From Latin America and the Caribbean to China: improving care for the elderly
The number of elderly people has tripled since 1980. Between 2021 and 2050, the share of older persons in the global population is projected to rise from less than 10% to about 17%. The rapid growth in the number of people reaching old age highlights the importance of promoting health, along with disease prevention and treatment throughout life.
Expertise France is involved in the issue of ageing through two projects, one in Latin America and the Caribbean, the other in China.
In China, the project to improve care for dependent elderly people in Guizhou Province, financed by Agence Française de Développement (AFD), aims to address the issue of ageing and increased dependency. In 2020, AFD launched “VITAL – Facility on Public Policies on the Ageing and Autonomy of Older Persons” in five Latin American and Caribbean countries. This technical assistance programme aims to develop an appropriate response to the multi-dimensional consequences of ageing, with a gender-based approach.
Varying socio-demographic contexts with a lasting impact on health systems
In the West, the Latin American continent has been experiencing the fastest rate of population ageing in the world since the turn of the 21st century. However, this trend differs from country to country. According to the Inter-American Development Bank (IDB), in 30 years, people aged 60 and over will account for between 17% and 22% of the population in Bolivia and the Dominican Republic, between 23% and 29% in Colombia and Brazil, and over 30% in Cuba. While this growing proportion is due to the increase in life expectancy, it also involves a sharp rise in dependency on a daily basis. With no specific services for them, families generally provide the care, mostly women.
In the East, according to the World Bank, the share of China’s population aged 65 and over is projected to rise from 7% to over 14% of the total population between 2000 and 2025. There has only been a modest reversal in the trend, despite the abolition of the one-child policy, which was in place from 1979 to 2016 to stem the population explosion, and the introduction of measures to encourage families to have more children. Guizhou Province is particularly affected by population ageing due to its rurality and poverty. Elderly people are highly dependent on help to finance their care, which results in a deterioration in their living conditions and health.
Furthermore, the Covid-19 pandemic mainly affected the elderly and/or people with chronic diseases. It is therefore essential to redefine the role of the governments of these countries in adapting public policies to population ageing, and thereby ensure that robust social protection systems are developed and also strengthen citizen participation.
Projects to strengthen health systems for better quality access to care
In China, the project, which started in February 2019, initially plans to extend coverage of basic services to elderly people, and subsequently improve the quality and efficiency of services to the elderly.
Despite the difficult context caused by the health crisis and measures restricting freedom of movement, it continued the training for professional caregivers and managers of care facilities organised by the partners, the French Higher Institute of Psychomotor Therapy (ISRP) and the French School of Public Health (EHESP). It also introduced two tools to assess the needs of elderly people facing a loss of autonomy:
• A rapid test, applied to people aged 60 and over
• A professional assessment for people identified with a loss of autonomy following the test
On the other side of the Pacific Ocean, the VITAL project has started in Bolivia, Colombia, Costa Rica, Cuba and the Dominican Republic. It is governed by the principle of an “on-demand” mobilisation for public administrations that support elderly people, and is based on three thematic areas:
- The development of appropriate and quality medical and social services for elderly and/or dependent people.
- The adaptation of health systems to their needs, in particular to treat chronic diseases.
- The introduction of financial support mechanisms to cover their basic needs.
The technical assistance ensures that the gender perspective is incorporated in these policies through the Gender Help Desk tool.
2023, a year giving fresh impetus to policies on ageing
The reopening of China’s borders in early 2023 made it possible to resume the events organised for Franco-Chinese high-level discussions in this field. The annual seminar on the support provided for care for the elderly was held on 22 and 23 May in Zunyi, in Guizhou Province. It highlighted the strategies and expertise of Expertise France and French operators in elderly care in terms of addressing the challenges faced by the province.
The project is continuing until the end of 2023, which will culminate in the publication of quality standards, the formalisation of a training manual for managers of elderly care facilities, and the development of strong cooperation relations between French and Chinese professionals in the elderly care sector.
For VITAL, 2023 is the year of its full implementation, with more than 20 activities to organise. In Colombia, four technical assistance activities were already proposed in 2022, and included the preparation of the National Silver Economy Strategy of the National Planning Department (DNP), and the creation of a National Register of Caregivers. In the Dominican Republic, three technical assistance activities were launched on 31 May 2023. Care protocols for the elderly, a range of innovative services for them, and a communication strategy are currently being prepared to strengthen the institutional capacity of the National Council of the Ageing Person (CONAPE).
Pending the completion of the project, a study visit was organised in France last June, gathering 30 representatives from institutions in the five partners countries and Brazil. The objective was to give an understanding of France’s policy on ageing.
To find out more about the VITAL project, consult the project sheet 