The first China's 'healthy ageing' policy research released in the Lancet Regional Health

The Lancet Regional Health - Western Pacific has recently accepted a review of China's healthy ageing policies led by Mao-Yi Tian, a senior researcher at the George Institute for Global Health (China). The study is the first of its kind to use an overview methodology to systematically analyse national policies on healthy ageing in China during the 13th Five-Year Plan period (2016 - 2020). It also for the first time compiles a detailed list of public policy database in China, and summarises the types, transmission direction, advice strength, and formulation purpose of policy documents in China, providing important research elements for future academic studies in this area.

The concept of "Healthy Ageing" began in the late 1980's. According to the World Health Organisation (WHO), the goal of healthy ageing is to enable everyone to experience healthy ageing by creating environments and opportunities - not to eradicate disease or infirmity, but to access better quality health care. In China, the concept was formally incorporated into national policy framework in 2017, with the release of "13th Five-Year Plan for Healthy Ageing", jointly issued by the China’s National Health and Family Planning Commission (NHFPC, now the National Health Commission) and 12 other ministry and departments. During the 13th Five-Year Plan period, the Chinese government has issued a series of policy documents related to healthy ageing, aiming to build a health service system for the elderly that is in line with national economic and social development. Despite the government's clear political will to address the issue, the academic literature on healthy ageing policies in China is quite limited and it is unclear what policy gaps remain from public health perspective.

This study fills the gap. Using an integrated framework of the WHO’s Health System Building Blocks and the Chinese 13th Five-Year Plan for Healthy Ageing, Mao-Yi Tian’s team examine the number, types, themes, publication characteristics and internal linkages of all policies on healthy ageing in China over the past five years. It can be found that the integration of health services and care for older people has been widely mentioned in China's policy development during the 5 years, due to the high priority of “governance models” placed by the Chinese government. Although there is a lack of national-level plans for an integrated model of healthcare for older people, the political will of the government to develop a sustainable financing model for healthy ageing is strong. This indicates that there is an urgent need to improve the affordability of healthcare services to meet the needs of a rapidly ageing population.

Four key policy recommendations include:

1. to enhance multisectoral collaboration in policy development;
2. to strengthen health system building blocks, including healthcare workforce, service delivery, health information, and medical products and technologies;
3. to establish a consolidated policy system centered on the national healthy ageing plan;
4. to formulate a national implementation work plan to promote an integrated health care model for older people.

Mao-Yi Tian, Senior Research Fellow at the George (China) and corresponding author of the study, highlighted that as the challenges of China's ageing population getting bigger, the demand for health services for older people has increased dramatically. Given the cross-cutting nature of healthy ageing, more than half of the relevant policies in China are currently developed jointly by two or more government departments, but the extent of sectoral collaboration remains limited. "Multisectoral collaboration is strongly recommend by WHO as a key strategy to achieve the vision of healthy ageing. Over the past five years, China has made a strong political commitment to actions and we believe that with greater number of sectors being involved, strengthening health systems and care services, it would greatly benefit China in accelerating the achievement of healthy ageing."

As the first review study of policies related to healthy ageing in China, the paper also outlines the types, transmission direction, advice strength, and formulation purpose of policy documents in China, as well as detailing public data sources and search paths for the national policies - also the first of its kind in the relevant academic field. "The number of studies analysing policies from a public health perspective is still limited, we hope that our work will provide necessary reference and assistance for similar research by peers in the future", said Mao-Yi Tian.