
shared, facility. In Benue, K ogi, Niger, Bauchi, Ebonyi, Bayelsa, Cross R iver,
Ekiti, O ndo, O sun, and O yo, betw een 10 percent and 20 percent of h ouseholds
have access to an improved, not shared facility. In G ombe and Kano, 6 in 10
households (67 percent and 64 percent, respectively) have access to such a facility
(NPC and ICF International, 2014).
WHO and UNICEF (2010) estim ated that 1.2 billion people worldwide gained
access to improved sanitation between 1990 and 2004, yet 2.6 billion people –
including 980 m illion children – were found to have had no toilets at home. In
addition, if current trends continue, there would still be 2.4 billion people without
basic sanitation beyond 2015, and the children among them w ill continue to pay
the price in lost lives, m issed schooling, disease, m alnutrition and poverty (W HO
and UN ICEF, 2010), w hich may have deteriorating effect on the hea lth of the
elderly. Continuous use of unimproved toilet facilities by households might hinge
on the perception that ‘human dry waste facilities are less inferior to flush toilet
systems’ (UN-Habitat, 2014), irrespective of their access to w ater facility.
However, the conditions of urban poverty, th rough inadequate access to land,
clean water, good and nutritious food and inadequate sanitary services, put poor
urban residents at further health risk, especially the elderly. Thus, regular
households without proper toilet facilities will increase the health challenges
among the older people.
7. Use of Solid W aste D isposal by H ouseholds
Exam ination of means of solid waste disposal shows that the majority (66.2%) of
households in Ogbomosho dispose of their solid waste at unapproved sites while
68 Nigerian J ou rn al of E conom ic and Soc ia l S tudies
mo re than one-third of households in Abuja (37.6%) and about the same size in
Ilorin (36.2% ) use unapproved dum p sites. About one quarter of households in Jos
(25.3% ), Ibadan (23.4% ), Enugu (28.2%) and Benin City (23.2% ) dispose of their
solid waste indiscriminately at unapproved dum p sites. Overall, the majority
(87% ) of households in Ogbomosho dispose of solid waste inappropriately. In the
sam e manner, about half of households in A buja (50.0%), Ibadan (48.4% ), Ilorin
(55.4% ) and E nugu (49.3% ) also dispose of their solid waste inappropriately, as
presented in table 5.
Table 5. Distribution of Regular Households by Method of Solid Waste Disposal
Ci tie s
Bu ried by
Ho u se ho ld
(% )
Un a pp ro ved
Du m p si te (% )
Bu rn t by
Ho u se ho ld
(% )
Co ll ec ted
(% )
Pu blic
Ap p ro ve d
Du m p Site
(% )
To ta l
(%)
Lagos 2682 (1.4) 6334 (3.3) 3667 (1.9) 132613 (70.0) 44256 (23.4) 189552 (100.0)
Kano 9037 (6.1) 20145 (13.5) 20624 (13.9) 45482 (30.5) 53621 (36.0) 148909 (100.0)
Ibadan 5887 (3.4) 39930 (23.4) 36876 (21.6) 43827 (25.7) 44166 (25.9) 170686 (100.0)
Abuja 5664 (3.2) 67288 (37.6) 16523 (9.2) 59522 (33.2) 30064 (16.8) 179061 (100.0)
Port Harcourt 6804 (4.0) 31290 (18.6) 6679 (3.9) 33794 (20.2) 89446 (53.3) 168013 (100.0)
Kaduna 8972 (5.9) 20523 (13.5) 14927 (9.9) 59194 (39.1) 47905 (31.6) 151521 (100.0)
Benin City 12248 (7.4) 17660 (10.7) 38406 (23.3) 76471 (46.3) 20244 (12.3) 165029 (100.0)
Ogbomosho 3376 (2.6) 84433 (66.2) 23202 (18.2) 5001 (3.9) 11435 (9.1) 127447 (100.0)
Onitsha 14266 (9.6) 25594 (17.2) 24159 (16.2) 37661 (25.3) 47008 (31.7) 148688 (100.0)
Aba 15571(9.5) 31841 (19.4) 13898(8.5) 25727 (15.7) 76913 (46.9) 163950 (100.0)
Maiduguri 11428 (7.8) 22044 (15.4) 19776 (13.8) 41133 (28.7) 49010 (34.3) 143391 (100.0)
Ilorin 6194 (3.7) 59870 (36.2) 25621 (15.5) 12997 (7.9) 60805 (36.7) 165487 (100.0)
Enugu 11365 (7.0) 45776 (28.2) 22949 (14.1) 35773 (22.1) 46456 (28.6) 162319 (100.0)
Jos 11432 (7.0) 41555 (25.3) 48893 (29.8) 26398 (16.1) 35739 (21.8) 164017 (100.0)
So ur ce : Com p ut ed from UN -H abita t, 201 4; N P C, 2 010 P rio ri ty T ab les V ol. I I
The findings in this study imply that almost all the cities in Nigeria develop
and grow through som e forms of inform ality. As shown in this study, slightly
more than half of households in Ibadan, Ilorin, Jos and Abuja dispose of their solid
waste indiscriminately. For instance, Abuja, the Federal Capital Territory of
