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17 of 24 Background: Socially vulnerable groups such as immigrants have been shown to have higher rates of morbidity and mortality in Norway and the health of elderly migrants has been identiﬁed as worse than that of the general older population. Elderly African immigrants are facing exceptional challenges as they are mostly new to Norway with limited knowledge on how to become socially active in this very strange environment. Therefore, they need to be targeted in health promotion programmes, through interventions that are sensitive to their circumstances, backgrounds and culture. African elderly immigrants are from cultures where age is considered beneﬁcial. In such cultures, one’s position in the society is determined by one’s age; the older the person is, the higher of his position in the decision making hierarchy (1). As this age-advantage may be lost in migration, such groups are often exposed to isolation and subsequent ill-health (2). Therefore, civic participation by means of membership in community organizations and volunteering may provide them an environment where they can enjoy active community roles similar to that they had in their home countries. The aim of the project is to create activities and promote social interaction, through civic participation, for elderly African immigrants in Oslo, at the age of ≥60, with the aim being to counteract loneliness, passivity and social withdrawal. Prior studies have associated membership in voluntary organizations with indicators of good health (3) and wellbeing in the elderly (4). This type of social engagement was found to have protective effects against cardiovascular disease mortality independent of socio-economic factors, disease and disability (5). A study among older people in Ireland associated social engagement with better quality of life, self-rated happiness and the view that life is worth living (6). A national representative panel data study of the long-term impacts of volunteerism on self-rated health among elderly persons found increased life satisfaction and greater positive changes in perceived health (7). Furthermore, civic engagement is considered particularly important for elderly immigrants who often face special difﬁculties in establishing themselves in new cultures (8). A prior study in Oslo found that elderly African immigrants in Oslo face a common impasse in accessing civic engagement with resultant unwanted isolations (9). The study underlined that elderly immigrants can pursue healthy ageing if organizations and civil societies enact active ageing programs that enhance the participation of elderly people. One goal of the Norwegian plan of action for integration and social inclusion of the immigrant population is to ensure that everyone living in Norway, regardless of their age or gender has equal opportunity, rights and duties to participate in society and make use of their skills (10). Prior study in Oslo highlighted the traditional role of African elders which involve mediating family conﬂicts and solving family issues, as well as advising youth and preventing them from joining criminal gangs and becoming drug dealers (9). The study suggested that if organizations create such service programs for elderly immigrants, it may not only provide opportunities for them to use their lifetime experiences and skills to help address challenges faced by immigrants and refugees, but it may also inﬂuence their self- perception, provide them networks, activities and as result improve their overall wellbeing (9). In response to this, African Health Organization tend to implement a project aimed at creating activities and promoting social interaction for elderly African immigrants at the age of ≥60 to counteract loneliness, passivity and social withdrawal. Stimulating civic participation of elderly African immigrants in Oslo and Akershus

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