Long-Term Care and

Human Resource
Development
Country Case Study
 About the Research

Health & Social

Development Sector
and Thematic
Groups

Strategy 2030 –
Demographic
Transition &
Operational Priority
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 TESDA

Dr. Shelly De La
Vega

POEA
COSE

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Country Study

South Korea
Japan

Singapore Philippines

Indonesia

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long-Term Care (LTC)
Activities undertaken by others to ensure that people with or at
risk of a significant ongoing loss of intrinsic capacity can
maintain a level of functional ability consistent with their basic
rights, fundamental freedoms and human dignity (WHO 2015)

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 Global Population Ageing
In 2017, 962 million people are aged
80 y/o and above
2017 – 137 million 60 or over 13% of the world’s
2050 – 425 million population - 500 million in 1990
Triple growth – 288
million increase

Cause
declining fertility rates
and increasing life
expectancies. 2.1 billion by 2050 at 3% growth rate

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 Ageing Trend in Asia & Pacific and the Human
Resource Challenges

Trends Challenges
Declining fertility rate and increasing
Prevalence of non-communicable
life expectancy
diseases & cognitive impairment
Japan – 1.44 (dementia)
South Korea – 1.05
Changing Socio-economic and family
By 2050, Asia & the Pacific region will structures
have the largest share of persons
aged 60+ (870 million) from 334
SDG 3: Ensure healthy lives and promote
million in 2016
wellbeing for all at all ages

Dynamic in ageing – pace varies

among countries in the region
o East and North Asia – Japan,
Korea
o Southeast Asia – Philippine,
Indonesia
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8,200,000
Long-term care workers
missing in Asia (ILO)

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 ILO Definition of LTC Workers

Health Occupations Non-health Occupation

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1.
Singapore
Case Study

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 Low Fertility and High Life Expectancy

Fertility rate in 2017 –

1.16 (7-year low) Old-age support ratio
4.4 in 2017 to 2.4 in
Total Population – 5.612 2030
million

1/10 aged 60+ has

dementia
People aged 65+ 50% of those aged 85+
516,700 (2017) have it
900,000 (2030)
By 2030, dementia
patients will grow 2-fold
to 103,000
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 “
Nursing homes must look beyond the medical model and
institution-based care and toward a holistic and humanistic
approach grounded in residents’ emotional and socio-
psychological needs...Such needs are mostly not adequately met
by Singapore’s nursing homes presently

” Gabriel H.Z Wong, Weng Sun Pang,

Philip Yap1Department of Geriatric
Medicine, Khoo Teck Puat Hospital

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 Manpower Shortage in LTC
Overall 9,000 – 10,000 healthcare workers missing
LTC Sector - need 3,700 direct care workers by 2020

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 Manpower (Local) Shortage in LTC

Professional Care Staff Doctors

• Nurse & Allied Health • Not enough generalists
professionals • Needs more doctors who
• 5th most hard-to-fill specialize in geriatrics or
professions by locals internal medicine
• Unattractive pay & little • However few medical
work balance students aspire to
• 85% foreign hire in become geriatricians
nursing homes (support
care staff)
• Undertrained & underpaid
•
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 Steps Towards the Right Direction

Capacity Building
2020 Healthcare
and Resource Migrant Worker
Manpower Plan Integration

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 Steps Towards the Right Direction

2020 Healthcare Capacity Building and Migrant Worker Levy

Manpower Plan Resource Integration Subsidies
Integrated nursing Agency for Integrated Flat rate S$265
scholarship Care & Silver Page Concessionary rate S$60
caregiver training
program
Degree-conversion
Healthcare Programs
Home-to-Hospital Scheme
The return-to-nursing
Programs

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Technology in Elderly Care

Smart Health TeleRehab

Physiotherapist system – one

ipad & 2 sets of censors

Allows patients to complete

rehab exercise in place at
cheaper price

Boost participation rates and

lowers re-admission risk

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2.
Philippine
Case Study

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 Ageing in Philippine
Growth of number of elderly persons is higher than that of
its population growth

Number of citizens aged 60+ grew from 4.6 – 6.5 million

(from 2000-2010)
By 2030, 126 million elderly persons, 13% of the
population

Home/ family centered care

Institutional care is not socially acceptable

Outmigration – “brain drain”

