“I live alone,” says Nguyen Thi Tuyen, a 78-year-old woman living with Parkinson’s Disease in Viet Nam’s Nghia Ninh commune in Quang Binh province. “I have three children, but they have migrated to other places to earn their living and rarely visit me. I do not eat much and do not need much clothing. What I need more is medications for my disease and have someone to talk with and help me.”
Living alone is hard for older people like Tuyen, who has difficulty walking. Her medication costs about US$25 per month, while a contributory pension—her only source of income—is just US$170.
Globally, by 2050, 1.5 billion people will be 65 and older. As the World Bank publication “Silver Opportunity: Building Integrated Services for Older Adults around Primary Health Care” makes clear, seniors have much to offer society but they need support to stay healthy and connected.
Viet Nam is one of the most rapidly ageing countries in the world. According to the UN population project, the number of Vietnamese people over 60 years of age is projected to increase rapidly from 11.8 percent of the population (11.4 million people) in 2019 to 20.8 percent (22.8 million people) in 2039. The proportion of older people living alone is also increasing due to smaller family sizes and rising domestic and international migration. Currently 6.3 percent of the older population (or 796,000 people) needs care to attend activities of daily living.
Intergenerational Self-Help Clubs: Providing care for older adults
In response, the Vietnamese government is supporting the roll out of Intergenerational Self-Help Clubs (ISHCs). Established at the grassroots level, each club consists of between 50-70 members, the majority being older people, women, and vulnerable groups, who provide mutual support to one another. The clubs are managed by the national Association of the Elderly.
“Intergenerational Self-Help Clubs are an innovative model that provide comprehensive services for disadvantaged people, utilizing existing community resources,” says Nguyen Ngoc Toan, Deputy Director of the Social Protection Bureau at Viet Nam’s Ministry of Labor, Invalids, and Social Affairs.
The government wants to see the clubs in at least 80% of communes in Viet Nam by 2030. If this target is achieved, it would make them the largest care provider for older people in Viet Nam.
Since 2021 the World Bank in partnership with the Japan Social Development Fund (JSDF), through the Reducing Income- and Health-Related Vulnerability of Older Persons in Viet Nam, has supported the expansion of ISHCs in six provinces: Thanh Hoa, Hoa Binh, Quang Binh, Da Nang, Khanh Hoa and Ninh Thuan. The project is implemented by HelpAge International in Vietnam in partnership with the Association of the Elderly in the 6 provinces. To date, the project has helped establish 186 clubs and benefitted more than 24,725 people. The model is helping to fill a capacity gap. Over the last decade, the Vietnamese government has developed a public care system that includes 418 social protection centers serving around 10,000 older people. However, the demand goes far beyond the current capacity of the country’s aged care system.
The ISHC project aims to increase the participation of older people in income-generating activities, their use of community-level health and social care services through regular health checkups and monitoring, homecare services, sports and physical exercise, access to health insurance, access to rights and entitlement, culture and educational services, and other resources.
Bui Thi Duoi, 78, in Cao Phong district of Hoa Binh province, receives support from two ISHC homecare volunteers. Both of her legs have been paralyzed for the past four years due to complications from joint illness. It is difficult for her to move around and go about her daily life.
“Before I often cried because I could sit only in one place. But since they (ISHC volunteers) come to help, my life has changed, I feel much happier now,” Ms. Duoi says. “The ISHC care services really help to fill in the care need that currently the government system is unable to provide.”
Volunteers who feel like family
Back in Quang Binh province, Tuyen for the past two years has been receiving regular visits from two homecare volunteers who assist her with daily activities. They help her take a bath, wash clothes, do chores, shop for groceries, get physical exercise, and ensure she gets her medications as per her prescription.
Nguyen Thi Hien, Tuyen’s daughter, sees the volunteers’ visits helping her mother feel less lonely and isolated. “They do not mind coming to the house early in the morning to take care of her. The homecare volunteers are like our family members,” she says.
The Intergenerational Self Help Club model is clearly valued by older people, their communities, and local authorities. As Viet Nam’s population continues to age in the coming decade, the Clubs will be a valuable resource that helps to keep people healthy and thriving in their old age.
