The proposed project will support the development of an integrated elderly care system in Yichang Municipality (Yichang), Hubei Province through improving the coverage and utilization of home, community, and residential services. The project will be a complementary investment to a results-based loan to develop an elderly care public-private partnership in Yichang. Together, the projects will comprehensively develop the elderly care services in Yichang and demonstrate how the public and private sector can jointly develop the market and improve the quality and coverage of elderly care services.
|Project Name||Hubei Yichang Comprehensive Elderly Care Demonstration Project|
|Country||China, People's Republic of
|Project Type / Modality of Assistance||Loan
|Source of Funding / Amount||
|Strategic Agendas||Inclusive economic growth
|Drivers of Change||Gender Equity and Mainstreaming
Governance and capacity development
|Sector / Subsector||
Education / Education sector development - social protection initiatives
Health / Health sector development and reform - Health system development
|Gender Equity and Mainstreaming||Effective gender mainstreaming|
|Description||The proposed project will support the development of an integrated elderly care system in Yichang Municipality (Yichang), Hubei Province through improving the coverage and utilization of home, community, and residential services. The project will be a complementary investment to a results-based loan to develop an elderly care public-private partnership in Yichang. Together, the projects will comprehensively develop the elderly care services in Yichang and demonstrate how the public and private sector can jointly develop the market and improve the quality and coverage of elderly care services. The proposed project will develop (i) home and community care services and facilities to help address the care needs of a broad population of elderly and support international trends of aging in place and deinstitutionalization; (ii) systems to support improved EC quality and capacity, including the capacity of the CAB to manage, regulate, and monitor the sector; and (iii) facilities and services, such as rehabilitation care to address unmet needs and support the integration of health and elderly care.|
|Project Rationale and Linkage to Country/Regional Strategy||
The People's Republic of China (PRC) has the fastest aging, largest, and one of the most diverse elderly populations in the world. Rapid urbanization, internal migration of youth away from rural areas, and the one child policy have affected traditional family support systems. 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 services (ECS) and develop quality and affordable services exceeds current supply. Developing the elderly care sector is a major priority of the government. The PRC's Twelfth Five-Year Plan, 2011-2015 sought to create a three-tiered old age care system. The Thirteenth Five-Year Plan, 2016-2020 will continue to develop the sector by further defining the roles of government, the private sector, and civil society organizations and promoting a better integration of health and ECS.
In 2014, Asian Development Bank began working with Yichang Municipal Government to create a strategic plan for developing ECS. Yichang is one of 42 pilot cities chosen by the Ministry of Civil Affairs to comprehensively reform its ECS, expand coverage, and develop higher quality services. The municipality has a population of 4.03 million and of this, 20% are above the age of 60, which is well above the national average of 14.3%. Within the municipality, there is great diversity in the distribution of elderly, their care needs, and capacity to pay for services. Developing an ECS to address such complexity and demand is a significant challenge and one that is faced by many municipalities across the PRC.
The plan was completed in 2016 and covers the period of 2016-2030. It focuses on five strategic directions aimed at (i) expanding coverage and range of services; (ii) ensuring financial sustainability; (iii) improving quality; (iv) developing partnerships with private sector, civil society organization, and the public; and (v) expanding human resources. Based on the plan, Yichang Municipal Government proposed two loan projects, which are complementary and address critical areas for developing ECS. Development of the role of the private sector will be achieved under the PPP demonstration project. Creation of the broader systems to support the government in planning, regulation, and monitoring; use of information and communications technology in the sector; and improved services and human resources is the objective of the project loan. Together, the two loans will help create a better and more sustainable ECS with better coverage and service quality for Yichang. A sound ECS creates significant employment and business opportunities in a service area predominantly employing women. It will also have a positive impact on relieving the burdens of family caregivers.
Currently, the failure to develop a well-structured and managed system is expensive for the government and has left the elderly in Yichang underserved. Home- and community-based services are underdeveloped and unable to help residents remain in their communities and age in place. Residential care facilities (public and private) are limited, and either unable to provide quality services (leading low occupancy) or for the facilities that do offer quality at an affordable price have long waiting lists and are unable to meet demand. These imbalances in the system result in the majority of elderly receiving little, if any, assistance. The Civil Affairs Bureau is responsible for regulating and monitoring the sector and building the capacity and systems required to ensure coordination. However, Civil Affairs Bureau has little experience in managing the range of providers and regulating the sector.
|Impact||A three-tiered elderly care system (home, community, and residential) be established.|
|Outcome||Coverage and utilization of EC services in Yichang increased|
Community and home care services and facilities improved
Systems to support EC expansion and service delivery capacity improved
Facilities and services supporting integration of health and EC established
|Summary of Environmental and Social Aspects|
|Stakeholder Communication, Participation, and Consultation|
|During Project Design|
|During Project Implementation|
|Responsible ADB Officer||Shiroishi, Hiroko Uchimura|
|Responsible ADB Department||East Asia Department|
|Responsible ADB Division||Urban and Social Sectors Division, EARD|
Yichang Municipal Government
No. 102 Yanjiang Blvd.
Yichang City, Hubei PRC
Post Code : 443000
|Concept Clearance||23 Nov 2016|
|Fact Finding||23 May 2018 to 30 May 2018|
|MRM||28 Jun 2018|
|Last Review Mission||-|
|Last PDS Update||31 Mar 2017|
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