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 Nursing Shortage

• 2.3 healthcare workers per 10,000 population

• WHO recommendation 24/10,000
• 500,000 registered nurse working
• 200,000 unemployed
• Nurse to patient ratio 1:30 (Ideally should be 1:12)
• 92,277 nurses have left the country to work abroad
since 2012
• Alternative - Call centers
• Problem does not lie in the number of nurses
• Nursing schools and training institutions are booming in response
to global demand
• Lack of health and nursing care facility, and employment
opportunity

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8,013,059 Elderly Persons

147 Geriatricians

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 Steps Towards the Right Direction

Research NGO Policy

Funded by National Coalition of Services for Republic Act 7432
Institute of Health the Elderly – Home Care • 20% discounts for
• Status of Gerontology Training elderly persons
Education in Philippine • Situation analysis • Exempted from certain
Medical and Nursing • Resource mapping state health facilities
Schools & Status of
• Necessary skills in • Automatically enroll in
Dementia Care and
geriatric care PhilHealth
Workforce in the
Philippines • Self-care • Social Pension
Ongoing - Longitudinal
Study of Ageing and Connects elderly persons Geriatrics added to
Health in the Philippines with health facilities medical school curricular
(LSAHP)

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Japan-Philippine Economic Partnership Agreement

◈ Bilateral economic partnership agreement (2006)

• Investment, free trade and movement of natural
persons
• Qualified nurses and care workers can work in
Japanese nursing institutions
• Given 2-3 years to pass the national exam
• Low passing rate
• Harsh working conditions
• Up to 38% who passed the exam returned
home
• Language (37.8%), training and accreditation
issues

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 Certification Gap and Mobility

Skills and
accreditation
Supplying Country Receiving Country

TESDA Japan

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Triple-Win Project with Germany

Agreement between German Federal Employment

Agency and Philippine Overseas Employment
Administration
• Allows qualified nurses find employment in Germany
• Win-Win-Win Situation
• Language and professional preparation assistance
• Integration support in Germany
• Better career development path
• Permanent residence available

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 Recommendations

Improve nurse & Improve branding

Promote public
care worker’s and pay for
discussion and
working condition geriatricians
awareness
and salary

Collaboration Investment in Regional solution

among healthcare capacity – act locally think
government and technology regionally
agencies and civil
society
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 ADB’s Role in LTC Human Resource Development

Provide Platform and spark Develop education & health

conversation programs in DMCs
i.e. Innovations and Actions Against i.e. ADB $100 Million Assistance to
Non-Communicable Diseases Improve Elderly Care Services in
(IAAN)Conference (July 16-18) Hebei Province

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 Thanks!

Any questions?
You can find me at:
yichen.zhu@u.nus.edu

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Reference
https://www.japantimes.co.jp/news/2015/02/24/national/filipino-indonesian-trainee-nurses-to-get-
more-time-to-pass-japan-exams/#.W1-vAmZ7Fp8

https://www.straitstimes.com/singapore/health/more-help-at-hand-for-dementia-patients

https://mipaa.unescapsdd.org/files/documents/SDD%20Ageing%20Fact%20Sheet%20Overview.pdf

http://www.gs.org.sg/sg50conference/pdf/s4-1.pdf
http://www.lienfoundation.org/sites/default/files/Long%20Term%20Care%20Manpower%20Study%
20FINAL_0.pdf

http://www.un.org/en/sections/issues-depth/ageing/

http://www.lienfoundation.org/sites/default/files/Long%20Term%20Care%20Manpower%20Study%
20FINAL_0.pdf

https://www.irishtimes.com/news/world/asia-pacific/birth-rates-in-japan-fall-to-lowest-level-on-
record-1.3336732

https://www.straitstimes.com/singapore/health/more-help-at-hand-for-dementia-patients

https://qz.com/1219977/south-korea-recorded-its-lowest-ever-fertility-rate-in-2017/

Health workforce : a global supply chain approach : new data on the employment effects of health
economies in185 countries / Xenia Scheil-Adlung30; International Labour Office, Social Protection
Department. - Geneva: ILO,2016.
Appendix

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