Case Study

Expanding capacity of caregiving professionals: Asian Development Bank geriatric training program in Liaoning, China

Long-Term Care

The ADB, in collaboration with the Chinese government, developed policies and training programs to increase the capacity of geriatric nurses in Liaoning province.

The focus: With a rapidly growing, aging demographic, China is grappling with a lack of long-term care (LTC) workers. At present, China has about 500,000 LTC workers, which amounts to roughly 0.29 workers per 100 older adults, compared with an OECD average of 4.9 per 100 as of 2016. Moreover, geriatric nurses in the country are typically trained only in acute care rather than LTC.

How it works: Starting in 2016, the ADB collaborated with the Chinese government and carried out a three-year program in Liaoning province to develop policies and training programs in geriatric nursing. Local and international experts worked together to develop policy recommendations and create a training curriculum. The program also established a system for teaching three groups—training experts, trainers and caregivers for older adults—to not only train more caregivers but also enable future training.

Enabling environment: A variety of actors, co-ordinated by the ADB, worked together to successfully implement this program, including central and provincial government officials as well as domestic and foreign experts (eg, from the First Affiliated Hospital of China Medical University in Liaoning and Chiba University in Japan). In Liaoning, a multidisciplinary working group—consisting of representatives from the Liaoning provincial departments of finance, education, health and family planning, as well as the civil affairs bureau—was established to provide policy and implementation guidance. However, the ADB served as a cornerstone, director and funder for the project. The program was also presaged and guided by national- and local-level policy initiatives for improving the care of older adults and expanding training programs for care workers, including the Law on the Protection of the Rights and Interests of the Elderly from 2013 and several other national and provincial policies explicitly mandating the improvement of education in caring for older adults, including geriatric nursing.

Impact: The program improved geriatric nursing capacity and future training within Liaoning province, and it improved China’s national geriatric nursing education. Four hundred individuals received high-quality training and gained certification. One hundred percent of clients reported satisfaction with the services provided by the trained nurses. ADB’s technical assistance also led to the development of nationally distributed geriatric training and education materials. Standardized modules and other materials developed through the program have been disseminated to training centers and social welfare institutions around the country. Thus, the program created a pathway for more and better trained geriatric nurses in the future.

Sources Include

Sources include:

Habib N. Caring for Carers in Liaoning Province: Strengthening Elderly Workforce in the People’s Republic of China. ADB, 2019. Available from:

People's Republic of China: Development of Geriatric Nursing Policy Principles and Training Program in Liaoning Province [Internet]. ADB. Available from:

People's Republic of China: Development of Geriatric Nursing Policy Principles and Training Program in Liaoning Province Completion Report. ADB, 2020. Available from: