**4. Access to reliable healthcare financing statistics**

Globally, universal access to reliable healthcare financing has not been achieved and the proportion of people who have access to reliable healthcare financing vary from one country to another. Also, the varied rate of access across countries were unequally distributed and disadvantaged or vulnerable people were most denied access, including older people [17, 21]. For example, a study conducted among people aged 50+ years with chronic illness in six middle-income countries showed that access rates were unevenly distributed except in South Africa where primary healthcare was free for all [17]. Specifically, the study demonstrated that the proportion of older people with access to basic chronic care ranged from 20.6 per cent in Mexico to 47.6 per cent in South Africa. In another study among formal sector workers in Ilorin, Nigeria, it was shown that only 13.5 per cent of the respondents had access to reliable healthcare financing [21]. This proportion excluded the elderly population because they were no more members of the federal civil servants considering their retirement status and hence, lacked access to reliable healthcare financing. Ensuring that elderly population are provided with and have access to reliable healthcare financing is therefore crucial especially as the African society experiences demographic change in favour of older people.

Existing studies have not shown consensus on the factors determining access to reliable healthcare services among the elderly. While some agree that education, place of work, residence, income, age, number of general practitioners, sex, social network and social participation determine access to healthcare financing and services, some other scholars disagree to some of these factors. For examples, a study carried out in Ilorin, Nigeria established that respondents who had post-secondary education and who were in the federal civil service were more likely to have access to reliable healthcare financing [21]. This shows that illiterate older people might be denied access to reliable healthcare financing even if exempted from health insurance premium and the elderly who are not in federal civil service might not have the opportunity of being enrolled in health insurance scheme, which provides reliable healthcare financing. Another study conducted among the older Chinese indicated that income group, educational attainment, age-category, marital status, gender, and geographical location influence access to reliable healthcare financing [7]. Inability to access reliable healthcare financing is detrimental to population health and especially to vulnerable older people. Recent statistics in Nigeria showed that only very small proportion of the total population in Nigeria had access to reliable healthcare financing [22]. This is worrisome as it indicates high health inequality. Since pooled resources is the only reliable and sustainable source of healthcare financing [12], provision of, and access to, pooled resources becomes vitally imperative. It is important to note that differential in access to reliable healthcare financing and other social resources is influenced by many factors [23], and these are discussed in next section.
