China, People's Republic of: Hubei Yichang Comprehensive Elderly Care Demonstration Project

Sovereign Project | 49309-002

The proposed project aims to support the development of a three-tiered elderly care system (ECS) in Yichang Municipality, Hubei Province by improving the coverage and utilization of home-based, community-based, and residential-based elderly care services.

The project is aligned with the following impact: a three-tiered ECS (home-based, community-based, and residential-based care services) established. The project will have the following outcome: coverage and utilization of elderly care services in Yichang increased. Outputs include (i) home-based and community-based care services and facilities improved, (ii) elderly care service capacity increased and its support system improved, (iii) facilities and services supporting the integration of healthcare and elderly care established, and (iv) capacity of elderly care management and project management support developed.

Project Details

  • Project Officer
    Bai, Jie
    East Asia Department
    Request for information
  • Country
    China, People's Republic of
  • Sector
    • Health
Project Name Hubei Yichang Comprehensive Elderly Care Demonstration Project
Project Number 49309-002
Country China, People's Republic of
Project Status Active
Project Type / Modality of Assistance Loan
Source of Funding / Amount
Loan 3767-PRC: Hubei Yichang Comprehensive Elderly Care Demonstration Project
Ordinary capital resources US$ 150.00 million
Strategic Agendas Environmentally sustainable growth
Inclusive economic growth
Drivers of Change Gender Equity and Mainstreaming
Governance and capacity development
Knowledge solutions
Sector / Subsector

Education / Technical and vocational education and training

Health / Health sector development and reform - Health system development

Gender Equity and Mainstreaming Effective gender mainstreaming
Description

The proposed project aims to support the development of a three-tiered elderly care system (ECS) in Yichang Municipality, Hubei Province by improving the coverage and utilization of home-based, community-based, and residential-based elderly care services.

The project is aligned with the following impact: a three-tiered ECS (home-based, community-based, and residential-based care services) established. The project will have the following outcome: coverage and utilization of elderly care services in Yichang increased. Outputs include (i) home-based and community-based care services and facilities improved, (ii) elderly care service capacity increased and its support system improved, (iii) facilities and services supporting the integration of healthcare and elderly care established, and (iv) capacity of elderly care management and project management support developed.

Project Rationale and Linkage to Country/Regional Strategy

The People's Republic of China (PRC) has the largest elderly population in the world. Rapid urbanization, internal migration of youth from rural areas, and the previous one-child policy have affected traditional family support systems, which are currently unable to meet elderly care needs. The population is aging rapidly, while per capita income remains modest and social security systems are still developing. The growing demand to create a sustainable elderly care system (ECS) and develop adequate elderly care services exceeds current supply. Developing adequate elderly care is a major government priority. The PRC's Twelfth Five-Year Plan, 2011 2015 sought to create a three-tiered ECS. The Thirteenth Five-Year Plan, 2016 2020 continues to support the development of elderly care by further defining the roles of the government, private sector, and civil society organizations; and promoting better integration of health care and elderly care services.

Yichang is one of 42 pilot cities jointly chosen in 2014 by the Ministry of Civil Affairs and National Development and Reform Commission to comprehensively develop its ECS, expand coverage, and ensure adequate service provision. The Asian Development Bank (ADB) began working with the Yichang Municipal Government (YMG) in 2014 to support its program of comprehensive reform by creating the Yichang elderly care strategic plan. In 2017, 22% of Yichang Municipality's population of 4.14 million was above the age of 60, well above the 2017 national average of 14.3%. Within the municipality, there is great diversity in the distribution of elderly and their care needs. Developing an ECS to address such complexity and demand is a significant challenge and one that is faced by many municipalities in the PRC.

Yichang's elderly care strategic plan for 2016 2030 was finalized in 2016, and has five strategic directions aimed at (i) expanding coverage and range of services, (ii) ensuring financial sustainability, (iii) improving service quality, (iv) developing partnerships with private sector and civil society organizations, and (v) strengthening human resources. The project will align with the Yichang elderly care strategic plan, help develop Yichang's ECS, and improve services and human resources.

