China, People's Republic of: Strategic Elderly Care Services Development in Yichang

Sovereign Project | 48004-001

Summary

The TA will assist the Yichang Municipal Government (YMG) in preparing an elderly service strategic development plan, covering institutional, community, and home-based services (including opportunities to initiate public-private partnerships). The TA will (i) review national and international experience on elderly care to learn from best practices and assess whether some measures can be transferred or adapted to fit the local context; (ii) provide capacity development for officials of the Yichang municipality to increase their understanding of tools to assess needs, plan, and implement elderly care services; (iii) review and update the Yichang elderly service facilities construction plan; and (iv) disseminate findings.

Latest Project Documents

Consulting Notices

See also: CMS

No notices are currently available for this project.

Procurement Notices

See also: Operational Procurement

No notices are currently available for this project.

Procurement Documents

No documents of this type are currently available for this project.


Project Data Sheets (PDS) contain summary information on the project or program. Because the PDS is a work in progress, some information may not be included in its initial version but will be added as it becomes available. Information about proposed projects is tentative and indicative.

The Public Communications Policy (PCP) recognizes that transparency and accountability are essential to development effectiveness. It establishes the disclosure requirements for documents and information ADB produces or requires to be produced.

The Accountability Mechanism provides a forum where people adversely affected by ADB-assisted projects can voice and seek solutions to their problems and report alleged noncompliance of ADB's operational policies and procedures.

In preparing any country program or strategy, financing any project, or by making any designation of, or reference to, a particular territory or geographic area in this document, the Asian Development Bank does not intend to make any judgments as to the legal or other status of any territory or area.

Project Name Strategic Elderly Care Services Development in Yichang
Project Number 48004-001
Country China, People's Republic of
Project Status Approved
Project Type / Modality of Assistance Technical Assistance
Source of Funding / Amount
TA 8672-PRC: Strategic Elderly Care Services Development in Yichang
Technical Assistance Special Fund US$ 350,000.00
Strategic Agendas Inclusive economic growth
Drivers of Change Governance and capacity development
Private sector development
Sector / Subsector

Health - Health care finance - Health insurance and subsidized health programs

Water and other urban infrastructure and services - Urban policy, institutional and capacity development

Gender Equity and Mainstreaming Effective gender mainstreaming
Description The TA will assist the Yichang Municipal Government (YMG) in preparing an elderly service strategic development plan, covering institutional, community, and home-based services (including opportunities to initiate public-private partnerships). The TA will (i) review national and international experience on elderly care to learn from best practices and assess whether some measures can be transferred or adapted to fit the local context; (ii) provide capacity development for officials of the Yichang municipality to increase their understanding of tools to assess needs, plan, and implement elderly care services; (iii) review and update the Yichang elderly service facilities construction plan; and (iv) disseminate findings.
Project Rationale and Linkage to Country/Regional Strategy

The main demographic challenges facing the PRC in this century are the dramatic aging of its population and the scale of internal migration largely driven by urbanization. The proportion of people above the age of 60 across the PRC is expected to grow from roughly 12% to 34% from 2010 to 2050. Aging in the PRC is happening at an accelerated pace when the per capita income is still modest and social security systems, although wide in population coverage, are still insufficient to cover the financial needs of retired senior citizens as illustrated by the Yichang experience. The high cost of care for the elderly will require long-term care financial coverage mechanisms to avoid major inequities in the way people experience their life as seniors. The current acute shortage of caregivers and nurses specialized in elderly care is exacerbated by compensation level and working conditions that make these professions unattractive.

The PRC has addressed aging of the population and its consequences since the late 1970s with successive policies to finance old age care, stimulate private sector participation, define families' responsibilities, and organize community-wide responses to support the elderly. The PRC's 12th Five-Year Plan further recognizes these challenges. It calls for the establishment of an old age care system (with targets for home-based care, community care, institutional care); expanding grassroots aging associations; encouraging volunteerism among senior citizens; and improving health management services.

The 2012 revision of the Elderly Law, includes requirements for local governments to develop community services for senior citizens. The recent opinions of the State Council (September 2013) to accelerate the development of the elderly care service industry recognizes the progress made and the significant challenges that still exist. It includes a comprehensive list of policy directions; sets development goals; describes organization and management arrangements; and assigns responsibilities to combine public, private, and civil society efforts.

Traditionally children have the prime responsibility to care for their parents' medical and nonmedical needs (e.g., activities of daily living, emotional, and financial). Children's responsibility is challenged by several factors such as small family size due, among others, to the one child policy, high labor force mobility, high labor participation rate of women, increasing financial burdens on the families of children with the duty to care, and the eroding importance of filial piety. Support provided by the government for poor elderly includes (i) payment of social pension for poor rural and urban citizens; (ii) provision of residential or community-based care services for selected elderly living on social assistance; and (iii) support to the most destitute, including childless old people; and elderly whose children live in poverty as well.

Currently only childless elderly living on social assistance such as the Three Nos in the cities and Five Guarantees households in the countryside are provided residential or community-based care services by the government. Other elderly dibao recipients are generally ineligible for care subsidies by the government. Obviously, there is a need for the government to expand subsidies to these old people and to other low-income households slightly above the poverty threshold (marginal poor).