Nigeria has almost 2 in 5 (37.6% ) households that dump their domestic solid waste
Ho usin g Fa cilities and the H ealth of th e Elde rly in Nigerian C ities 69
product at unapprov ed dump sites (as shown in table 5). This may be a result of
high domestic waste generation by households. It is affirmed by UN-H a bitat that
African cities generate between 0.3 kg and 0.8 kg of solid waste per capita/day
compared to the global average of 1.39 kg/capita/day. T hough it is clear that poor
solid-waste management poses extrem e hazard to health (especially that of the
elderly) and water quality through pollution (Y om and Cohen, 2012), waste
management systems in many African cities are still not adequate, with solid waste
disposed of directly adjacent to households. The flood disaster that ravaged many
Nigerian cities in 2011 and 2012 was mostly caused by indiscrim inate dumping of
solid waste (Salami et al., 2014; O lajuyigbe et al., 2012; Bariweni et al., 2012;
Ayoade, 2012) among other factors.
There was a global fear that containment of the Ebola virus disease would be
very difficult in Nigerian cities, especially in Lagos (The Punch, 2014) w here the
challenges of a mega-city and slum settlements com bine (Obono, 2007) to produce
poor sanitary practices. D uring the Ebola virus disease epidemic in N igeria, the
United States C onsul-General in Nigeria confirmed that “The last thing anyone in
the world wants to hear is the two word s, ‘Ebola’ and ‘Lagos’ in the same
sentence” (The Pu nch, 2014). If L agos as a city w as declared as the fourth worst
city to live in the world (V anguard News, 2013), and as findings of this study
reveal that othe r cities in Nigeria are worse than or at par with Lagos, then
Nigerian cities are sarcastically not conducive to live. This subm ission som ehow
compliments the position of Coker et al. (2007) that Nigerian cities experience
decay in housing and other infrastructure, except the Federal Capital Territory,
Abuja. Solid waste is considered toxic and contains greater variety of pathogenic
microorganisms which threaten and are injurious to public health, m ost especially
the health of the elderly.
As chronological age increases, the chances of being vulnerable to he alth
challenges also increase. Health challenges such as eye problem s, general body
pain, fever, depression, ulcer and fatigue, among others, affect the elderly in
Nigeria (Idris et al., 2012; Ibitoye et al., 2015). In the USA, on e out of five
elderly aged 55 years or older experienced some type of mental health issue
(American Association of Geriatric P sychiatry, 2008; CD C and N ACDD, 2008).
Elderly people are highly vulnerable to dementia (K enner, 2008) and apart from
infants, they appear to be at the g reatest disadvantage of having diarrhoea (W G O,
2008).
70 Nigerian J ou rn al of E conom ic and Soc ia l S tudies
8. Conclusion
This study concludes that Nigeria is urbanizing rapidly as almost all its cities are
expanding and remain exceedingly unplanned, with most households lacking
quality housing. One might say that Nigerian cities are full of informality.
Nevertheless, as Nigeria continues to lead in the population of the elderly in sub-
Saharan Africa, it is imperative to take the health of the elderly into serious
consideration in health care and planning. M any households facilities are injurious
to the health of the elderly and conversely, household members may not
understand the health im plications of poor housing on elderly people. Poor housing
quality can be avoided by ensuring good source of water, appropriate domestic
waste disposal, improved toilet facility and avoiding overcrow ding in bedrooms.
All these housing-related hazards take their toll on the health of the elderly in
Nigeria. Findings from the different data used in this study provide insights on the
need for adequate good housing and facilities for good living for the citizenry. As
the general population increases, so the population of the elderly increases hence
the need to prepare for future social security which should include decent hom es
and facilities for the elderly since it is fundamental to their well-being and would
facilitate peaceful ageing.
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