Yichang's ECS is still being developed. Home-based and community-based elderly care services are underdeveloped, and available human resources are severely limited. Elderly people who need care are unable to remain in their communities. Residential-based elderly care facilities are limited, either unable to provide adequate services (leading to low occupancy), or in the case of public facilities that offer quality services at a reasonable price have long waiting lists and are unable to meet demand. The imbalance between demand and supply results in the majority of the elderly receiving little assistance, if any.

Impact A three-tiered elderly care system (home-based, community-based, and residential-based care services) established
Project Outcome
Description of Outcome Coverage and utilization of elderly care services in Yichang increased
Progress Toward Outcome

Recruitment for 4 individual consultants (project management specialist, architect, environment specialist and land resettlement specialist) has been completed. Project management consultants awarded in April 2021 and environment monitors are in place. Individual consulting packages for the Geriatric care specialist, Medical Facility engineer, Medical equipment specialist, ICT Specialist and Geriatric Hospital planner have been recruited.The first works contract has been submitted and awarded for YC-ZX-C03a in November 2020. First goods/equipment package revised BER has been submitted. Contract award expected in Q3, 2021. Geriatric Hospital building (YC-2h-C01) has been awarded in September 2021. Civil works packages for CECC Building in Yiling, Yidu and Zigui have been awarded.

Several missions have been fielded loan inception, and 2 loan review missions in 2020 and a loan review mission in 2021 to check on status of implementation of the loan.

Implementation Progress
Description of Project Outputs

1. Home-based and community-based care services and facilities improved

2. Elderly care service capacity increased and its support system improved

3. Facilities and services supporting the integration of health care and elderly care established

4. Capacity of elderly care management and project management support developed

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

In progress. First civil works package have been awarded in 2020.

In progress. First goods package recruitment is underway.

In progress. Geriatric Hospital building package has been awarded in September 2021.

Project management team and external monitors have been recruited. Safeguards reports have been timely submitted.

Geographical Location Yichang
Safeguard Categories
Environment B
Involuntary Resettlement B
Indigenous Peoples C
Summary of Environmental and Social Aspects
Environmental Aspects An initial environmental examination (IEE), including an environmental management plan (EMP), was prepared and disclosed on the ADB website on 19 July 2018. The EMP identified potential environmental impacts and risks for the pre-construction, construction, and operational phases; and proposed mitigation measures. The IEE concluded that the anticipated environmental impacts are insignificant and temporary, and can be mitigated through EMP implementation. Construction of 2 proposed geriatric hospitals, an elderly care nursing home, a dementia care center, and 16 CECCs is expected to have minor impacts on air and water quality, solid waste management, and soil and groundwater contamination during construction and operational stages; which can be adequately mitigated through EMP implementation and monitoring. Medical waste management due diligence addressing storage, transportation, treatment, and associated facilities found safeguards procedures and operations to be adequate and strictly followed, and in compliance with both PRC and international regulations. YMG confirmed its commitment and capacity to implement the EMP. Further capacity-building measures were proposed in the EMP and agreed by YMG. A grievance redress mechanism will be established. The procedures, reporting timelines, and roles and responsibilities of all agencies are described in the EMP. YMG has full responsibility for safeguards oversight and EMP implementation and compliance.
Involuntary Resettlement The project will acquire 6.28 hectares (ha) of land, 4.19 ha of collectively owned land, and 2.09 ha of state-owned land. A total of 15,313 square meters (m2) of houses will be demolished, including residential houses (5,433 m2) and nonresidential buildings of three enterprises (about 9,880 m2). The 269 affected persons include (i) 170 persons in 44 households, (ii) 51 employees in three enterprises, and (iii) 4 renters with 48 persons. Three households with 10 persons will lose their residential houses because of the demolition or the conversion to CECCs. Land acquisition will affect 23 households with 88 persons, and 18 households with 72 persons will be affected by land acquisition and demolition. The YMG will be responsible for compensation and provision of support and assistance prior to land acquisition and relocation activities. Affected persons do not rely on agriculture for their livelihoods, and the area of land lost is too small to impact household incomes. Land compensation payments will be considerable. Those who lose houses will be offered cash compensation at replacement cost or resettlement housing from the local government, and building compensation will enable them to purchase houses equal in size to their original houses. The three affected enterprises will receive negotiated prices before project implementation. The four affected renters with 48 persons will be compensated according to their contractual arrangements. The project team has informed the affected business owners and their employees when the properties will be acquired, and the local government will help them find new locations to continue their business activities. The project will provide skilled and unskilled job opportunities on a priority basis for all project-affected persons during construction and operation.
Indigenous Peoples The People's Republic of China (PRC) has preferential policies for ethnic minorities, to ensure they participate in service administration and development programs, and manage their internal affairs. Ethnic minorities account for less than 1% of the population in the project impact areas. Most of the ethnic minorities in project impact areas (87%) are from the Tujia ethnic minority group, who share similar economic opportunities and social recognition with the PRC's dominant Han population. The project will ensure elderly people, regardless of ethnicity, gain equal access to elderly care services based on care needs, and that their cultural and religious sensitivities are recognized and elderly care providers accommodate any special dietary requirements. Ethnic minorities associate well with other communities and will equally benefit from the project. Therefore, an ethnic minority development plan is not needed.
Stakeholder Communication, Participation, and Consultation
During Project Design The project will (i) ensure that elderly men and women participate equally in project-related public consultations; (ii) incorporate gender-responsive features in the project design, if any; (iii) promote increased employment opportunities for women; and (iv) build the executing and implementing agencies' institutional capacity for gender mainstreaming by engaging the All China Women's Federation to undertake employment training and public awareness creation.
During Project Implementation
Business Opportunities
Consulting Services