The Municipality of Yichang, Hubei Province submitted a project proposal to the Asian Development Bank (ADB) through the Ministry of Finance to provide technical assistance to strengthen local policies and strategies, and to prepare a comprehensive plan and a way forward for the municipality to address elderly care issues for the urban population. Hubei Province has recommended Yichang to become a model city for the provision of elderly care in the PRC. The TA findings will potentially be replicable in Hubei and nationally, and will contribute to the growing body of knowledge on financing elderly care in the PRC. In 2012, Yichang Municipality had a total population of over 4.00 million, an urban population of 1.34 million, and senior citizens over 60 years of age reached 652,100, representing about 16.06% of the overall population and above the national average of 13.70%. The Municipality adopted an elderly service facilities construction plan in urban areas of Yichang City in accordance with the 12th Five-Year Plan of the PRC.

Impact The elderly care system is more inclusive and affordable in Yichang.
Project Outcome
Description of Outcome A balanced elderly services strategic development plan (covering infrastructure, community, and home-based care) for Yichang
Progress Toward Outcome New strategies and approaches to elderly care have been discussed with the YMG and private and civil society stakeholders. A clear path to the drafting of the strategic development plan for elderly care in Yichang has been agreed on. Concepts like aging in place, healthy aging, and aging mainstreaming will be adopted. Strategies on private sector engagement, affordabliity, quality of long-term care, quality and safety monitoring, IT platforms for home-based care and community care, sustainable financing, and human resources development for elderly care have been thoroughly discussed and agreed on. Over the next 7 months, the TA will provide intensive advisory support to develop the plan in cooperation with the YMG and other stakeholders.
Implementation Progress
Description of Project Outputs

1. Study report on national and international experience on elderly care services

2. Capacity development to plan elderly care services for concerned officials of Yichang Municipal Government

3. Elderly service facilities construction plan of Yichang reviewed and updated into a strategic development plan

4. Dissemination of findings

Status of Implementation Progress (Outputs, Activities, and Issues)

Output 1

The study report on international and national experience is developed and was discussed extensively with YMG.

Output 2

The TA provided training to YMG officials, bureaus, and agencies involved in elderly care. The overseas study tour will take place in Q2 2015.

Output 3

See outcome section.

Geographical Location
Summary of Environmental and Social Aspects
Environmental Aspects
Involuntary Resettlement
Indigenous Peoples
Stakeholder Communication, Participation, and Consultation
During Project Design A reconnaissance mission took place in Yichang City, Hubei Province from 24 February 3 March 2014 to formulate the proposed policy and advisory technical assistance. A Memorandum of Understanding was signed with YMG on 3 March 2014. The mission held meetings with YMG; Yichang Finance Bureau; the bureaus of Civil Affairs, Development and Reform Commission, Human Resources and Social Security; the Poverty Bureau, Public Health Bureau; the Council on Aging, School of Nursing of the Three Gorges College of Profession and Technology; and private sector representatives. The mission visited Yichang's social welfare institution, several private not-for-profit elderly care apartments, community elderly care services, and several hospitals in Yichang providing geriatric health care, and conducted two focus group discussions with a group of elderly citizens and social welfare officers involved in elderly care.
During Project Implementation Regular meetings and seminars are being held involving concerned Yichang government bureaus and agencies, relevant educational institutions, and private sector representatives. Dissemination of TA achievements will be ensured through two workshops during the preparation of the Yichang elderly care services strategic development plan, the preparation of a knowledge product on elderly care systems development in PRC, and a final conference on TA findings with local, provincial, national, and international experts. A survey of the needs of the elderly and the availability of adequate elderly care services in Yichang municilality will be undertaken during project implementation.
Business Opportunities
Consulting Services In dialogue with YMG/YFB, ADB has engaged two national (12 person-months) and an international consultant (3 person-months), reporting to YFB and ADB, and as requested, to YMG. ADB has also recruited a national consultant (3 person-months) on a lump-sum basis to implement a survey on the needs and services for elderly people. The consultants were hired on an individual basis in accordance with ADB's Guidelines on the Use of Consultants (2013, as amended from time to time). The two national consultants include specialists with expertise in (i) elderly care, social and community approaches, health, training, and survey methodology; and (ii) elderly care, private sector development, including not-for-profit approaches, finance, and planning. The senior international consultant is an aging specialist with multi-country expertise in elderly care services planning. Consultants' reports will be prepared in Chinese and English.
Responsible ADB Officer Claude Bodart
Responsible ADB Department East Asia Department
Responsible ADB Division Urban and Social Sectors Division, EARD
Executing Agencies
Yichang Municipal GovernmentNo. 102 Yanjiang Blvd.
Yichang City, Hubei PRC
Post Code : 443000
Timetable
Concept Clearance 14 May 2014
Fact Finding 24 Feb 2014 to 05 Mar 2014
MRM -
Approval 27 Jun 2014
Last Review Mission -
Last PDS Update 21 Mar 2015

TA 8672-PRC

Milestones
Approval Signing Date Effectivity Date Closing
Original Revised Actual
27 Jun 2014 21 Jul 2014 21 Jul 2014 23 Jul 2015 30 Jun 2016 -
Financing Plan/TA Utilization Cumulative Disbursements
ADB Cofinancing Counterpart Total Date Amount
Gov Beneficiaries Project Sponsor Others
350,000.00 0.00 100,000.00 0.00 0.00 0.00 450,000.00 27 Jun 2014 190,000.72
Title Document Type Document Date
Strategic Elderly Care Services Development in Yichang Technical Assistance Reports Jun 2014

Safeguard Documents

See also: Safeguards

No documents found.

Evaluation Documents

See also: Independent Evaluation

No documents found.


The Public Communications Policy (PCP) establishes the disclosure requirements for documents and information ADB produces or requires to be produced in its operations to facilitate stakeholder participation in ADB's decision-making. For more information, refer to the Safeguard Policy Statement, Operations Manual F1, and Operations Manual L3.

Requests for information may also be directed to the InfoUnit.