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2016 Conference Presentation

(Inter)national systemsEconomics CanadaChinaEnglandIndonesiaKenyaMexicoSouth AfricaSouth Korea

7 September 2016

Key issues and challenges in long-term care organization and financing in differently resourced countries: from service coverage to sustainability

Adelina Comas-Herrera, PSSRU, London School of Economics and Political Science, United Kingdom


Ageing is a global phenomenon but is happening at different speeds in different countries. In most high-income countries the ageing process has happened over a long period of time, and alongside sustained economic growth, which has enabled those countries to gradually develop the policies and infrastructures needed to adapt to the health, care and other needs of an older population. In low- and middle-income economies, and some countries that have reached ‘high-income’ more recently, the ageing process is happening at a much faster pace than that experienced by the more ‘traditionally old’ countries.

The degree to which the growth in the numbers of older people is accompanied by economic growth will have a major effect on how well placed countries will find themselves to support the development of long-term care systems that can adequately meet the needs of growing populations with care needs. The models of care that have emerged in the ‘slow ageing’ high-income countries may not necessarily be the right ones for countries that are ageing at high speed and with fewer resources.

This paper, produced for the World Health Organisation Working Group on Long Term Care Systems, considers the key policy issues and challenges for the financing and organization of long-term care in Canada, China, England, Kenya, Indonesia, Mexico, South Africa and South Korea. While these countries have very diverse demographic, social and economic contexts, there are common policy concerns with regards coverage access to care in rural areas, equity in relation to financing, gender inequality, sustainability, supporting carers, ensuring workforce capacity, improving care coordination, regulation and quality of care.

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