China, People's Republic of : Hebei Elderly Care Development Project

Education / Education sector development - social protection initiatives

Health / Health sector development and reform - Health system development

The most significant demographic challenge facing the PRC today is aging of the population, and the social and economic impacts that will occur as a result of the rapid pace and huge scale. The proportion of people above the age of 60 across the PRC is expected to grow from roughly 12% in 2010 to 34% by 2050. Combined with fast urbanization, internal migration of youth away from rural areas, and the one child policy, traditional family support systems are stressed and increasingly unable to meet the elderly care (EC) needs. The PRC''s population is aging rapidly at a time when the country''s per capita income remains modest and social security systems are still insufficient to meet the financial needs of senior citizens. The growing demand for quality and affordable ECS exceeds current supply and is an urgent issue that must be addressed.

The PRC has been tackling the consequences of its aging population since the late 1970s, with successive policies to finance old age care, stimulate private sector participation, define the responsibilities of families, and organize community-wide responses to support the elderly. The PRC''s Twelfth Five-Year Plan, 2011-2015 supports developing a three-tiered old

age care system (home, community, and institutional); expanding grassroots associations; encouraging volunteerism for senior citizens; and improving geriatric care and health delivery services. The 2013 Opinions of the State Council to accelerate the development of the EC service industry recognizes the progress made and significant challenges that remain, including improving services and human resources; developing the EC market; addressing unbalanced rural-urban development; and outlining responsibilities for public, private, and civil society stakeholders.

Hebei Province entered into an 'aging society status in 1999 when it passed the 10% threshold of population over the age of 60. By the end of 2013, it had risen to 14.46%, is projected to be 15% in 2015, and will continue to rise by 3% annually. Within the province, there is diversity in the distribution of elderly and their care needs. The significant increase of the elderly is creating pressure to develop an ECS that expands coverage of home and community care, and can serve rural and urban populations, and low and middle income households. At the institutional nursing care level, only 50% (210,000) of the projected need for beds is currently available. Government facilities which target and subsidize the poorer older population are limited, and affordable quality private sector institutional care is underdeveloped. Human resources to provide care services are insufficient, and incentives and policies to retain and train staff are just being initiated. Planning for expansion of EC services is not systematic, and home and community care services are underdeveloped. The private sector does not yet play a significant role and affordability of services is a key constraint to uptake and sustainability. The major challenge is to develop EC into a financially sustainable system that provides quality and affordable care, and creates replicable models. A sound ECS can create significant employment and business opportunities.