A Closer Look at Causes of Youth Unemployment in the PRC
![A Closer Look at Causes of Youth Unemployment in the PRC](https://rksi.adb.org/wp-content/uploads/2023/06/cover-adb-brief-247-causes-youth-unemployment-prc.png)
Online training of caregivers using a popular mobile app and a digital monitoring and assessment platform help improve the quality of services.
Overview
The People’s Republic of China (PRC) is aging at an unprecedented rate. Among the challenges the country faces are increasing demand and costs for quality care for seniors or those aged 60 or older.
Hebei is one of the PRC provinces that has reached “aging society” status. It crossed the threshold in 1999 when those more than 60 years old comprised 10% of the population. The senior population was projected to have reached 17% in 2016 and is expected to rise to 31% by 2050—just below the national estimate of 34%. The province was not ready to support its aging population. There were severe shortages of residential care facilities, community elder care services, and skilled caregivers.
A knowledge and technical assistance grant to support a project funded by the Asian Development Bank expanded access to elder care services and improved the capacity of caregivers in Hebei through knowledge and skills training using an online communications application (app). It also developed an efficient monitoring and assessment platform and promoted the involvement of civil society organizations.
Project information
TA 9326-PRC : Establishment of an Integrated Comprehensive Three-tier System for Elderly Care
Project snapshot
Context
Fast urbanization, migration of youth from rural to urban areas, and the one-child policy weakened traditional family support systems, which provided care for older relatives in the country.
The PRC government’s Twelfth Five-Year Plan (2011–2015) supported the creation of a three-tiered elder care system with home care as base, community care as support, and institution-based care as supplement. In line with international trends, this system values “aging in place” (seniors live in their own home and community), de-institutionalization, and active aging.
The country’s Thirteenth Five-Year Plan (2016–2020) seeks to expand coverage and enhance the quality of elder care services by developing the capacity of the private sector and civil society organizations to play a greater role.
Challenge
In 2020, there were 14.81 million people over 60 years old in Hebei. However, there were only 1,721 residential elder care centers with 214,000 available beds, which could only serve 1.3% of the projected demand.
This situation was further aggravated by insufficient staffing and inadequate skills of caregivers at county, township, and village levels, as most of the licensed caregivers are concentrated in urban residential districts. Mainly family members or community caregivers took care of older people. In five counties, the average profile of caregivers was rural female, aged 35–60 years old, and less educated. There were also no standardized training programs for both institutional and family caregivers in these areas.
Solutions
As an aging society, Hebei has a strong desire to identify strategies, models, and partnerships that can deliver affordable and quality elder care services that address diverse needs.
The technical assistance component of the Hebei project sought to promote and expand the three-tiered health care system by delivering module-based trainings that cover a variety of topics through an online communications app for wider access by family, community, and institutional caregivers at county, township, and village levels. These trainings were designed to build their capacity to provide basic services to older people who require daily care from chronic and geriatric diseases, rehabilitation, and dementia-related support.
Leveraging the use of a popular app
WeChat, a popular messaging and social media application in the PRC, was used as a knowledge dissemination platform to livestream the training and demonstration videos. The content was provided by the leading elder care residential institutions in Beijing and delivered by experts in the field to help caregivers learn new skills and upgrade professional standards. Chat groups were created to facilitate questions to experts. Caregivers can also request interactive sessions with the trainers through this app. The use of this platform made capacity building more convenient and less costly than face-to-face training.
Upon completion of the technical assistance, Yanshan University took over this service model and expanded the training scope to include geriatrics, health maintenance, and functional rehabilitation.
Building a monitoring and assessment platform
An information and communications technology (ICT) platform was built to monitor and assess the quality of elder care in She and Shuangluan counties, which are located in the economically less-developed parts of Hebei. They were selected based on the demand of the local civil affairs bureau.
The evaluation criteria for elder care institutions are based on national standards and further segmented into detailed assessment categories, such as hygiene and sanitation, food safety, quality of medical and health care, and contract management. The appointed evaluators visit each residential care center in the counties, complete the evaluation results online, and then upload the evaluation results through the platform. Once submitted, the evaluators cannot change the submitted data. The assessments guide the elder care institutions and the civil affairs bureau in identifying bottlenecks and required improvements.
Results
Lessons
Asian Development Bank (ADB). 2017. Report and Recommendation of the President to the Board of Directors: Proposed Loan and Technical Assistance Grant to the People’s Republic of China for the Hebei Elderly Care Development Project. Manila.
ADB. 2022. Technical Assistance Completion Report: Establishment of an Integrated Comprehensive Three-Tier System for Elderly Care in People’s Republic of China. Manila.
Government of the PRC, State Council. 2016. Healthy China 2030. Beijing.
Senior Project Officer, East Asia Department, ADB
This blog is reproduced from Development Asia.