QCBS (project implementation support) - 156 person-months

QCBS (external monitoring) - 72 person-months

Individual consultants selection (start-up) - 57 person-months

QCBS (elderly care technical support) - 49 person-months

Individual consultants selection (elderly care system development) - 60 person-months

CQS (elderly care-ICT platform preparation) - 27 person-months

QCBS (elderly care-ICT software development) - 200 person-months

Procurement

National competitive bidding - 26 contracts

Shopping - 2 contracts

Responsible ADB Officer Bai, Jie
Responsible ADB Department East Asia Department
Responsible ADB Division Urban and Social Sectors Division, EARD
Executing Agencies
Hubei Provincial Finance Department
No. 8 Zhongbei Road, Wuchang District,
Wuhan City, Hubei Province,
People's Republic of China
Yichang Municipal Government
No. 102 Yanjiang Blvd.
Yichang City, Hubei PRC
Post Code : 443000
Timetable
Concept Clearance 23 Nov 2016
Fact Finding 23 May 2018 to 31 May 2018
MRM 06 Aug 2018
Approval 13 Dec 2018
Last Review Mission -
Last PDS Update 30 Sep 2021

Loan 3767-PRC

Milestones
Approval Signing Date Effectivity Date Closing
Original Revised Actual
13 Dec 2018 31 May 2019 12 Sep 2019 31 Dec 2024 - -
Financing Plan Loan Utilization
Total (Amount in US$ million) Date ADB Others Net Percentage
Project Cost 305.05 Cumulative Contract Awards
ADB 150.00 18 Nov 2021 36.36 0.00 24%
Counterpart 155.05 Cumulative Disbursements
Cofinancing 0.00 18 Nov 2021 11.00 0.00 7%
Status of Covenants
Category Sector Safeguards Social Financial Economic Others
Rating Unsatisfactory Unsatisfactory Satisfactory Unsatisfactory Satisfactory Unsatisfactory

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 Access to Information Policy (AIP) 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.


Safeguard Documents See also: Safeguards
Safeguard documents provided at the time of project/facility approval may also be found in the list of linked documents provided with the Report and Recommendation of the President.


Evaluation Documents See also: Independent Evaluation

None currently available.


Related Publications

Title Document Type Document Date
ADBヘルス・ボンド2019 Brochures and Flyers Aug 2019

The Access to Information Policy (AIP) 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.

