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The role of formal social networks in mitigating age-related mental stress among older Nigerians living in poverty: Insights from social capital theory

Published online by Cambridge University Press:  30 May 2025

Sunkanmi Folorunsho Open the ORCID record for Sunkanmi Folorunsho [Opens in a new window] ,
Munirat Sanmori  and
Medinah Suleiman
Sunkanmi Folorunsho*
Affiliation:
Department of Sociology, University of Nebraska-Lincoln, Lincoln, NE, USA
Munirat Sanmori
Affiliation:
Department of Sociology, Georgia State University, Atlanta, GA, USA
Medinah Suleiman
Affiliation:
Department of Common and Islamic Law University of Ilorin, Ilorin, Nigeria
*
Corresponding author: Sunkanmi Folorunsho; Email: sfolorunsho2@huskers.unl.edu
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Abstract

As Nigeria’s aging population increases, older adults living in poverty face growing threats to their psychological well-being. This study examines the role of formal social networks such as government programs, non-governmental organizations and faith-based initiatives in alleviating mental stress, defined as persistent psychological distress characterized by anxiety, loneliness and emotional strain, distinct from clinically diagnosed mental illness. Using Social Capital Theory as a guiding framework, the review explores how bonding, bridging and linking social capital influence the ability of formal networks to reduce financial insecurity, social isolation and health-related vulnerabilities. Traditional family caregiving structures are weakening due to rapid urbanization and economic pressures, leaving many older Nigerians unsupported. Although formal initiatives like the National Social Safety Nets Project exist, their effectiveness is limited by delayed disbursements, poor coordination and cultural stigma surrounding mental health. Strengthening the National Senior Citizens Centre as a coordinating body, expanding culturally relevant community-based care and integrating informal support systems are identified as crucial steps forward. Without such reforms, the continued neglect of this population risks worsening mental health outcomes, straining public health resources, and undermining intergenerational solidarity. This review offers actionable insights for improving older adult-care systems in Nigeria and provides guidance for other low-resource settings confronting similar demographic transitions.

Topics structure

Topic(s)

EtiologyHuman RightsPolicy and systemsQuality of Care

Subtopic(s)

Community supportCommunity-based careGovernment programmesRisks and protective factors, including social riskTreatment access and equity of care

Keywords

formal social networksmental stressolder adultspovertysocial capital theory

Information

Type
Review
Information
Cambridge Prisms: Global Mental Health , Volume 12 , 2025 , e56
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Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
Copyright
© The Author(s), 2025. Published by Cambridge University Press

Impact statement

This study points to the critical role of formal social networks in alleviating age-related mental stress among older Nigerians living in poverty, a growing yet underserved population in Nigeria. By applying Social Capital Theory, the research underlines how bonding, bridging and linking social capital can enhance the accessibility and effectiveness of support systems. As traditional family structures erode due to urbanization and economic challenges, formal networks such as government programs, non-governmental organizations and faith-based initiatives offer significant potential to address mental stress caused by poverty, social isolation and health vulnerabilities. The study’s findings have far-reaching implications for policymakers, practitioners and community leaders. Recommendations include strengthening formal support structures through increased funding, improved coordination and culturally sensitive approaches that align with Nigeria’s socio-cultural norms. Integrating informal community practices, such as savings groups and traditional care systems, into formal frameworks can improve accessibility and sustainability. Expanding pension coverage and healthcare services, particularly in rural areas and leveraging trusted institutions like faith-based organizations can reduce stigma and enhance trust in formal mental health interventions. Beyond addressing immediate needs, these measures can foster economic resilience, improve mental health outcomes and promote social inclusion for older Nigerians. The study contributes to a broader understanding of the intersection between poverty, aging and mental health in low-resource settings, offering important insights for other developing nations grappling with similar challenges. By advocating for integrated and culturally grounded solutions, the research aims to inform policies that prioritize the dignity and well-being of older adults, ensuring their inclusion in Nigeria’s socio-economic development agenda.

Introduction

Nigeria’s aging population is expanding rapidly, yet the country’s social and economic infrastructure remains ill-equipped to meet the needs of this growing demographic (Mbam et al., Reference Mbam, Halvorsen and Okoye2022). The United Nations (2020) defines older adults as individuals aged 60 years and above, and in 2020, an estimated 9–10 million Nigerians fell within this category. Projections indicate that this number will double by 2050 (World Bank, 2023). Despite this rapid growth, existing policies and support systems are inadequate, raising concerns about the country’s ability to provide adequate care and ensure the well-being of older adults (Oyinlola, Reference Oyinlola2024). Without significant improvements in social welfare programs, Nigeria faces an impending crisis in older adult care.

The connection between population aging and widespread poverty has given rise to a highly at-risk group – older adults struggling with economic hardship and social isolation (Mahmoud et al., Reference Mahmoud, Baker, Esiaka and Balogun2023; Oni-Eseleh and Badaiki, Reference Oni-Eseleh and Badaiki2024). These challenges contribute to mental stress, a growing but often overlooked public health concern. Mental stress encompasses persistent psychological distress, including anxiety, social isolation and depression, often triggered by financial instability, deteriorating health and weakened social support systems (Donovan and Blazer, Reference Donovan and Blazer2020). While mental stress is distinct from clinically diagnosed psychiatric conditions such as major depressive disorder or generalized anxiety disorder, it significantly impacts quality of life and, if left unaddressed, may escalate into severe mental health conditions (Crielaard et al., Reference Crielaard, Nicolaou, Sawyer, Quax and Stronks2021). Despite its prevalence, mental stress among older Nigerians remains largely understudied, as research has traditionally focused on clinically diagnosed psychiatric disorders (Ekoh et al., Reference Ekoh, Agbawodikeizu, Ejimkararonye, George, Ezulike and Nnebe2020).

Historically, Nigeria’s extended family networks served as a crucial safety net for older adults, ensuring financial and emotional support through intergenerational cohabitation (Salami and Okunade, Reference Salami and Okunade2020). However, rapid socioeconomic changes are eroding these traditional support systems. Urbanization and migration patterns particularly the increasing trend of younger generations relocating to urban centers or emigrating for economic opportunities, a phenomenon locally known as “Japa” (Iwuagwu et al., Reference Iwuagwu, Ugwu, Ugwuanyi and Ngwu2022) have disrupted familial structures. Studies in southern Nigeria suggest that when adult children migrate for employment, their older parents experience heightened loneliness and emotional neglect (Akosile et al., Reference Akosile, Onyekwuluje, Mgbeojedo, Okoye, Fabunmi, Mong and Okafor2023; Folorunsho and Okyere, Reference Folorunsho and Okyere2025). Additionally, economic pressures have diminished the ability of younger family members to provide consistent caregiving, as financial survival often takes precedence over older adult care responsibilities (Ezulike et al., Reference Ezulike, Lu and Chiu2024).

Intensifying these challenges, Nigeria lacks adequate formal support structures to address the needs of its aging population (Mobolaji, Reference Mobolaji2024). The country’s social security system primarily benefits retirees from the formal workforce, excluding the majority of older individuals who spent their working years in informal sectors such as farming, petty trade, and artisanal work (Oyinlola, Reference Oyinlola2024). Additionally, geriatric healthcare and mental health services remain severely underfunded and largely inaccessible, particularly in rural areas (Mahmoud et al., Reference Mahmoud, Baker, Esiaka and Balogun2023). The COVID-19 pandemic increased these vulnerabilities, exposing the fragility of Nigeria’s older adult-care systems. During lockdowns, many older adults experienced disruptions in access to health services, medication and social support. Restrictions on movement and the prioritization of pandemic-related care left chronically ill and economically disadvantaged older persons with minimal assistance, contributing to increased psychological distress (Ekoh et al., Reference Ekoh, Agbawodikeizu, Ejimkararonye, George, Ezulike and Nnebe2020; Ikeorji et al., Reference Ikeorji, Akah and Ramsey-Soroghaye2024).

The pandemic also deepened isolation, particularly for older adults without active family networks, as communal gatherings and religious activities which are key sources of social engagement were suspended (Mahmoud et al., Reference Mahmoud, Baker, Esiaka and Balogun2023). As a result, older Nigerians, especially those living in poverty, face multiple intersecting challenges, including chronic illnesses with limited healthcare access, financial insecurity due to inadequate pension coverage, and intensified social isolation resulting from both structural neglect and pandemic-related disruptions (Ekoh et al., Reference Ekoh, Agbawodikeizu, Ejimkararonye, George, Ezulike and Nnebe2020). Empirical studies emphasize a strong correlation between financial hardship and late-life depression. In Oyo State, older adults experiencing economic strain were found to be over four times more likely to suffer from depression (Baiyewu et al., Reference Baiyewu, Yusuf and Ogundele2015). Similarly, in Cross River State, nearly 45% of surveyed older adults reported depressive symptoms, with social disconnection being a primary contributing factor (Akosile et al., Reference Akosile, Onyekwuluje, Mgbeojedo, Okoye, Fabunmi, Mong and Okafor2023).

This literature examines the role of formal social networks in alleviating mental stress among older Nigerians by evaluating their impact, integration with informal caregiving structures and policy implications. While aging research has predominantly focused on high-income nations, there remains a significant gap in understanding the mental health challenges faced by older adults in sub-Saharan Africa (UN, 2020). By focusing on Nigeria, this review contributes to the growing body of research on aging in low-income countries. Specifically, it assesses how formal support systems, including government programs, non-governmental organizations (NGOs), and faith-based initiatives, mitigate financial strain, social isolation and psychological distress among older adults which are contributory indices of mental stress. Furthermore, it examines the extent to which these formal networks complement or conflict with traditional caregiving structures and identifies barriers to access. Lastly, this review offers evidence-based policy recommendations to enhance the sustainability and effectiveness of older adult support systems. The findings are particularly relevant to policymakers, as strengthening formal social networks can improve mental well-being and ensure dignity for Nigeria’s aging population in the face of rapid demographic changes.

Age-related mental stress in Nigeria

Research on aging in Nigeria consistently draws attention to the mental health challenges faced by older adults, often characterized by heightened stress, depression and anxiety linked to socioeconomic hardship. While studies may not always explicitly use the term mental stress, they frequently document the underlying factors contributing to psychological distress. A recurring theme in this literature is the strong correlation between poverty and late-life depression. Baiyewu et al. (Reference Baiyewu, Yusuf and Ogundele2015) reported that older adults experiencing financial hardship in Oyo State were over four times more likely to suffer from depression. This finding underlines the significant role of economic insecurity, particularly in the absence of pensions or social safety nets, as a key stressor in later life. Similarly, Abdullateef et al. (Reference Abdullateef, Adams, Olawale and Adeyemi2018) found that in rural northern Nigeria, unstable income and poverty were closely associated with symptoms of mental distress among older adults. These studies align with broader evidence suggesting that financial insecurity in later life is not merely a material concern but also an emotional burden, as it undermines an individual’s sense of stability and control (Rahman and Steeb, Reference Rahman and Steeb2024).

Beyond financial difficulties, social isolation has emerged as another critical predictor of mental stress among older Nigerians. Tuki (Reference Tuki2025) found that a large number of older Nigerians rely on family support for survival, yet increasing economic pressures have led to reduced financial assistance. As family sizes shrink and migration patterns shift younger generations to urban centers, many older adults experience limited social engagement and diminished familial support. Akosile et al. (Reference Akosile, Mgbeojedo and Okoye2024) reported that in Cross River State, 45.5% of older adults exhibited significant depressive symptoms, with insufficient social connections identified as a primary contributing factor. These findings are consistent with global literature on aging, which recognizes social isolation and loneliness as major risks for poor mental health in later life. However, in Nigeria, these issues are exacerbated by cultural expectations that family members will provide care and companionship in old age. When these expectations go unmet, older adults may experience a heightened sense of abandonment, exacerbating psychological distress. A qualitative study in Enugu State found that older adults without active family engagement reported feeling forgotten and irrelevant in their communities, contributing to symptoms of anxiety and emotional distress (Okoye, Reference Okoye2024).

Effectiveness of formal social networks in alleviating mental stress

Formal social networks encompass structured support mechanisms facilitated by governmental institutions, non-governmental organizations (NGOs), and faith-based initiatives that extend beyond immediate family structures (Collinson, Reference Collinson2011). In Nigeria, these networks serve as critical intervention points for older adults, particularly those experiencing financial hardship. While their effectiveness in mitigating mental stress remains understudied, preliminary evidence suggests that these networks alleviate psychological distress among older Nigerians living in poverty (Mbam et al., Reference Mbam, Halvorsen and Okoye2022).

At the governmental level, the National Social Safety Nets Project (NASSP) is a significant policy initiative aimed at supporting vulnerable households, including older adults. Through the National Cash Transfer Office, NASSP administers unconditional cash transfers to eligible recipients, reducing financial strain (National Social Safety Nets Project, 2023). Although direct empirical evaluations of NASSP’s impact on mental health are limited, studies from similar contexts indicate that cash transfer programs improve psychological well-being by alleviating financial stress (Fenny, Reference Fenny2017). Anecdotal reports from Nigeria suggest that state-level programs such as the “Owo Arugbo” elderly grant in Ekiti State provide not only economic relief but also a sense of dignity and social belonging (The Sun, 2023).

Healthcare-focused formal networks also play a crucial role in addressing mental health concerns among older Nigerians. The National Health Insurance Scheme (NHIS) is theoretically designed to provide healthcare coverage; however, its reach remains inadequate, particularly for those outside formal employment (Adesanya et al., Reference Adesanya, Olatunde, Osungbade and Roberts2023). To address these gaps, alternative models such as community-based health insurance schemes (CBHIS) and NGO-led clinics have emerged. For instance, mobile health clinics, such as Wellness-on-Wheels, originally established to combat infectious diseases, now offer general health outreach, including mental health screenings and counseling for older adults (Shepard et al., Reference Shepard, Halasa-Rappel, Zeng, Rowlands and Musange2023). Preliminary evaluations indicate that older Nigerians receiving regular visits from health outreach teams report lower levels of anxiety and improved emotional well-being, though further research is needed (Mahmoud et al., Reference Mahmoud, Baker, Esiaka and Balogun2023).

NGOs complement governmental efforts, particularly in regions where formal state support is insufficient. Organizations such as HelpAge Nigeria implement community-based healthcare programs, older persons’ clubs, and livelihood support initiatives that address both medical and social needs (Mbam et al., Reference Mbam, Halvorsen and Okoye2022). Participation in these programs has been linked to enhanced well-being by mitigating loneliness and increasing access to essential services (Ubaka et al., Reference Ubaka, Chikezie, Amorha and Ukwe2018). Another significant initiative is the Association for Family and Reproductive Health (ARFH), which operates adult daycare centers in urban areas, providing mental stimulation, social engagement and respite from social isolation (Eze et al., Reference Eze, Iseolorunkanmi and Adeloye2024). Faith-based organizations also contribute meaningfully to older adult support services. The Christian Rural and Urban Development Association of Nigeria (CRUDAN) has organized free medical eye camps for seniors, while Jama’atu Nasril Islam (JNI) facilitates food distribution to impoverished older adults, particularly during Ramadan (Klinken, Reference Klinken2016). These initiatives primarily address physical needs while also fostering social inclusion and alleviating stress.

