Regional: Developing Innovative Community-Based Long-Term Care Systems and Services
The knowledge and support technical assistance (TA) will build on the findings, recommendations, and lessons learned from TA 9111: Strengthening Developing Member Countries' (DMCs) Capacity in Elderly Care, approved in May 2016 and expected to be completed in May 2020. TA 9111 aimed to develop DMC capacity to adapt to aging populations and develop long-term care (LTC) systems and services. The country diagnostic studies conducted under the TA in six countries (Indonesia, Mongolia, Sri Lanka, Thailand, Tonga, and Viet Nam) have revealed large deficits in LTC services, especially those providing affordable and quality care. In each country, developing community-based services has emerged as a priority.
Sustainable Development and Climate Change Department
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|Project Name||Developing Innovative Community-Based Long-Term Care Systems and Services|
|Country / Economy||Regional
|Project Type / Modality of Assistance||Technical Assistance
|Source of Funding / Amount||
|Strategic Agendas||Inclusive economic growth
|Drivers of Change||Gender Equity and Mainstreaming
|Sector / Subsector||
Education / Education sector development - social protection initiatives
Health / Health insurance and subsidized health programs - Health system development
Information and communication technology / ICT industries and ICT-enabled services
|Gender Equity and Mainstreaming||Effective gender mainstreaming|
The knowledge and support technical assistance (TA) will build on the findings, recommendations, and lessons learned from TA 9111: Strengthening Developing Member Countries' (DMCs) Capacity in Elderly Care, approved in May 2016 and expected to be completed in May 2020. TA 9111 aimed to develop DMC capacity to adapt to aging populations and develop long-term care (LTC) systems and services. The country diagnostic studies conducted under the TA in six countries (Indonesia, Mongolia, Sri Lanka, Thailand, Tonga, and Viet Nam) have revealed large deficits in LTC services, especially those providing affordable and quality care. In each country, developing community-based services has emerged as a priority. This TA will (i) continue to build the knowledge base on LTC; (ii) develop innovative and sustainable community-based LTC service models that can operate in low income settings, deliver quality and affordable services, are sustainable and have potential for replication and; (iii) strengthen knowledge sharing and networking on LTC in the region. The TA seeks to create new partnerships for service delivery and to address the multiple care needs of older persons in Indonesia, Mongolia, Sri Lanka, and Viet Nam.
The TA is included in the management-approved 2019 results-based work plan of the Sustainable Development and Climate Change Department. It is aligned with the Asian Development Bank's (ADB) Strategy 2030, particularly operational priority one's agenda of addressing remaining poverty and reducing inequalities among the region's most vulnerable populations. The proposed community-based care models will support the development of technical assistance and lending portfolios on adapting to aging.
|Project Rationale and Linkage to Country/Regional Strategy||The Asia and the Pacific region is at the forefront of one of the most profound demographic transitions due largely to the achievements of increased longevity and decreased fertility rates. It is currently home to over half of the global population over age 60 years, and this number is expected to rise to nearly two-thirds, or close to 1.3 billion, by 2050. The transition is happening at an unprecedented pace and at a time when traditional family support systems are weakening due to factors, such as migration and expanding female labor market participation. To date, the majority of care provision is supplied informally by family members, who rarely receive any support or training. As population demographics change there is a need to develop systems and services which can help alleviate the widening gap between demand and supply and provide quality services. Existing LTC is very limited in types of services, providers, and geographic and beneficiary coverage. The country diagnostic studies conducted under TA 9111 have found that a major challenge across all countries is to shift from policy development to implementing sustainable services on the ground that are affordable and which address the particular contexts and strengths in each country. Developing community-based LTC service models in the four selected countries will (i) help expand access to a majority of the older population, and particularly the poor and vulnerable, (ii) create a clear evidence base for good practice and (iii) an enabling environment for scaling up in the main area of service delivery that each country is prioritizing.|
Remaining poverty and inequalities for the region's most vulnerable population including older persons addressed
|Description of Outcome||
Capacity of DMCs to develop and scale up community-based care systems and services for older persons improved
|Progress Toward Outcome|
|Description of Project Outputs||
Knowledge base on long-term care improved
Capacity building program and community-based care models developed
Knowledge sharing and networking systems strengthened
|Status of Implementation Progress (Outputs, Activities, and Issues)|
|Geographical Location||Indonesia - Nation-wide; Mongolia - Nation-wide; Sri Lanka - Nation-wide; Viet Nam - Nation-wide|
|Summary of Environmental and Social Aspects|
|Stakeholder Communication, Participation, and Consultation|
|During Project Design|
|During Project Implementation|
|Consulting Services||ADB will engage consultants following the ADB Procurement Policy (2017, as amended from time to time) and the associated project administration instructions and staff instructions.|
|Procurement||Non-consulting services and goods (i.e., computer software packages, exercise machines, simple medical devices, and other small items for services to older persons in community care centers). Procurement to be undertaken by the selected consulting firm and/or consultants in each country (Indonesia, Mongolia, Sri Lanka, and Viet Nam) using request for quotation method, following the ADB Procurement Policy (2017, as amended from time to time) and the associated project administration and staff instructions.|
|Responsible ADB Officer||Wyse, Meredith|
|Responsible ADB Department||Sustainable Development and Climate Change Department|
|Responsible ADB Division||SDTC-SOC|
Asian Development Bank
|Concept Clearance||06 Nov 2019|
|Fact Finding||02 Oct 2019 to 02 Oct 2019|
|Approval||19 Dec 2019|
|Last Review Mission||-|
|Last PDS Update||26 Dec 2019|
|Approval||Signing Date||Effectivity Date||Closing|
|19 Dec 2019||-||19 Dec 2019||30 Nov 2022||30 Nov 2024||-|
|Financing Plan/TA Utilization||Cumulative Disbursements|
|200,000.00||2,600,000.00||0.00||0.00||0.00||0.00||2,800,000.00||27 Jan 2023||904,132.87|
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|Title||Document Type||Document Date|
|Developing Innovative Community-Based Long-Term Care Systems and Services: Technical Assistance Report||Technical Assistance Reports||Dec 2019|
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