Tenders

Tender Title Type Status Posting Date Deadline
Consulting service for the construction of information platform of intelligent elderly service Firm - Consulting Closed 30 Mar 2021 28 Apr 2021
Geriatric Hospital Planner Individual - Consulting Closed 03 Feb 2021 09 Feb 2021
3767-PRC: Hubei Yichang Comprehensive Elderly Care Demonstration Project (YC-TC-E20) Invitation for Bids Closed 04 Dec 2020 09 Dec 2020
Geriatric Hospital Planner Individual - Consulting Closed 27 Oct 2020 02 Nov 2020
External Monitoring & Evaluation (M&E) Services Firm - Consulting Closed 04 Sep 2020 25 Oct 2020
Medical facility engineer Individual - Consulting Closed 14 Aug 2020 21 Aug 2020
Medical equipment specialist Individual - Consulting Closed 05 Aug 2020 07 Aug 2020
Geriatric Hospital Planner Individual - Consulting Closed 28 Jun 2020 19 Jul 2020
Geriatric care specialist Individual - Consulting Closed 28 Jun 2020 19 Jul 2020
Elderly Care Expert Individual - Consulting Closed 28 Jun 2020 19 Jul 2020
ICT specialist Individual - Consulting Closed 28 Jun 2020 15 Jul 2020
Project Management and Capacity Development Consulting Service Firm - Consulting Closed 13 Dec 2019 12 Jan 2020
Environmental Safeguard Individual - Consulting Closed 09 Nov 2019 18 Nov 2019
Social and Resettlement Safeguard Individual - Consulting Closed 09 Nov 2019 18 Nov 2019
Management and Procurement Expert Individual - Consulting Closed 06 Jul 2019 14 Jul 2019
Elderly care facility design specialist Individual - Consulting Closed 06 Jul 2019 14 Jul 2019

Contracts Awarded

Contract Title Approval Number Contract Date Contractor | Address Executing Agency Total Contract Amount (US$) Contract Amount Financed by ADB (US$)
CECC Main Building Construction at Zigui Loan 3767 18 Sep 2021 Tianbao Construction Group Co. Ltd. | Guanyun East Road #33 Zhuozhou City Baoding City in Hebei Province Yichang Municipal Government 2,347,581.07 2,345,348.06
Building construction-Geriatric Hospital Construction Loan 3767 18 Sep 2021 Shanxi Construction Engineering Group Co. Ltd | 9 Xinjian Road Yingze District Taiyuan Province Shanxi Province 030032 Yichang Municipal Government 22,759,450.50 22,701,397.05
EXTERNAL MONITORS Loan 3767 28 May 2021 WUHAN YUNHAICHENG ENG CONSULTING | WUHAN, YICHANG CHINA, PEOPLE'S REP. OF Yichang Municipal Government 456,900.00 456,900.00
CECC MAIN BUILDING CONSTRUCTION IN YIDU Loan 3767 19 Mar 2021 FUJIAN LONGCHENG CONSTRUCTION GROUP CO., LTD | FLOOR 22-23 IN LONGCHENG BUILDING, ZIWEI ROAD, SHIMA TOWN, LONGHAI CITY, FUJIAN CHINA,PEOPLE'SREP.OF Yichang Municipal Government 4,192,631.07 4,022,798.58
YILING DISTRICT CIVIL AFFAIRS BUREAU COMMUNITY- BASED ELDERLY CARE CENTER RECONSTRUCTION WORK Loan 3767 10 Dec 2020 XIAMEN CHENGJIAN CONSTRUCTION CO., LTD | ROOM 206, NO. 101 LIANHUA ST LIANHUA TOWN, TONG?AN DISTRICT, XIAMEN CITY CHINA,PEOPLE'SREP.OF Yichang Municipal Government 3,013,932.88 2,520,936.98
PROJECT MANAGEMENT SUPPORT AND CAPACITY DEVELOPMEN T Loan 3767 10 Dec 2020 HUBEI CHENGKANG FUTURE CERTIFIED PUBLIC ACCTS | HUBEI CHENGKANG FUTURE ENGINEERING CONSULTING CO., LTD. (PRC CHINA,PEOPLE'SREP.OF Yichang Municipal Government 594,367.00 594,367.00
COMMUNITY-BASED ELDERLY CARE CENTER (CHILDREN'S PARK AND FORMER LABOR BUSINESS HOTEL) CIVIL AND DECORATION WORKS Loan 3767 26 Nov 2020 ZHONGDI YINGGANG CONSTRUCTION GROUP CO., LTD | RN ROAD, RARE EARTH HIGH-TECH ZONE, BAOT OU CITY, IMAR, PRC CHINA,PEOPLE'SREP.OF Yichang Municipal Government 2,887,878.06 2,887,878.06