Comparative assessments of formal support networks on mental health in Nigeria remain limited. However, evidence from other African countries stresses the potential benefits of well-structured support systems. In Ghana, participation in the NHIS has significantly improved healthcare access for older adults and reduced financial stress related to medical expenses (Fenny, Reference Fenny2017). Similarly, South Africa’s Old Age Grant has lowered poverty rates and strengthened intergenerational financial support, reinforcing older adults’ sense of purpose and social stability (Thovoethin and Ewalefoh, Reference Thovoethin and Ewalefoh2018).

Despite the existence of formal support systems such as NHIS and pension programs in Nigeria, their reach and efficacy remain limited. Many older adults, particularly those in informal employment sectors or rural communities, lack access to these benefits, leaving them financially and socially vulnerable. Expanding health insurance coverage and strengthening pension schemes could provide much-needed relief, as evidenced by successful models in Ghana and South Africa. Additionally, implementing CBHIS, akin to Rwanda’s Mutuelles de Santé, could enhance healthcare accessibility for older adults in underserved communities (Shepard et al., Reference Shepard, Halasa-Rappel, Zeng, Rowlands and Musange2023). Apart from governmental initiatives, collaborative efforts between NGOs, religious organizations and community-based groups are essential for sustainable older adult support systems. Successful models in West Africa, such as HelpAge International, have demonstrated the benefits of integrating healthcare, social engagement and financial assistance programs for older populations (Baillie et al., Reference Baillie, Aligawesa, Birabwa-Oketcho, Hall, Kyaligonza, Mpango, Mulimira and Boardman2015).

Table 1 presents a comparative analysis of formal social support networks in Nigeria and their counterparts in other African and international contexts. While Nigeria has existing initiatives, the implementation of these programs remains fragmented and often inaccessible to a large portion of older adults, particularly those outside the formal employment sector.

Table 1.

Selected formal social support networks in Nigeria compared to other African countries

Integration of formal and informal networks

Older adults in Nigeria rely on both informal and formal support structures to navigate daily life. Traditionally, families have served as primary caregivers, but economic changes, urban migration and weakening extended family networks have strained these arrangements (Ojagbemi et al., Reference Ojagbemi, Bello and Gureje2020). As formal support networks bridge these gaps, their effectiveness depends on how well they integrate with existing informal caregiving structures. Successful models reinforce rather than displace traditional caregiving networks. For example, targeted cash transfer programs not only provide direct financial relief but also reduce the economic burden on caregivers. Family members and community leaders often act as facilitators, assisting older adults in enrolling in government programs or accessing NGO-led initiatives. Studies indicate that older adults with active family support are more likely to participate in formal services, achieving better health outcomes (Subu et al., Reference Subu, Holmes, Arumugam, Al-Yateem, Maria Dias, Rahman, Waluyo, Ahmed and Abraham2022). However, socially isolated seniors may struggle to access programs due to a lack of awareness or distrust of formal institutions, prompting NGOs to establish community-based referral systems leveraging trusted local figures (Mentally Aware Nigeria Initiative [MANI], 2023). Some initiatives have successfully integrated formal and informal support systems. In Anambra State, the “Care for the Elderly” initiative deploys healthcare workers to conduct home visits, ensuring older adults receive medical attention while remaining in familiar environments (Tanyi et al., Reference Tanyi, André, Mbah and Tong2018). This model acknowledges older adults’ preference for home-based care over institutionalized settings, demonstrating the feasibility of harmonizing formal and informal older adult care systems (HelpAge Nigeria, 2022).

Social capital theory

This review employs Social Capital Theory to examine how formal social networks mitigate mental stress among older Nigerians living in poverty. Social capital refers to the resources embedded in social relationships that provide individuals with emotional support, financial assistance and access to essential services (Bourdieu, Reference Bourdieu1986; Putnam, Reference Putnam2001). The theory is typically categorized into bonding, bridging, and linking social capital, each playing a distinct role in improving well-being and reducing psychological distress.

Bonding social capital

Bonding social capital refers to the resources and support exchanged within close-knit networks, such as families, neighbors and community groups, which rely on strong interpersonal trust and mutual obligations (Putnam, Reference Putnam2001). In Nigeria, these relationships form the backbone of older adult care, as extended family structures have historically provided financial assistance, daily caregiving and emotional support for older adults. The traditional Yoruba concept of omoluwabi, which emphasizes respect and duty toward older adults, reinforces caregiving expectations within families. Similarly, among the Igbo, the age-grade system (otu ogbo) fosters communal responsibility for older adult welfare, ensuring that older adults without immediate family support receive assistance from peers (Mba et al., Reference Mba, Anene and Mba2023). Outside familial structures, indigenous self-help associations continue to play an essential role in sustaining older adult support. Osusu and Adashe, traditional rotating savings and credit schemes, provide financial buffers for older adults, particularly those in informal employment sectors (Omari et al., Reference Omari, McCall and Hneiny2024). Women’s cooperatives in the Middle Belt and southeastern Nigeria organize mutual aid funds that cover medical expenses for aging members, while Nze na Ozo societies among the Igbo ensure that older members receive financial and social support, especially during health crises (Mba et al., Reference Mba, Anene and Mba2023). These informal structures reduce dependence on formal social welfare schemes, particularly in rural communities with limited government intervention. However, economic migration and urbanization have significantly weakened these traditional safety nets. In response, faith-based older adult support groups have emerged, such as the Catholic Women’s Organization (CWO) and Muslim Sisters Organization (MSO), which provide financial assistance and visitation services for abandoned older adults. Integrating formal older adult-care policies with these existing traditional networks can enhance support for Nigeria’s aging population.

Bridging social capital

Bridging social capital includes the connections that link individuals to broader networks and resources outside their immediate social circles, facilitating access to new opportunities and services (Putnam, Reference Putnam2001). In Nigeria, bridging social capital plays a critical role in older adult support by connecting older adults to religious institutions, NGOs, community-driven healthcare initiatives and social inclusion programs that enhance their well-being. Religious organizations serve as a major source of bridging social capital, filling gaps where formal state support is limited. The Justice, Development and Peace Commission (JDPC) of the Catholic Church provides essential welfare services, including food distribution, free health screenings and social gatherings for older parishioners, thereby addressing both financial hardship and loneliness (Justice, Development and Peace Commission, 2019). Similarly, mosque-based charities, such as Zakkat Foundations in northern Nigeria, distribute stipends and medical assistance to older adults, particularly widows and those without family caregivers.

Community-driven healthcare programs further illustrate the role of bridging social capital in improving health outcomes among older Nigerians. The Wellness-on-Wheels initiative, initially launched to combat communicable diseases, has been expanded to offer mobile hypertension and diabetes screenings for older adults, ensuring access to medical attention in underserved communities (Ezulike et al., Reference Ezulike, Lu and Chiu2024). In Lagos, the Elderly Health Fund (EHF), a public-private partnership, subsidizes medical expenses for low-income seniors who would otherwise be unable to afford out-of-pocket payments.

Apart from financial and medical support, bridging social capital fosters social inclusion through structured community engagement programs. In Enugu and Oyo states, Community Older adults’ Forums have been established to offer recreational activities, peer counseling and skill-building workshops for older adults, helping to maintain their cognitive and emotional well-being. Additionally, local governments in some states have partnered with NGOs to organize intergenerational mentorship programs, where older adults share knowledge and skills with younger community members, promoting social integration and a sense of purpose. While these initiatives have proven effective, their sustainability depends on continued investment and collaboration between government agencies, religious institutions and civil society organizations. Expanding these programs through strategic funding and policy support could further enhance their reach, ensuring that more older Nigerians benefit from the opportunities provided by bridging social capital.