Watch key moments in project programming, appraisal, identification, and implementation of ADB’s Yichang Elderly Care Demonstration Project. Listen to some of the difficulties encountered, and solutions as well as innovations introduced.
Related event: Elderly Care System Development Forum
Rethinking urban design necessary to ensure sustainable, healthy and age-friendly urban communities.
The last 40 years have seen soaring urbanization in the PRC, as a result of which 60 percent of its population now lives in urban areas. the PRC’s society is also aging rapidly. As these two trends are ongoing, the PRC needs to make its cities more livable, healthy and age-friendly, as well as environmentally sustainable and socially inclusive.
Contemporary urban life in the PRC and elsewhere has seen increased individuality with reduced social cohesion, smaller families, fewer children and many people living alone. This requires reconsideration and improvement of the social security and pension systems and health and elderly care services. But city design and urban management also have roles to play in addressing these issues by promoting social cohesion and restoring community life.
For example, the PRC could promote healthier and more age-friendly cities with cohesive neighborhoods if it rethinks and rehabilitates its system of compounds. The rehabilitation of urban compounds in the PRC will need to be a comprehensive and participatory effort to promote improved health, safety, resilience and an active community life.
This means reducing the number of fences and gates and introducing new pathways for pedestrians and bicycles through compounds to create a finer mesh of pedestrian and bicycle networks. In the process, walking distances would be significantly shortened. Also, new small buildings with two to four stories can be introduced, as careful in-fill development between residential high-rise buildings, with community spaces, small shops and other uses.
All these will create a more humane environment amid the typical wide roads and tall buildings, as well as create well-defined spaces that are either public or semi-public for local residents, or private for individual households.
If Chinese cities and urban spaces can be made less dependent on cars, this would bring healthier lifestyles to the residents and enable more interaction within communities. That would be good news for everybody, especially the elderly and children.
One out of every five people will be aged over 60 in the PRC by 2030, heralding a “super-aged society”; and it will rise to more than one in three by 2050. Many of these elderly will age further, becoming part of an emerging four-generation urban society. It is a trend observed not only in the PRC but in many other countries, especially high-income ones. The pressures of an aging society and inaccessible urban environments affect women disproportionally due to their longer life expectancy and care duties.
Recognizing this, urban planners could consider a number of internationally recognized best practices for sustainable urban development. These include the “compact city” concept, in which an urban area is organized in clusters of pedestrian-friendly, high-density mixed-use centers within walking distance of public transport stations, inclusive of green open space. This is known as transit-oriented development.
Other practices are low-carbon development, to which compact cities contribute, and climate-resilient urban development. In this, green infrastructure and parks are combined with gray infrastructure to provide flood and drought risk management, air quality and microclimate improvements, habitat for a diversity of plant and animal species, and green amenities for urban residents.
The overall objective must be to make cities liveable and socially inclusive. This includes not only environmentally sustainable planning but ensuring access to affordable and social housing and to public services, education, health and attractive jobs. Integrating health and aging into sustainable urban environment improvement and city planning and urban design will bring together many agencies and specialists to work across sectors and disciplines.
While these good principles create many benefits, it is important to adapt health-and age-specific features into cities and new urban developments, buildings, infrastructure and open spaces. This will be vital for urban competitiveness and will influence individuals’ and companies’ decisions to remain in a certain city or relocate to another.
Making cities healthier and more friendly to the elderly and children requires well-planned urban green spaces, safe, clean and walkable urban environments, and accessible services and facilities for these groups. Women who tend to live longer than men will in particular benefit from these improvements. All of these will help ease public health management in an era when infectious diseases such as the COVID-19 pandemic, noncommunicable diseases and the challenges of aging populations are converging.
Cities also need to combine an age-friendly public transport system with safe and convenient sidewalks and pathways, bicycle parking, parks, public spaces and public service facilities. This effort needs to be integrated with universal urban design to ensure that public spaces, sidewalks, parks, and buildings are accessible for people of all ages and the physically impaired.
Prioritizing health and age-inclusion will not only become the driver and platform for action to address the many challenges of the emerging four-generation cities, but is also a great opportunity to transform urban community life for the better.
Neighborhoods, if designed well, would encourage all residents to contribute to the care of children and the elderly, just by being part of a highly interactive local community.
Urban rehabilitation and retrofitting would reduce carbon emissions as people walk more, and contribute to the country’s objective of peaking carbon emissions before 2030 and reaching carbon neutrality before 2060.
If these principles of urban rehabilitation are applied, local social cohesion and wellbeing in the PRC’s cities will also improve. Urban health and age-inclusive designs will also contribute to the Healthy the PRC 2030 Plan and more generally promote well-being and high-quality development, an overarching objective of the 14th Five-Year Plan (2021-25).
Senior Urban Development Specialist, East Asia Regional Department, ADB
This Op-Ed is reproduced from China Daily.
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