Mental resilience among caregivers of older persons in contexts of structural precarity: A qualitative study from Ghana, Malawi, and Nigeria

Population ageing is accelerating across sub-Saharan Africa, yet caregivers of older persons there continue to provide care under conditions of severe structural precarity. However, their mental resilience remains poorly understood and largely invisible within national health and gerontological discussions. Also, less attention has been paid to how caregivers sustain resilience while navigating these structural constraints. This study explored how caregivers of older persons in Ghana, Malawi, and Nigeria experience, interpret, and sustain mental resilience within informal and formal caregiving contexts. With two research questions guiding this study and drawing on Social Ecological Resilience, a qualitative instrumental case study design was employed. Data were collected through semi-structured interviews with 27 caregivers across the specific areas of the countries. Participants were recruited through purposive and convenience sampling, while data were analysed using Reflexive Thematic Analysis. Three interconnected themes were identified. Internal coping resources, relational and care dynamics, and structural, cultural, and systemic conditions. These findings demonstrate that caregivers’ mental resilience is not solely an individual attribute but a dynamic process shaped by interactions between personal and external resources. Hence, to strengthen caregiver mental well-being, social protection policy, and the goals of the UN Decade of Healthy Ageing and sustainable development, it is necessary to integrate caregiver support into health and social care systems. It is also important to recognise community-based support structures and address structural inequalities that sustain caregiving precarity.