Linking social capital

Linking social capital refers to the connections between individuals and formal institutions, including government welfare programs, healthcare systems and legal aid. In Nigeria, this dimension is critical for ensuring that older adults, particularly those in poverty, can access structured social protection mechanisms. Government-led cash transfer programs serve as primary linking mechanisms. The NASSP provides stipends to vulnerable households, including older Nigerians, to mitigate economic distress (National Social Safety Nets Project, 2023). Similarly, the Owo Arugbo scheme in Ekiti State offers targeted financial relief to older individuals with no regular income (The Sun, 2023).

Advocacy organizations have also played a significant role in strengthening and linking social capital. HelpAge Nigeria has successfully lobbied for pension reforms, increased healthcare funding and legal protections for older citizens. Additionally, the Coalition for the Rights of Older Persons in Nigeria (CROP-N) has pushed for the implementation of the National Senior Citizens Act, which aims to establish dedicated older adult-care services across the country. Legal aid organizations such as Human Rights Law Service (HURILAWS) provide free legal assistance to older Nigerians facing pension disputes or financial exploitation, ensuring that they receive the benefits to which they are entitled.

Healthcare access remains a critical area where linking social capital can be strengthened. The National Health Insurance Scheme (NHIS) includes provisions for older adults, but coverage is limited, particularly for those outside formal employment sectors. In response, private-sector collaborations have emerged, such as Hygeia’s Elderly Care Plan, a subsidized insurance package specifically designed for retirees. Scaling such models through public-private partnerships could significantly improve healthcare access for Nigeria’s aging population.

Challenges and opportunities in strengthening formal networks

The expansion of formal social networks for older Nigerians faces significant financial, policy, cultural, governance and human resource challenges. Addressing these barriers presents opportunities to enhance older adult support systems through innovative reforms. One of the most pressing challenges is financial sustainability, as many government initiatives, including cash transfer programs, experience budget shortfalls or rely on unstable donor funding. Programs such as the NASSP have reported delayed disbursements due to financial constraints, reducing their impact on vulnerable older adults (World Bank, 2024). Establishing a dedicated Older Adult Care Fund, supported through tax levies or redirected subsidies, could provide stable financing. Public-private partnerships (PPPs) also offer an opportunity for sustainable funding, with private sector actors such as telecom and financial institutions contributing to mobile health clinics and senior welfare centers as part of corporate social responsibility initiatives.

Fragmentation and poor coordination among social welfare agencies further weaken the effectiveness of formal networks. Different ministries manage parallel programs with little collaboration, leading to inefficiencies and service gaps (Aregbeshola, Reference Aregbeshola2021). Strengthening the National Senior Citizens Centre (NSCC) as a coordinating body could harmonize services and streamline older adult support efforts. A national database of older adult support programs would help eliminate redundancy and ensure resources are efficiently allocated (Aregbeshola, Reference Aregbeshola2021). Lagos State has piloted integrated senior welfare centers that combine healthcare, financial assistance and social services under one roof, offering a scalable model for nationwide implementation. Establishing an Older Persons’ Council composed of government officials, NGOs and community representatives could further improve participatory planning and oversight of older adult-care policies.

Cultural barriers also limit participation in formal older adult support programs. Many older Nigerians perceive mental distress as a spiritual issue rather than a medical condition, discouraging them from seeking professional mental health services. Additionally, financial aid is sometimes viewed as a sign of family neglect, leading some older adults to reject formal support. To address these concerns, culturally sensitive outreach strategies are needed. Religious and traditional leaders should be engaged to promote the benefits of older adult support programs, as faith-based institutions already provide food aid, health services and emotional support to older adults. Community-based structures, such as Osusu and age-grade associations, could be integrated into formal networks to improve acceptance. Recognizing and funding existing older councils in local communities would further enhance accessibility and trust in formal programs.

Governance and accountability challenges have also hindered the success of older adult support programs. Reports of corruption and mismanagement in pension and welfare schemes have eroded public trust, making it essential to strengthen oversight mechanisms. Expanding biometric smart cards and mobile payment systems, already used in Nigeria’s contributory pension scheme, to non-contributory pensions and cash transfers could improve efficiency and transparency (Aregbeshola, Reference Aregbeshola2021). Community watchdog groups and independent NGOs could play a role in monitoring service delivery and ensuring that funds reach their intended beneficiaries. Establishing whistleblower protections and a grievance redress system specifically for older adults would further enhance accountability. A digital dashboard, similar to the pension transparency system used in Lagos, could provide real-time tracking of older adult support services, increasing confidence in the system.

The shortage of trained personnel is another critical challenge limiting the reach and effectiveness of formal older adult-care services. Nigeria lacks sufficient geriatricians, mental health professionals and social workers, making it difficult to provide specialized care for older adults. Many primary healthcare centers do not have personnel trained to manage aging-related health conditions, particularly mental health and chronic illnesses. A practical solution is task-shifting, where community health workers (CHWs) and nurses receive specialized geriatric care training (Ikeorji et al., Reference Ikeorji, Akah and Ramsey-Soroghaye2024). This approach has been successfully implemented in Rwanda and could be adapted to Nigeria. Engaging older adults as peer supporters could also help address emotional well-being, following models used in South Africa’s senior companion program. Additionally, incorporating geriatric care into medical and social work training curricula would help build long-term expertise in older adult care. Expanding partnerships with faith-based hospitals and mission clinics, which already provide a significant portion of Nigeria’s healthcare services, could further strengthen geriatric mental health programs (Ikeorji et al., Reference Ikeorji, Akah and Ramsey-Soroghaye2024).

Policy recommendations for strengthening formal social networks for older adults in Nigeria

To enhance formal social networks for older Nigerians, several targeted policy measures should be implemented. Establishing community-based older adult support centers at the local level would improve access to pensions, healthcare check-ups and mental health screenings. These centers should be co-funded by the government, NGOs, and private partners to ensure sustainability. Leveraging existing primary healthcare clinics to provide dedicated older adult-care services on specific days could expand service coverage without the need for significant new infrastructure investment.

Expanding non-contributory pensions and cash transfer programs would reduce financial insecurity among older adults. A universal or means-tested pension scheme, starting with individuals aged 70 and above, could be gradually expanded. Strengthening NASSP to ensure timely disbursements and integrating additional services such as health check-ups and psychosocial counseling into payment collection processes would enhance its effectiveness.

Integrating geriatric and mental health services into primary healthcare would improve healthcare accessibility for older Nigerians (Ikeorji et al., Reference Ikeorji, Akah and Ramsey-Soroghaye2024). Training CHWs to identify and manage age-related depression and anxiety could help bridge the gap in specialized geriatric care. Expanding mobile health clinics, modeled after the Wellness-on-Wheels initiative, would provide routine screenings, mental health support and medication distribution to underserved areas. Introducing a subsidized older adult-care package under the NHIS would improve affordability and encourage participation.

Traditional and religious institutions should be leveraged to increase older adult-care accessibility. Community leaders can help identify at-risk seniors and facilitate enrollment in social programs, while age-grade associations could receive small grants to strengthen their support for older members. Religious organizations should be encouraged to establish Elder Fellowship Groups that provide social engagement, health education and access to welfare services. Training pastors and imams to recognize mental health symptoms and provide referrals would further bridge the gap between spiritual and professional support.

Public awareness campaigns are necessary to reduce stigma around mental health and encourage help-seeking behavior. Nationwide campaigns using radio, television, community dramas and religious platforms should emphasize that depression and anxiety are treatable medical conditions. Testimonies from respected older adults and religious figures could help normalize mental health interventions. Establishing “Elder Mental Health Ambassadors” in local communities would promote available services and guide seniors toward appropriate support systems.

Strengthening data collection and research is essential for evidence-based policymaking. Nigeria should conduct regular aging surveys to track mental health, living conditions and social support systems among older adults. Disaggregated data would enable targeted interventions for the most vulnerable groups. Additionally, evaluating pilot initiatives such as peer support groups and cash-plus-care models would provide insights into their effectiveness. Collaborations with universities and international research institutions could help build a robust evidence base for aging policies.

Ensuring transparency and accountability in social programs is critical for maintaining public trust. A monitoring and evaluation framework should be established to track service reach, beneficiary satisfaction and improvements in mental well-being. Independent civil society groups should be involved in tracking pension disbursements and older adult-care services. A digital dashboard, similar to Lagos State’s pension transparency system, could provide real-time updates for beneficiaries. Establishing whistleblower channels and a grievance redress mechanism would allow older adults to report service failures and receive timely assistance.

Limitation and future research

Some limitations in the present review should be noted. The first concerns the reliance on secondary data rather than primary empirical research. Although the study offers an integrative synthesis of available programs and policies, it does not present first-hand accounts of older adults who are directly affected by poverty and mental stress. While the review draws from documented interventions and government reports, the absence of primary fieldwork limits the ability to fully capture the lived realities and subjective meanings older adults attach to formal support systems. Future research should include qualitative interviews or ethnographic methods to gather narratives from older Nigerians, especially those in rural or marginalized settings, to provide richer, more grounded perspectives.

Another limitation is that the review, while drawing upon Social Capital Theory, did not empirically measure bonding, bridging, or linking social capital across different interventions. Although these categories helped conceptualize the role of formal social networks, their actual influence on mental stress reduction remains speculative. For instance, while religious networks were identified as sources of bridging capital, there is little evidence on how sustained participation in such networks affects long-term mental well-being. Future studies might explore how the frequency of interaction with faith-based institutions or perceptions of trust in state-led programs mediate the relationship between social capital and psychological outcomes.

A third limitation relates to the demographic and contextual scope of the literature reviewed. The analysis focused primarily on older adults in urban and semi-urban settings, with less attention to those in remote or conflict-affected regions, where access to formal support is more limited and where cultural interpretations of mental stress may differ. Future research should investigate how regional disparities, language diversity and local governance structures influence the uptake and outcomes of formal support programs. Expanding the geographic and cultural scope of research would strengthen the generalizability of findings and inform more regionally appropriate interventions.

The review also did not sufficiently disaggregate findings by gender or disability status. While older adults were examined as a collective demographic, evidence suggests that older women – particularly widows – and those living with physical or cognitive impairments may face distinct barriers in accessing formal social support. These populations may be more likely to be socially isolated, less economically independent and more vulnerable to institutional neglect. Future research should adopt an intersectional lens to explore how gender, disability, and socio-cultural status intersect to shape the accessibility and effectiveness of formal support systems for mental stress reduction.

Additionally, the review included limited discussion on how older adults navigate potential conflicts between formal interventions and cultural norms surrounding filial care. In some communities, receiving assistance from external agencies may be perceived as a sign of family failure or neglect, leading older individuals to resist formal support even when it is available. Future studies could investigate how cultural expectations around dignity, reciprocity and dependence influence older adults’ engagement with formal programs. Such insights would be especially valuable for designing interventions that align with local values while still meeting the psychosocial needs of aging populations.

Another limitation is the lack of systematic program evaluations in the reviewed literature. While initiatives like the National Social Safety Nets Project and various NGO-led outreach efforts were discussed, few have been independently assessed for impact, scalability, or sustainability. There is a need for longitudinal studies that evaluate not just program outputs but also long-term effects on older adults’ mental health, quality of life and social inclusion. These studies should consider using mixed-methods approaches to link quantitative outcome measures with qualitative insights into user satisfaction and lived experiences.

Finally, Nigeria currently lacks a national longitudinal aging survey that includes validated measures of mental stress, health service use and social support. The absence of such data creates significant gaps in national planning and obscures the full scale of older adults’ psychosocial needs. Future research should prioritize the development of aging-specific data systems that are disaggregated by age, gender, location and socioeconomic status. Doing so would provide an empirical foundation for targeted policy action and allow for better monitoring and evaluation of support programs.

Conclusion

The evolving landscape of aging in Nigeria accentuates the critical role of formal social networks in mitigating late-life mental stress. While traditional family-based support structures have historically provided financial and emotional security, shifts in economic patterns, urbanization and migration have increasingly strained these informal caregiving systems. In response, government programs, NGOs, and religious organizations have stepped in to bridge these gaps, offering financial aid, healthcare services and structured social engagement opportunities. The findings presented in this review suggest that targeted policy interventions can enhance the efficacy of these formal support systems. Expanding noncontributory pensions, streamlining access to healthcare through community-based outreach, and strengthening collaborations between government agencies and local organizations can improve service delivery and participation. Moreover, integrating culturally grounded interventions, such as leveraging religious institutions and indigenous community networks, can increase trust and accessibility among older Nigerians, many of whom remain skeptical of formal assistance.

The broader policy implications are clear. As Nigeria’s aging population continues to grow, a failure to adapt its social infrastructure will only deepen existing vulnerabilities, exacerbating financial hardship, social isolation and mental distress among older adults. A more coordinated, multisectoral approach, grounded in sustainable financing, cross-sector collaboration, and evidence-based policy design, can ensure that formal social networks function not as isolated interventions but as integral components of a more resilient and inclusive older adult-care system. Moving forward, investing in these frameworks will be essential not only for alleviating mental stress but also for safeguarding the dignity and well-being of Nigeria’s aging population.

Open peer review

To view the open peer review materials for this article, please visit http://doi.org/10.1017/gmh.2025.10012.

Data availability statement

This study did not involve primary data collection. All secondary data and references used in the study are publicly available and properly cited in the manuscript.

Author contribution

S.F. Conceptualized the study, developed the theoretical framework, conducted the literature review, and drafted the initial manuscript. M.S.: Contributed to data synthesis, provided critical revisions, and enhanced the analysis of formal social networks and Social Capital Theory. M.S.: Provided and assisted with manuscript editing, and ensured the inclusion of culturally relevant recommendations.

Financial support

No external funding was received for this study.

Competing interests

The authors declare no conflicts of interest related to this study.

Ethics statement

As this study is a perspective-based analysis, it did not require Institutional Review Board (IRB) approval. The research adheres to ethical guidelines for the use of secondary data and theoretical interpretations in academic work.

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Figure 0

Table 1. Selected formal social support networks in Nigeria compared to other African countries

Author comment: The role of formal social networks in mitigating age-related mental stress among older Nigerians living in poverty: Insights from social capital theory — R0/PR1

Published online by Cambridge University Press:  30 May 2025
DOI: https://doi.org/10.1017/gmh.2025.10012.pr1 [Opens in a new window]
Sunkanmi Adams Folorunsho [Opens in a new window] Sociology, University of Nebraska-Lincoln, United States
Revision round: 0
Role: author

Comments

Dear Editor-in-Chief,

I am pleased to submit our manuscript titled “The Role of Formal Social Networks in Mitigating Age-related Mental Stress Among Older Nigerians Living in Poverty: Insights from Social Capital Theory” for consideration for publication in Cambridge Prisms: Global Mental Health. This manuscript investigates the impact of formal social networks on alleviating age-related stress among older adults in Nigeria, a demographic increasingly affected by economic and social challenges.

Aging populations in low- and middle-income countries face significant stressors due to inadequate social support structures, and our study highlights the critical role that formal social networks can play in addressing these issues. Drawing from Social Capital Theory, the manuscript explores the effectiveness of formal interventions such as healthcare access, community aid, pension schemes, and community counseling in reducing mental health challenges among older Nigerians living in poverty.

