MANILA, PHILIPPINES (6 September 2018) — The People’s Republic of China (PRC) needs to improve financial incentives for service providers to strengthen the PRC’s three-tiered elderly care system if it is to cope with an old aged population set to double to 289 million by 2034, according to a new Asian Development Bank (ADB) brief.

The PRC has the world’s largest elderly population with 142 million aged over 65 years in 2016. The government’s change in policy in 2016 to allow parents to have two children is unlikely to change the pattern of single child families in the near term. This is contributing to the aging population and putting stress on families who need to care for elderly parents and on the economy, the report, Aging and Implications for Elderly Care Services in the PRC, said.

“Policy actions are needed to create proper incentives for elderly care service providers, to prepare regulations to ensure the adequacy and quality of services provided by either public or private service providers, and to ensure the country has people who are properly trained to care for the country’s elderly,” said ADB Senior Social Sector Specialist for East Asia Ms. Hiroko Uchimura-Shiroishi.

The three-tiered elderly care system comprises home-based care, community-based day care, and residential care services. Government subsidies should be focused on financially incentivizing providers of elderly care to deliver better quality services instead of just focusing on infrastructure including constructing care facilities or increasing the number of beds. This will help expand much needed home- and community-based care services in the PRC, which can cater to a larger number of people with different needs. While residential care facilities have grown by more than 20% from 2010 to 2012, home- and community-based services are critically underdeveloped.

The PRC also needs to set up a system linking needs assessment, care standards, and the provision of care services. The system needs to make sure those standards are always being met.

Finally, the PRC needs to strengthen training programs to meet the shortage in elderly care workers. At the moment, very few schools or universities provide suitable training in how to care for the aged at home or at community-based day care center. Further, professionalization of elderly care related jobs and the support for clear career development are important to attract students and improve the quality and adequacy of services.  

ADB has been working with the PRC government to improve elderly care services in the country. In December 2016, ADB provided a $50 million loan to strengthen residential elderly care service provision in Yichang City, and complementing it, another elderly care project is being prepared for Yichang City to establish a comprehensive elderly care system. ADB also provided $100 million in June 2017 to help develop home-, community-, and residential elderly care services in Hebei Province. ADB is working on another two elderly care-public-private partnership projects to demonstrate the elderly care and health care integration to ensure seamless services for the elderly in need.

ADB is committed to achieving a prosperous, inclusive, resilient, and sustainable Asia and the Pacific, while sustaining its efforts to eradicate extreme poverty. Established in 1966, it is owned by 67 members—48 from the region. In 2017, ADB operations totaled $32.2 billion, including $11.9 billion in cofinancing.

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