Long-term Care in Developing Countries – Ten Case Studies

Demographic and epidemiological transitions will result in dramatic changes in the health needs of the populations of the world. Everywhere, there is a steep increase in the need for long-term care (LTC). These trends reflect two interrelated processes. One involves the growth in factors that increase the prevalence of long-term disability in a population. The second involves the change in the capacity of the informal support system to address these needs. Both of these processes enhance the need for public policies to address the consequences of these changes.

The growing need for LTC policies is generally associated with industrialized countries. What is less widely acknowledged is that LTC needs are increasing in the developing world at a rate that far exceeds that experienced by industrialized countries. Moreover, the developing world is experiencing increases in LTC needs at levels of income that are far lower than those which existed in the industrialized world when these needs emerged.

Therefore, the search for effective LTC policies is one of the most pressing challenges facing modern society. Recognizing that such trends greatly increase the need for well-coordinated and cost-effective LTC, the World Health Organization (WHO) launched a global initiative. The JDC-Brookdale Institute, a WHO Collaborating Centre, is leading this effort.

The goal of the project was to prepare a practical framework for guiding the development of long-term care policies in developing countries. This framework will address the major issues and alternatives in designing LTC systems. The framework is not intended to provide specific prescriptions, but rather a basis for translating national conditions, values, culture and existing health and social policies into a long-term care policy.

This framework was designed to emphasize elements that would be important in the developing country context, and also to examine the more general health and social policies and service structure along dimensions that have major implications for long-term care. Case-studies of the general health system and current LTC provision in ten developing countries were written by national health care experts (People’s Republic of China, Costa Rica, Indonesia, Lebanon, Lithuania, Mexico, Republic of Korea, Sri Lanka, Thailand, and Ukraine).

This volume is the seventh in this series of publications, which is designed to make more widely available the full and final materials developed through the project.

The full report is also available on the WHO Web site.

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