This manuscript is original, has not been published before, and is not currently under consideration for publication elsewhere. I believe it is well-suited to the scope of Cambridge Prisms: Global Mental Health given the journal’s focus on mental health issues, global perspectives, and policy implications. The insights offered could inform policies and interventions aimed at enhancing the well-being of aging populations, not only in Nigeria but in other resource-poor settings.

Review: The role of formal social networks in mitigating age-related mental stress among older Nigerians living in poverty: Insights from social capital theory — R0/PR2

Published online by Cambridge University Press:  30 May 2025
DOI: https://doi.org/10.1017/gmh.2025.10012.pr2 [Opens in a new window]
Reviewer_1
Date of review:  17 October 2024
Revision round: 0
Role: reviewer
Recommendation/decision: major-revision

Conflict of interest statement

Nil

Comments

I am really pleased to be reading this article. The manuscript, titled “Role of Formal Social Networks in Mitigating Age-Related Mental Stress Among Older Nigerians Living in Poverty: Insights from Social Capital Theory,” is both timely and significant. Firstly, I want to commend the authors for their outstanding work and for initiating a conversation on this crucial topic regarding the mental health of older adults. However, I have some feedback:

The topic appears to be objectifying the population of older adults. Firstly, it would be helpful to clarify the author’s definition of “mental stress” and “older Nigerians” and how the author classified older Nigerians. The abstract seems somewhat disjointed. It would greatly benefit from clearly articulating the main problem that this paper aims to address and what makes the idea unique. This would help capture the issues that could influence policy directives more effectively.

In the introduction section of the manuscript, several ageist statements are made, such as ‘knotty.’ It may be beneficial to reconsider the language used to avoid any derogatory implications for the status of older adults in Nigeria. Furthermore, it would be helpful to clearly define who is considered elderly and the age classification of older adults in Nigeria. Boldly addressing the issues and problems associated with the formal provision of support for older adults in Nigeria and how this can improve their mental health would enhance the paper’s impact.

What makes this paper unique? Exploring what the existing literature tells us about formalized support and how this support translates into either improvement or counterproductivity to the well-being of older adults in Nigeria would enrich the discussion. What does the policy or human rights legislation have to offer regarding the mental health and care of older adults in Nigeria? It would also be beneficial to consider the implications of the newly established National Senior Citizens Centre.

To enhance this paper, I suggest focusing on critically conceptualizing formalized support for older adults. Additionally, considering a theoretical paradigm that moves our thinking away from Eurocentric social capitalization theory to a more Afrocentric philosophical idea about supporting the mental health and well-being of older adults in Nigeria would be thought-provoking.

If the authors can critically examine the contextual factors that either inhibit or facilitate formal support services for older adults in Nigeria, this paper will undoubtedly make a valuable contribution to the field of mental health services for older adults in Nigeria.

Review: The role of formal social networks in mitigating age-related mental stress among older Nigerians living in poverty: Insights from social capital theory — R0/PR3

Published online by Cambridge University Press:  30 May 2025
DOI: https://doi.org/10.1017/gmh.2025.10012.pr3 [Opens in a new window]
Reviewer_2
Date of review:  30 October 2024
Revision round: 0
Role: reviewer
Recommendation/decision: major-revision

Conflict of interest statement

Reviewer declares none.

Comments

The manuscript provides an examination of the challenges faced by older Nigerians in accessing formal social support. The integration of Social Capital Theory is insightful, offering a strong framework for understanding the role of formal networks in mitigating age-related stress. Below, I provide section-by-section feedback on potential areas for improvement.

Introduction

• The introduction might be strengthened by further elaborating on Social Capital Theory’s relevance to Nigerian culture specifically.

• Although a general theoretical background is offered, connecting it more directly to the cultural dimensions of Nigerian society could enhance the theoretical framework’s applicability.

• On page 1, lines 46-49, use more suitable research citations from the Nigerian setting.

• The figure on poverty rates (p. 4) is not well-integrated with the narrative text. The description does not include sufficient analysis of how the data specifically affects the aging population, which would make the data more relevant.

• The introduction mentions that “over 40% of the population lives below the poverty line,” citing the National Bureau of Statistics, but the citation (2020) is arguably outdated. If more recent data are available, they would enhance the paper’s relevance.

Contextualizing Poverty and Aging in Nigeria

• While the economic challenges are well-articulated, there is limited discussion on psychological impacts specific to poverty and aging, which would help reinforce the mental health dimension of the study.

Impact of Poverty on Older Adults' Health

• A more detailed analysis of specific barriers to healthcare (e.g., cultural stigmas around mental health) could improve the section’s relevance to the study’s focus on mental health.

• A clearer distinction between informal support insufficiencies and potential roles for formal systems would enhance the reader’s understanding.

• Page 7, line 35, write NGO in full before subsequent abbreviations.

The Role of Formal Social Networks in Supporting Older Nigerians

• The section might benefit from a more systematic assessment of Nigeria’s current social programs, specifically analyzing why these systems fall short and identifying actionable steps for improvement.

• Also, discussing potential challenges to implementing new formal social networks (e.g., political, economic) could provide a more balanced viewpoint.

• The caption and content are informative, yet some example columns lack context. Clarifying how each program (e.g., NSITF and NHIS) would specifically apply to Nigerian elder care would help ensure relevance.

• In comparing Nigeria’s social systems with those in other African countries, more specific statistics would strengthen the argument. For example, if the Old Age Grant in South Africa significantly reduced poverty in older adults, providing specific data would clarify the impact.

Social Capital Theory

• The authors could strengthen this section by explaining more precisely how each form of social capital could directly mitigate mental stress.

• More examples specific to the Nigerian context (e.g., traditional support networks) could help clarify how Social Capital Theory operates practically within Nigerian communities.

Conclusion

• Summarizing potential challenges in implementing these recommendations, along with proposed solutions, would provide a more actionable and forward-looking conclusion.

Proofread for grammatical errors. For example:

• In the abstract, the phrase “Drawing from the insights from Social Capital Theory, this study point to” contains a subject-verb agreement error. It should read “this study points to.”

• In phrases like “Drawing from the insights from Social Capital Theory,” the preposition “from” is repeated unnecessarily. It should be “Drawing on insights from Social Capital Theory.”

• Throughout the manuscript, there is inconsistent use of terms such as “elderly,” “older adults,” and “aging population.” Standardizing these terms would improve clarity. Also, using the term ‘elderly’ when describing older adults is no longer acceptable.

• There is some inconsistency in referring to the National Health Insurance Scheme as both “NHIS” and its full form in various sections. Choosing and using one term consistently after the initial mention would help with readability.

• The reference style/formatting is inconsistent.

Review: The role of formal social networks in mitigating age-related mental stress among older Nigerians living in poverty: Insights from social capital theory — R0/PR4

Published online by Cambridge University Press:  30 May 2025
DOI: https://doi.org/10.1017/gmh.2025.10012.pr4 [Opens in a new window]
Reviewer_3
Date of review:  04 November 2024
Revision round: 0
Role: reviewer
Recommendation/decision: major-revision

Conflict of interest statement

Reviewer declares none.

Comments

Thank you for the opportunity to review this manuscript. This is a well written paper. The suggestions (figure 2 - should be ‘table 2’) and description of the relevance of Social Capital Theory for this topic are great.

My main comments are:

- The study is about stress but this is never defined. Please define this.

- Traditional/historical availability of family support is mentioned repeatedly. Please provide some relevant references to backup this claim. I am not very familiar with the Nigerian context but in India the absolute availability of family support has been refuted (see Penny Vera-Sanso’s work)

- Generally a lot of statements are made without any references to support them (e.g., that adults are left to manage their conditions which leads to worsening health in Nigeria, that norms restrict women’s opportunities in northern Nigeria ) / with old references (e.g., a 2004 reference regarding rising inflation) / references to studies conducted in other countries. Please ensure that all statements are referenced appropriately.

- Some points are repeated throughout the paper, please try and streamline the paper structure and points made

Recommendation: The role of formal social networks in mitigating age-related mental stress among older Nigerians living in poverty: Insights from social capital theory — R0/PR5

Published online by Cambridge University Press:  30 May 2025
DOI: https://doi.org/10.1017/gmh.2025.10012.pr5 [Opens in a new window]
Primrose Nyamayaro [Opens in a new window] University of Zimbabwe Faculty of Medicine, Zimbabwe
Date of review:  05 November 2024
Revision round: 0
Role: Handling Editor
Recommendation/decision: major-revision

Comments

No accompanying comment.

Decision: The role of formal social networks in mitigating age-related mental stress among older Nigerians living in poverty: Insights from social capital theory — R0/PR6

Published online by Cambridge University Press:  30 May 2025
DOI: https://doi.org/10.1017/gmh.2025.10012.pr6 [Opens in a new window]
Dixon Chibanda [Opens in a new window] London School of Hygiene & Tropical Medicine, United Kingdom of Great Britain and Northern Ireland
Revision round: 0
Role: Editor in Chief
Recommendation/decision: major-revision

Comments

No accompanying comment.

Author comment: The role of formal social networks in mitigating age-related mental stress among older Nigerians living in poverty: Insights from social capital theory — R1/PR7

Published online by Cambridge University Press:  30 May 2025
DOI: https://doi.org/10.1017/gmh.2025.10012.pr7 [Opens in a new window]
Sunkanmi Adams Folorunsho [Opens in a new window] Sociology, University of Nebraska-Lincoln, United States
Revision round: 1
Role: author

Comments

No accompanying comment.

Review: The role of formal social networks in mitigating age-related mental stress among older Nigerians living in poverty: Insights from social capital theory — R1/PR8

Published online by Cambridge University Press:  30 May 2025
DOI: https://doi.org/10.1017/gmh.2025.10012.pr8 [Opens in a new window]
Reviewer_1
Date of review:  08 January 2025
Revision round: 1
Role: reviewer
Recommendation/decision: major-revision

Conflict of interest statement

Nil

Comments

Thank you for giving me the opportunity to review this manuscript for a second time. I appreciate the authors' efforts to incorporate improvements into the manuscript. However, I feel that there are still areas where clarity and refinement would significantly enhance the work. I also suggest submitting a version of the manuscript with tracked changes, which would make it easier to follow the revisions.

Abstract

The abstract still feels somewhat fragmented. For instance, the concept of “mental stress” requires clearer definition. Is it synonymous with mental illness, or does it refer to something different? Providing a concise explanation would help the reader better understand the scope of your work. Additionally, while you have outlined key actions—such as strengthening formal structures, improving coordination, and fostering culturally sensitive approaches—the abstract lacks a clear “so what” factor. Why should the reader care? What are the consequences of inaction? Strengthening the takeaway message here would add impact.

Also, a quick note: the keywords need to follow APA formatting guidelines. You can refer to the APA resource: https://apastyle.apa.org/instructional-aids/abstract-keywords-guide.pdf

The introduction is well-written, but conceptually, I remain unclear about the core idea of “mental stress” among older adults. What makes this issue unique in the Nigerian context? Moreover, why is your commentary paper particularly significant? What should researchers and policymakers (especially those you classify as formal social networks) learn from this? Most importantly, what are the risks if this issue is ignored? Adding these dimensions would greatly strengthen the manuscript’s relevance.

Age-Related Mental Stress Among Older Adults in Nigeria: This section is somewhat confusing. It’s not entirely clear whether your goal is to highlight existing empirical evidence or to argue for increased attention to the mental stress of older adults in Nigeria. If the latter, what specific gaps did you identify in the literature? And what are the implications of these gaps for policy and care for older adults in Nigeria? Additionally, most of the studies you cited are focused on mental health broadly, rather than mental stress specifically. The studies largely center on hospital settings, with only one addressing a community-based context. For instance, you mentioned the work of Animasahun and Chapman (2017), but this was not a multi-state study. Furthermore, there is a significant body of research on older adults’ mental health during COVID-19 that you seem to have missed. Including these would provide a more comprehensive foundation for your arguments. Again, ask yourself: who were these studies investigating, where were they conducted, how were they designed, and what were their key findings? Addressing these questions would improve the manuscript’s depth.

The section on formal social networks in Nigeria had some inaccuracies that need to be addressed. For example, the Association of Reproductive and Family Health does not provide services specifically for older adults. Furthermore, how have you conceptualized “formal structures”? You mentioned landlord associations, community development groups, and the Egbe Ajo system—are these not formal structures? These associations are typically governed by constitutions and legal frameworks, and many are registered organizations in Nigeria. It’s important to note that formal structures don’t necessarily need to be government-affiliated. This distinction should be clarified. Additionally, while formal social support for older adults living with mental illness is gradually emerging, the manuscript would benefit from examples of novel social support initiatives in Nigeria. For instance, you could highlight the psychogeriatric clinic at the first geriatric center in Africa. It would also be helpful to include more concrete examples of existing mental health support activities for older adults. I feel the manuscript overemphasizes the challenges related to mental health among older adults, while overlooking the broader context. For instance, the activities of NGOs like MANI (which you mentioned) are youth-focused, and they currently lack targeted support for older adults. A more balanced discussion of the existing efforts and gaps would provide a fuller picture.

There is considerable repetition throughout the manuscript, which needs to be addressed. A shorter, more concise version with tracked changes would improve readability. While the manuscript has great potential, these corrections are necessary to strengthen its contribution to understanding the intersection of poverty and mental health crises among older adults in Nigeria.

Review: The role of formal social networks in mitigating age-related mental stress among older Nigerians living in poverty: Insights from social capital theory — R1/PR9

Published online by Cambridge University Press:  30 May 2025
DOI: https://doi.org/10.1017/gmh.2025.10012.pr9 [Opens in a new window]
Reviewer_2
Date of review:  25 January 2025
Revision round: 1
Role: reviewer
Recommendation/decision: reject

Conflict of interest statement

The first author contacted me to connect recently. While I briefly met with the author, we did not discuss this manuscript. After our meeting and while working on this review, I realized it was the same person.

Comments

Minor comments:

• Some statements lack citations or appropriate citations. For example, add citations on page 28, lines 47-51.

• Be consistent with the citation format used for this manuscript. Some in-text citations missed proper citations. For example, (UN, 2020) should be (United Nations, 2020). Also, (Abubakar, 2022) had more than one author and should be cited accordingly.

• Check that you are using appropriate terms. For example, “elderly” is frowned upon nowadays as an ageist term. Yet, it is a keyword for this manuscript.

Major comments:

• The narratives in the different sections are not adequately tied back to the three aims of the paper. Also, the transition from some sections/subheadings to the next is very disconnected, detracting from its readability.

• The comparative analysis (Table 1) is underexplored and lacks critical evaluation of why Nigerian programs lag behind.

• The repetitive use of “bonding,” “bridging,” and “linking” social capital without clear differentiation may confuse non-specialist readers. In this manuscript, technical terms like “bonding social capital,” “bridging social capital,” and “linking social capital” are essential but could benefit from consistent and concise definitions to aid readability.

o For example, “Bonding social capital involves close relationships, such as family or community ties, which serve as primary support systems (Bourdieu, 1986).” Page 15, lines 5-8.

o Another example, “Bridging social capital, which links diverse groups and institutions, is particularly relevant in addressing the mental health needs of older Nigerians who face geographic isolation, financial constraints, and cultural stigma.” Page 42, lines 15-22.

