Long-term care financing

Extending access and improving quality of long-term care (LTC) services are sound public investments that can result in economic and societal benefits. However, financing long-term care poses challenges. There is a need to better understand how countries can establish financing systems for long-term care to ensure that older people get needed care without falling into financial hardship.

To produce a series of WHO briefs summarizing the evidence to inform policies and investments financing long-term care in low-and middle-income countries, and a book about the importance of investing in long-term care produced jointly with EURO and the European Observatory for Health Systems and Policy.

Research is being undertaken to collect evidence to inform the WHO Financing Recommendations for Long-Term Care. The separate research papers will be issued as background papers. The background papers include the gender equity implications of financing long-term care, public finance and budgeting for long-term care, a rapid scoping review of important policy and systems initiatives for long-term care financing, and a review of issues in long-term care financing and implications for low- and middle-income countries. This research will also be informed by WKC previous research quantifying unmet need for care for older persons. This research also builds on work with the EURO observatory for health policies and systems in publishing an investment case for LTC in cooperation with academics globally. 

Research brief series. Long-term care financing: lessons for low- and middle-income settings

Brief 1. What is driving the demand for long-term care?

World Health Organization. (‎2023)‎. Long-term care financing: lessons for low- and middle-income settings: brief 1: drivers of the demand for long-term care. World Health Organization. https://iris.who.int/handle/10665/375891. License: CC BY-NC-SA 3.0 IGO

Brief 2. What are the approaches in determining population coverage for long-term care?

World Health Organization. (‎2024)‎. Long-term care financing: lessons for low- and middle-income settings: brief 2: decisions about population coverage of long-term care. World Health Organization. https://iris.who.int/handle/10665/376245. License: CC BY-NC-SA 3.0 IGO

Brief 3. How do countries pay for long-term care?

World Health Organization. (‎2024)‎. Long-term care financing: lessons for low- and middle-income settings: brief 3: how countries finance long-term care. World Health Organization. https://iris.who.int/handle/10665/376276. License: CC BY-NC-SA 3.0 IGO

Brief 4. What long-term care services will be covered?

World Health Organization. (‎2024)‎. Long-term care financing: lessons for low- and middle-income settings: brief 4: determining the long-term care services covered in the benefits package. World Health Organization. https://iris.who.int/handle/10665/376277. License: CC BY-NC-SA 3.0 IGO

Brief 5. How have countries aligned financing and delivery of long-term care services?

World Health Organization. (‎2024)‎. Long-term care financing: lessons for low- and middle-income settings: brief 5: aligning financing and delivery in long-term care. World Health Organization. https://iris.who.int/handle/10665/376615. License: CC BY-NC-SA 3.0 IGO

Brief 6. How have countries ensured financial protection for the poor?

World Health Organization. (‎2024)‎. Long-term care financing: lessons for low- and middle-income settings: brief 6: ensuring financial protection in long-term care. World Health Organization. https://iris.who.int/handle/10665/376619. License: CC BY-NC-SA 3.0 IGO

Brief 7. How do countries promote quality and value in long-term care?

World Health Organization. (‎2024)‎. Long-term care financing: lessons for low- and middle-income settings: brief 7: promoting quality and value in long-term care. World Health Organization. https://iris.who.int/handle/10665/376911. License: CC BY-NC-SA 3.0 IGO

Brief 8. How have countries ensured financial sustainability for long-term care?

World Health Organization. (‎2024)‎. Long-term care financing: lessons for low- and middle-income settings: brief 8: ensuring financial sustainability in long-term care. World Health Organization.  https://iris.who.int/handle/10665/376937. License: CC BY-NC-SA 3.0 IGO

Brief 9: How have countries supported the recruitment and retention of the LTC workforce?

World Health Organization. (2024). Long-term care financing: lessons for low- and middle-income settings: brief 9: Supporting workers in the formal long-term care system. World Health Organization. https://iris.who.int/handle/10665/378692. Licence: CC BY-NC-SA 3.0 IGO

Brief 10: Supporting informal long-term caregivers for older people

World Health Organization. (‎2024)‎. Long-term care financing: lessons for low- and middle-income settings: brief 10: supporting informal long-term caregivers. World Health Organization. https://iris.who.int/handle/10665/379077. License: CC BY-NC-SA 3.0 IGO

Brief 11: Technologies for promoting healthy ageing

World Health Organization. (‎2025)‎. Long-term care financing: lessons for low- and middle-income settings: brief 11: technologies for promoting healthy ageing. World Health Organization. https://iris.who.int/handle/10665/382156. License: CC BY-NC-SA 3.0 IGO

Background paper 1 and research brief: Issues in long-term care financing.

