Innovating Care for an Aging Nation: ADB’s Pilot Transforms Elder Support in Vietnam

The ADB-led study, in partnership with Vietnam’s Ministry of Health and HelpAge International, piloted a community-based long-term care model that integrated health and social services to help older adults age with dignity. Implemented across Thanh Hoa and Hoa Binh provinces, it improved seniors’ well-being, reduced caregiver stress, and strengthened local coordination, offering a blueprint for sustainable elder care in Asia.

The Asian Development Bank (ADB), in collaboration with the Ministry of Health of Vietnam, HelpAge International in Vietnam, and the Provincial Associations of the Elderly, launched an ambitious study titled “Developing Innovative Community-Based Long-Term Care Systems and Services: Lessons from a Pilot Project in Vietnam.” Implemented between 2022 and 2024 with support from the High-Level Technology Fund and Japan’s development programs, the project piloted a new model of long-term care (LTC) designed to help older adults “age in place.” It focused on strengthening community participation, integrating health and social services, and creating a sustainable, person-centered care system.

The Urgent Need for Long-Term Care

Vietnam’s demographic landscape is transforming rapidly. In 2019, 14.5% of the population was aged 60 or older, and by 2050, that figure is expected to reach 25%. Alongside this aging trend comes a rise in noncommunicable diseases and a decline in traditional family caregiving due to migration and social change. While family members, mainly women, remain the backbone of elder care, they often work without training or institutional support. The government’s 2020 national program on health care for older adults aims to strengthen these community systems, but formal long-term care infrastructure remains limited, with just 142 facilities nationwide serving around 9,000 elderly people. This gap highlights the pressing need for innovative, scalable community-based care solutions.

The Pilot: Testing Community-Based Innovation

The ADB’s pilot was implemented from July 2023 to November 2024 across twelve villages in Thanh Hoa and Hoa Binh provinces. It targeted older people with significant physical or cognitive decline or those at risk of losing independence. Each participating village trained five community caregivers to provide regular home visits, supported by commune health stations. The project introduced a structured case management system, a method integrating health and social care through risk screening, comprehensive needs assessments, and personalized care planning. These plans were guided by 32 “care foci,” covering areas such as mobility, nutrition, loneliness, and chronic disease management.

In practice, this model combined medical supervision with social and emotional support. Commune health workers conducted home checkups, while volunteers helped with daily tasks, monitored health, and offered companionship. In villages with established intergenerational self-help clubs (ISHCs), implementation was smoother thanks to existing volunteer networks and community trust. In others, more effort was needed to recruit and train caregivers.

Transforming Lives Through Local Empowerment

The outcomes were profound. Nearly three-quarters of the clients were women, and most were over 80 years old. Many faced mobility problems, malnutrition, or depression. After joining the program, their quality of life improved markedly, hospital admissions declined, family caregivers felt less burdened, and community caregivers gained pride and recognition. Local committees reported that older people were more active and engaged in community life.

The project also facilitated access to social protection. One case described an elderly woman named Son, who had been excluded from disability benefits despite her severe condition. The case management team intervened with district authorities, enabling her to receive a monthly allowance that eased her hardship and restored her dignity. Another participant, 94-year-old Yen, experienced reduced loneliness and improved health after regular home visits by caregivers. Such stories captured the human impact of this community-driven approach.

Lessons and the Road Ahead

The pilot demonstrated that integrating community caregivers, local health workers, and social agencies can dramatically improve long-term care outcomes. Yet it also revealed gaps. In some areas, only a fraction of those needing care received it, underscoring the need for greater resource allocation. Access to assistive devices remained limited, and most caregivers were unpaid women, raising questions about gender equity and sustainability. The study recommends fair remuneration, continuous training, and stronger policy backing to ensure long-term viability.

Moving forward, the report outlines a roadmap for scaling up the model nationwide. It proposes assigning commune-level responsibility for LTC within Vietnam’s simplified two-tier government structure, institutionalizing training programs under the Ministry of Health, and expanding health insurance coverage for home-based treatment and nursing. Financing should combine state budgets, community fundraising, and insurance contributions. The rapid expansion of ISHCs is also encouraged as they are essential for fostering healthy aging and social inclusion.

ADB’s pilot in Vietnam proves that long-term care can be compassionate, cost-effective, and community-led. By blending traditional solidarity with modern care management, Vietnam is paving the way toward a humane and sustainable system that ensures older citizens live not just longer, but better lives. This model, rooted in local empowerment and supported by global expertise, offers a blueprint for other Asian nations facing similar demographic transformations.