• Which of the World Bank-referenced citations is this sentence referring to? “In 2020, Nigeria had approximately 9.5 million older adults, a figure projected to double by 2050 (World Bank, 2022).” You have World Bank 2020 and World Bank 2023 in the reference list.

• The paper may benefit from expanding the section about Nigeria’s NHIS in the sentence, "Comparatively, Nigeria’s NHIS covers less than 5% of the population, with minimal impact on older adults due to limited rural outreach and challenges in enrollment (Adesanya et al., 2023)." What other reasons are there for why Nigeria’s NHIS is lagging? E.g., funding constraints, corrupt practices, cultural and socioeconomic barriers, etc.

• Check the sentence "Groups like the Christian Rural and Urban Development Association of Nigeria (CRUDAN) and Jama’atu Nasril Islam (JNI) offer vital services, including food assistance, medical outreaches, and spiritual counseling (Morse et al., 2023)." Though the cited article highlights leveraging support by Faith-Based Social Groups in rural villages in Nigeria, it does not explicitly mention the groups listed in the sentence. Reconsider properly citing this paper or another appropriate study.

• The introductory paragraph on Social Capital Theory and the section on Social Capital Theory is repetitive.

• Sato et al.’s (2019) study was conducted in Japan and based on Japanese experiences. Yet, it was used as a citation for the informal economic networks in Nigeria. Page 41, lines 20-22.

• The paper mentions the Sankofa philosophy in this sentence: “In the context of older Nigerians, the Sankofa philosophy highlights the value of honoring elders' experiences and knowledge while leveraging time-tested communal support systems.” What are the types of time-tested communal support systems?

• The authors should explain what traditional care models mean here: “It encourages societies to integrate traditional care models into modern frameworks, ensuring that cultural practices continue to sustain aging populations (Adam-Taylor et al., 2024; Asante, 2023).”

• The second recommendation, improving healthcare access for older adults in rural Nigeria, is not linked to social support. How can this support the formal social networks examined in the paper? The recommendation should focus on how healthcare access will enhance social support.

• “Training local residents, including retired healthcare workers, as community health volunteers can further bridge gaps, providing education and connecting older adults to formal healthcare systems.” Provide specific context on which gaps this sentence refers to and how connecting older adults to formal healthcare systems improves their social networks.

• Avoid redundancy by combining similar recommendations.

o The fourth and fifth recommendations are the same and should be collapsed into one.

o The sixth recommendation can also be collapsed into the third recommendation.

• For the seventh recommendation, the sentence “Research should also incorporate African perspectives on aging and community care, ensuring culturally relevant solutions. The authors should explain what ”African perspectives" mean here, tying that back to the study’s focus. Also, since the focus is on Nigeria, with a Table showing how the Nigerian system differs from other African countries such as South Africa, it makes better sense to argue for recognizing the Nigerian perspective. Africa is not monolithic.

• The paper lacks clear connection between the recommendations and the three aims of the paper..

• The conclusion introduces no new insights or critical reflections. Include a reflective discussion on the study’s limitations and areas for future research.

Recommendation: The role of formal social networks in mitigating age-related mental stress among older Nigerians living in poverty: Insights from social capital theory — R1/PR10

Published online by Cambridge University Press:  30 May 2025
DOI: https://doi.org/10.1017/gmh.2025.10012.pr10 [Opens in a new window]
Primrose Nyamayaro [Opens in a new window] University of Zimbabwe Faculty of Medicine, Zimbabwe
Date of review:  12 February 2025
Revision round: 1
Role: Handling Editor
Recommendation/decision: major-revision

Comments

No accompanying comment.

Decision: The role of formal social networks in mitigating age-related mental stress among older Nigerians living in poverty: Insights from social capital theory — R1/PR11

Published online by Cambridge University Press:  30 May 2025
DOI: https://doi.org/10.1017/gmh.2025.10012.pr11 [Opens in a new window]
Dixon Chibanda [Opens in a new window] London School of Hygiene & Tropical Medicine, United Kingdom of Great Britain and Northern Ireland
Revision round: 1
Role: Editor in Chief
Recommendation/decision: major-revision

Comments

No accompanying comment.

Author comment: The role of formal social networks in mitigating age-related mental stress among older Nigerians living in poverty: Insights from social capital theory — R2/PR12

Published online by Cambridge University Press:  30 May 2025
DOI: https://doi.org/10.1017/gmh.2025.10012.pr12 [Opens in a new window]
Sunkanmi Adams Folorunsho [Opens in a new window] Sociology, University of Nebraska-Lincoln, United States
Revision round: 2
Role: author

Comments

No accompanying comment.

Review: The role of formal social networks in mitigating age-related mental stress among older Nigerians living in poverty: Insights from social capital theory — R2/PR13

Published online by Cambridge University Press:  30 May 2025
DOI: https://doi.org/10.1017/gmh.2025.10012.pr13 [Opens in a new window]
Reviewer_1
Date of review:  24 March 2025
Revision round: 2
Role: reviewer
Recommendation/decision: accept

Conflict of interest statement

No

Comments

The author should confirm that grammatical errors are checked and verified.

Recommendation: The role of formal social networks in mitigating age-related mental stress among older Nigerians living in poverty: Insights from social capital theory — R2/PR14

Published online by Cambridge University Press:  30 May 2025
DOI: https://doi.org/10.1017/gmh.2025.10012.pr14 [Opens in a new window]
Primrose Nyamayaro [Opens in a new window] University of Zimbabwe Faculty of Medicine, Zimbabwe
Date of review:  03 April 2025
Revision round: 2
Role: Handling Editor
Recommendation/decision: minor-revision

Comments

Please may you address reviewer 2’s comment on including a reflective discussion on the study’s limitations and areas for future research.

Decision: The role of formal social networks in mitigating age-related mental stress among older Nigerians living in poverty: Insights from social capital theory — R2/PR15

Published online by Cambridge University Press:  30 May 2025
DOI: https://doi.org/10.1017/gmh.2025.10012.pr15 [Opens in a new window]
Dixon Chibanda [Opens in a new window] London School of Hygiene & Tropical Medicine, United Kingdom of Great Britain and Northern Ireland
Revision round: 2
Role: Editor in Chief
Recommendation/decision: minor-revision

Comments

No accompanying comment.

Author comment: The role of formal social networks in mitigating age-related mental stress among older Nigerians living in poverty: Insights from social capital theory — R3/PR16

Published online by Cambridge University Press:  30 May 2025
DOI: https://doi.org/10.1017/gmh.2025.10012.pr16 [Opens in a new window]
Sunkanmi Adams Folorunsho [Opens in a new window] Sociology, University of Nebraska-Lincoln, United States
Revision round: 3
Role: author

Comments

No accompanying comment.

Recommendation: The role of formal social networks in mitigating age-related mental stress among older Nigerians living in poverty: Insights from social capital theory — R3/PR17

Published online by Cambridge University Press:  30 May 2025
DOI: https://doi.org/10.1017/gmh.2025.10012.pr17 [Opens in a new window]
Primrose Nyamayaro [Opens in a new window] University of Zimbabwe Faculty of Medicine, Zimbabwe
Date of review:  29 April 2025
Revision round: 3
Role: Handling Editor
Recommendation/decision: accept

Comments

No accompanying comment.

Decision: The role of formal social networks in mitigating age-related mental stress among older Nigerians living in poverty: Insights from social capital theory — R3/PR18

Published online by Cambridge University Press:  30 May 2025
DOI: https://doi.org/10.1017/gmh.2025.10012.pr18 [Opens in a new window]
Dixon Chibanda [Opens in a new window] London School of Hygiene & Tropical Medicine, United Kingdom of Great Britain and Northern Ireland
Revision round: 3
Role: Editor in Chief
Recommendation/decision: accept

Comments

No accompanying comment.