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Southeast Asia’s aging population, projected to rise from 12.5% in 2023 to 22.6% by 2050, strains health systems, necessitating equitable, sustainable long-term care (LTC) solutions. Guided by the WHO’s Integrated People-Centered Health Services (IPCHS) framework, this study evaluates community-based LTC and digital inclusion to enhance health system resilience, drawing comparative insights from Thailand, Japan, and Germany. Thailand’s LTOP project, which utilizes village health volunteers, has reduced hospital readmissions by 15% and served 219,518 older adults as of 2019. Japan’s community salons and Germany’s Pflegeversicherung demonstrate cost-effective, culturally aligned care. Digital innovations like telehealth and AI-driven monitoring improve access for marginalized groups—rural poor, Indigenous, and disabled elders—but face barriers, including a digital divide (only 35% of disabled Thai elders access telehealth), data privacy, and cybersecurity. Challenges include workforce shortages (1.9 million projected by 2030), funding constraints, and gender disparities, with women providing 70% of unpaid care in Thailand. This study proposes a stakeholder-driven, equity-focused policy roadmap with short-term, medium-term, and long-term actions, including innovative financing, digital literacy training, and integrated care systems, to foster sustainable LTC. Aligning with SDG 3, it leverages cultural strengths, such as Vietnam’s Intergenerational Self-Help Clubs, to support resilient health systems by 2050.

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Sustainable and Equitable Health Systems in Southeast Asia: Integrating Community Based Long-Term Care and Digital Inclusion Through a People Centered Framework

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  • 发表日期：

    2025年

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  • I-Chun Chen,
  • Ruttiya Bhula-or

摘要

Southeast Asia’s aging population, projected to rise from 12.5% in 2023 to 22.6% by 2050, strains health systems, necessitating equitable, sustainable long-term care (LTC) solutions. Guided by the WHO’s Integrated People-Centered Health Services (IPCHS) framework, this study evaluates community-based LTC and digital inclusion to enhance health system resilience, drawing comparative insights from Thailand, Japan, and Germany. Thailand’s LTOP project, which utilizes village health volunteers, has reduced hospital readmissions by 15% and served 219,518 older adults as of 2019. Japan’s community salons and Germany’s Pflegeversicherung demonstrate cost-effective, culturally aligned care. Digital innovations like telehealth and AI-driven monitoring improve access for marginalized groups—rural poor, Indigenous, and disabled elders—but face barriers, including a digital divide (only 35% of disabled Thai elders access telehealth), data privacy, and cybersecurity. Challenges include workforce shortages (1.9 million projected by 2030), funding constraints, and gender disparities, with women providing 70% of unpaid care in Thailand. This study proposes a stakeholder-driven, equity-focused policy roadmap with short-term, medium-term, and long-term actions, including innovative financing, digital literacy training, and integrated care systems, to foster sustainable LTC. Aligning with SDG 3, it leverages cultural strengths, such as Vietnam’s Intergenerational Self-Help Clubs, to support resilient health systems by 2050.