Project to improve care for dependent elderly people in China

Contributing to the development and structuring of the care system for elderly dependent people in Guizhou Province in China

Addressing the challenge of ageing: the reforms needed in the social protection system

China faces a major demographic challenge, with a population of 1.4 billion inhabitants recorded in 2017.

Between 2000 and 2025, the Chinese population aged 65 and over is expected to increase from 7% to more than 14% of the total population. This acceleration of population ageing is due to the combination of several factors: the decline in mortality, growing life expectancy, and the collapse in the birth rate in the country, in particular due to its one-child policy (1979-2015).

To address these social, health and demographic issues, China has undertaken to strengthen care services for the elderly. Since 2010, there have been successive reforms and opening to the private sector is strongly encouraged. To develop services in every segment of the market, these policies are implemented through three lines of action:

1. Home care (90%)
2. Reception in community day centres (7%)
3. Placement in accommodation facilities (3%)

The objective is to optimise the distribution of elderly people in these various structures, depending on the needs and resources of each person, while prioritising home care.

The care sector for the elderly remains underdeveloped in China with regard to the growing demand for care. This is due to structural difficulties:

• Lack of skilled labour
• Poor governance and coordination of the various services
• Most people cannot afford to pay for the services
• Imbalances between rural and urban areas

Objectives and action plan

The project to improve care for dependent elderly people will contribute to the implementation of the following activities:

1. Organisation of regular high-level discussions on the care sector for the elderly 

The first seminar was held in Guiyang in July 2019 and gathered nearly a hundred people (including local authorities, companies, donors and experts).

The second was held in Zunyi in May 2023 and focused on exchanges on the dissemination of the programme in the other Chinese provinces neighbouring Guizhou and care for elderly people with Alzheimer's disease.

2. Capacity building for professional caregivers and managers of care facilities for the elderly

The French School of Public Health (EHESP) is organising training for 90 trainers of facility managers through 3 training sessions. A first session was held in July 2019 and the second in February 2020.

The French Higher Institute of Psychomotor Therapy (ISRP) is organising training for caregivers. Six sessions will train 90 trainers of caregivers. A first training session was held in October 2019 and a second session in early 2020. 

3. Technical assistance for the formulation of a comprehensive and coherent policy for the development of services for dependent elderly people

a. Support for the assessment of care needs for elderly people.

b. Support for the definition of a basket of basic services for elderly people and subsidy criteria adapted to the situation in Guizhou.

c. Support for the development of standards to evaluate the quality of services.

d. Support for the definition of rules for contract agreements and the procurement of care services for the elderly.