发展创新的社区长期护理系统和服务：越南试点项目的经验教训（英）

DEVELOPINGINNOVATIVECOMMUNITY-BASEDLONG-TERM CARESYSTEMS ANDSERVICESLESSONS FROMA PILOT PROJECTIN VIET NAM DEVELOPING ACOMPREHENSIVELONG-TERM CARESYSTEM FOROLDER ADULTS KEY POINTS Viet Nam’s population is rapidly aging and there is a need for aradical increase in support for older adults to cope with futuredemand. Family carers are the backbone of long-term care (LTC)in Viet Nam. Mass organizations are also important stakeholders,notably the Viet Nam Association of the Elderly, and the 9,000-strongIntergenerational Self-Help Club(ISHC) network which, among otherthings, provides volunteer home care toover27,000 people. From 2022 to 2024, an Asian Development Bank (ADB)regional technical assistance project sought to pilotinnovative community-based LTC, including in Viet Nam,based on the principles of supporting aging in place, buildingon local community assets, and providing integrated holisticservices that meet the diverse needs of older people and their families to deliver person-centered care. ADB implemented the project with theMinistry of Health, together with HelpAge International in Viet Nam andthe Provincial Associations of the Elderly. The community-based LTC model, in12 villagesacross4 communes, focused onintegrating health and social services,and strengthening the capacity ofcommunity-based organizations to partner in a systematic process with the commune health stations and other socialcare service providers. This was achieved through the introductionof a community case management system,comprehensive needs assessment, individualized care plans based onspecified care foci, and coordinatingcare service provisions at communeand village levels. Each village hadfive trained community caregiverswho provided home care visits. The community-based LTC modelhas clearly shown the benefitsto older adults, family caregivers,and other family members. Careservices provided in the communityhave become routine, the qualityof care is better and more stable,and access to social protectionentitlements has increased. CONTENTS Figure and Boxes vi Abbreviationsvi On the Way toBeing an Aged Society Existing Long-TermCare in Viet Nam PilotImplementation6 A Community-BasedCare Pilot Outcomesfrom the Pilot10 17 Lessons Learnedfrom the Pilot 20 Recommendations forReplication and Scale-Up This case study was developed under the regional technical assistance forDeveloping InnovativeCommunity-Based Long-Term Care Systems and Services, financed by the High-Level TechnologyFund, Japan Fund for Prosperous and Resilient Asia and the Pacific, Japan Special Fund, and ADB’sTechnical Assistance Special Fund-6. The document was peer-reviewed by ADB’s Emiko Masaki,principal health specialist; Sakiko Tanaka, principal social sector specialist; and Vinh Ngo, socialsector officer. In this publication, “$” refers to United States dollars and “D” refers to Viet Nam Dong.ADB recognizes “Vietnam” as Viet Nam.On the back cover: Population aging in Asia and the Pacific creates an urgency to develop long-termcare systems for older people (photo by ADB). Creative Commons Attribution 3.0 IGO license (CC BY 3.0 IGO) © 2025 ADB. The CC license does not apply to non-ADB copyright materials in this publication.https://www.adb.org/terms-use#openaccesshttp://www.adb.org/publications/corrigendaPublication Stock No. ARM250402-2pubsmarketing@adb.org Figure and Boxes FIGURE Case Management Flow for Active Aging Hubs7 BOXES 1Care Foci and Interdisciplinary Care Protocols92Supporting Older People to Better Access Their Rights and Benefits113Regular Health Checkups at Home: The Role of the Commune12Health Stations4Hand-in-Hand with the Local Intergenerational Self-Help Club135Structure and Tasks of the Commune Care Coordinating14Committee Members6Change to the Benefits of Community Caregiving15 Abbreviations ADB–Asian Development BankISHC–intergenerational self-help clubLTC–long-term care On the Way toBeing an Aged Society Viet Nam’s 101.6 million population is rapidly aging.In 2019, 14.5% of the population were aged 60 andabove, but by 2050 the proportion is forecast to riseto 25%.1 Alongside this fast pace of population aging,Viet Nam is experiencing an increasing burden ofdisease. There has also been a decline in traditionalcare at home for older adults, due to migration andchanging family structures. These three factorsgreatly affect the long-term care (LTC) needs ofthe older adults in Viet Nam. Population ratio ofaged 60 and above The Government of Viet Nam has recognized these needs and considersolder adults to be a priority target group. On 13 October 2020, the PrimeMinister approved a program on health care for older people through 2030to ensure adaptation to population aging and to contribute to the successfulimplementation ofViet Nam’s Population Strategy to 2030.2This programincludes specific goals, such as improving the rate of examination, treatment,and disease management for older adults at health facilities