• Costa-Font J, Raut N. A review of issues in long-term care financing. WHO Centre for Health Development Working Paper on Long-Term Care. November 2022. DOWNLOAD 
• Costa-Font, Joan & Raut, Nilesh. (‎2025)‎. Global policies for financing long-term care. World Health Organization. https://doi.org/10.2471/B09361. License: CC BY-NC-SA 3.0 IGO

Background paper 2 and research brief: Lessons learned from the Kansai region of Japan

• World Health Organization, Imanaka, Yuichi, Sasaki, Noriko & Goto, Etsu. (‎2023)‎. Financing long-term care for older people: intergenerational transfers and financial stability in Japan. World Health Organization. https://iris.who.int/handle/10665/373541. License: CC BY-NC-SA 3.0 IGO
• Imanaka, Yuichi, Sasaki, Noriko & Goto, Etsu. (‎2025)‎. Intergenerational fairness in long-term care financing in Japan. World Health Organization. https://doi.org/10.2471/B09353. License: CC BY-NC-SA 3.0 IGO

Background paper 3 and research brief: Gender equity implications for long-term care financing

• World Health Organization, Saito, Tami, Jin, Xueying, Noguchi, Taiji, Komatsu, Ayane. et al. (‎2023)‎. Inequities by sex and gender in access to, and affordability of, long-term care: modifiable factors. World Health Organization. https://iris.who.int/handle/10665/373610. License: CC BY-NC-SA 3.0 IGO
• Saito, Tami, Jin, Xueying, Noguchi, Taiji, Komatsu, Ayane & Kanamori, Mariko. (‎2025)‎. Gender inequities in long-term care. World Health Organization. https://doi.org/10.2471/B09357. License: CC BY-NC-SA 3.0 IGO

Background paper 4 and research brief: How countries publicly finance long-term care

• World Health Organization, Cheng, Terence C., Yip, Winnie & Feng, Zhanlian. (‎2023)‎. Public provision and financing of long-term care: case studies in middle- and high-income countries. World Health Organization. https://iris.who.int/handle/10665/375854. License: CC BY-NC-SA 3.0 IGO
• Cheng, Terence C., Yip, Winnie & Feng, Zhanlian. (‎2025)‎. Public long-term care provision and financing. World Health Organization. https://doi.org/10.2471/B09360. License: CC BY-NC-SA 3.0 IGO

Background paper 5 and research brief: Rapid scoping review about initiatives to improve coverage, quality, financial protection and financial sustainability in long-term care

• World Health Organization, Macdonald, Marilyn, Langman, Erin & Caruso, Julie. (‎2023)‎. Initiatives to improve the coverage, quality, financial protection and financial sustainability of long-term care: a rapid scoping review. World Health Organization. https://iris.who.int/handle/10665/373547. License: CC BY-NC-SA 3.0 IGO
• Macdonald, Marilyn, Langman, Erin & Caruso, Julie. (‎2025)‎. Initiatives to improve long-term care financing and coverage. World Health Organization. https://doi.org/10.2471/B09359. License: CC BY-NC-SA 3.0 IGO

Cylus J et al. The Care Dividend: why and how countries should invest in long-term care. Cambridge University Press. 2025.

Collection "The care dividend from investing in long-term care" that summarizes the main findings of The Care Dividend:

• Unlocking economic growth in an ageing world. Geneva: World Health Organization; 2025. https://doi.org/10.2471/B09377
• The vital link between long-term care and health care systems. Geneva: World Health Organization; 2025. https://doi.org/10.2471/B09379
• Fostering individual health and financial well-being through robust care systems. Geneva: World Health Organization; 2025 (The care dividend from investing in long-term care). https://doi.org/10.2471/B09381
• How governments can lead on care innovation. Geneva: World Health Organization; 2025 (The care dividend from investing in long-term care). https://doi.org/10.2471/B09393

Barber SL, Ong P, Han ZA. (2025). Long-term care in Ageing Populations. In: Haring R, Kickbusch K, Ganten D, Moeti M (eds) Handbook of Global Health, Springer, Cham. https://link.springer.com/referencework/10.1007/978-3-030-05325-3

Macdonald M, Weeks LE, Langman E, et al. (2024). Recent innovations in long-term care coverage and financing: a rapid scoping review. BMJ open, 14(2), e077309. https://doi.org/10.1136/bmjopen-2023-077309