Publication: Caring for Thailand’s Aging Population
Loading...
Published
2021-04
ISSN
Date
2021-06-08
Editor(s)
Abstract
Thailand is the second-fastest aging country in the Association of Southeast Asian Nations (ASEAN) after Singapore, and it is growing old before it grows rich. Thailand has already made considerable progress in recognizing the ageing challenge and has initiated policy reforms and development programs to address it at both national and local levels. The 2012–16 National Economic and Social Development Plan and, more recently, the 2017–2036 National Strategy, underscore the welfare of older persons as a government priority. At the heart of Thailand’s approach is universal health insurance, supported by a community-based primary health care system with a reliance on volunteers. Thailand is now working to expand access to long-term care (LTC) at the community level as part of this volunteer-supported primary health care system. This report was prepared based largely on secondary sources, given the limitations on travel during 2020. It makes use of the comprehensive results of the Survey of Older Persons in Thailand, as well as excellent studies produced by various government, non-government, and academic authors. Nevertheless, in preparing the report the authors noted considerable data gaps, especially on private sector services, costs and usage, labor force, and projections of future demand for care. The team fact-checked the report with various country and sector experts; however, it should be considered a preliminary overview of the current situation. Additional data and consultation are needed to elaborate on the recommendations provided in this report.
Link to Data Set
Citation
“Glinskaya, Elena; Walker, Thomas; Wanniarachchi, Thisuri. 2021. Caring for Thailand’s Aging Population. © World Bank. http://hdl.handle.net/10986/35693 License: CC BY 3.0 IGO.”
Digital Object Identifier
Associated URLs
Associated content
Other publications in this report series
Journal
Journal Volume
Journal Issue
Collections
Related items
Showing items related by metadata.
Publication Sri Lanka : Addressing the Needs of an Aging Population(Washington, DC, 2008-06)This study is about the key issues that will have to be addressed in order to successfully avert serious problems, or even crisis, as Sri Lanka's inevitable population aging unfolds. The four main chapters of this report focus on these four critical areas in turn. The second chapter examines living arrangements, intergenerational transfers as well as the respect and authority old people enjoy. One of the biggest problems facing old people is lack of independent financial sources, so the third chapter provides an analysis of formal income support programs including pensions and relevant safety net programs. The fourth chapter evaluates the health status of old people and how well placed the healthcare system is to cope with an aging population. Finally, the fifth chapter analyzes the implications of an aging labor force. These chapters are preceded by an overview chapter that presents demographic trends that have contributed to population aging and sketches a portrait of the aging in Sri Lanka.Publication Thailand Public Finance Management Report(World Bank, Washington, DC, 2011-04)This discussion paper is one of five discussion papers for the Thailand public financial management report. It focuses on efficiency and equity in the financing of health services, and the evolving role of central and local government in the health sector. Over the last few decades, Thailand has seen significant improvements in health outcomes, reflecting sustained public investment in both infrastructure and human resources. Thailand has also succeeded in expanding the coverage of health protection schemes, culminating in the introduction of the Universal Coverage (UC) scheme in 2001. These efforts have broadened access to health services, contributed to greater and more equitable utilization, and helped reduce the financial burden and the risk of impoverishment associated with health care expenses. However, there are fewer data on broader measures of health system performance, including dimensions of quality. Overall, available evidence suggests a mixed picture. For instance, while there has been improvement in the management of chronic conditions, a significant number of cases remain undiagnosed or untreated. Similarly, Thailand has seen recent improvement in 2-year survival rates from cancer and heart attacks, but still lags far behind Organization for Economic Co-operation and Development (OECD) countries. While the achievements of Thailand's health system are undeniable, this paper highlights three key challenges: (i) inequalities in utilization and spending; (ii) mounting cost pressures; and (iii) fragmentation of financing and unresolved issues concerning the respective roles of central and local government. This paper provides evidence of regional differences in diagnosis and management of chronic disease, and of survival rates from cancer and heart attacks. These data do not suggest a strong relationship between the health system and spending on the one hand, and on quality or health outcomes on the other. Indeed, efficiency may be a greater concern, with over-provision now a growing problem in some parts of the health system. However, more evidence is needed on these issues. For example, while high levels of spending and utilization in the Civil Servant Medical Benefit Scheme (CSMBS) are often noted, it is less clear whether this is associated with better outcomes (e.g. higher cancer survival rates or improved health outcomes for the elderly). The implications of geographic disparities in spending in the Social Security Scheme (SSS) and the CSMBS also warrant further attention.Publication Why Should We Care About Care?(World Bank, Washington, DC, 2015-04-06)Without appropriate policies to address the expected rise in the care burden, population aging can reduce womens access to economic opportunities and decelerate future growth, thereby threatening the agenda of poverty reduction and shared prosperity in Europe and Central Asia. Based on the analysis of existing and newly collected quantitative and qualitative data, several key policy recommendations can be formulated for policymakers consideration: (a) improvement of the accessibility, affordability, and quality of formal childcare and eldercare options offers a way to address challenges related to excessive reliance on informal care and to capitalize on current opportunities; (b) the design of future demographic, health, and education policy reforms should take into account any potential effects on informal care providers; (c) care leave (both paid and unpaid) can shape families choices about care and market work; (d) flexible work arrangements can function as effective alternatives to unpaid leave; and (e) care-related allowances (both in-kind and cash) aim to promote quality care for children and elders and recognize the work of caregivers but may have negative repercussions on caregivers labor force outcomes. Increased recognition of the critical role of care in aging societies and careful review of the policy environment related to formal and informal care provision can help governments to harness the full potential of demographics, thereby promoting poverty reduction and shared prosperity.Publication From Red to Gray : The "Third Transition" of Aging Populations in Eastern Europe and the Former Soviet Union(Washington, DC: World Bank, 2007)This report focuses on the challenges that the region's aging countries will now face in having to deal with multiple transitions. It argues that their task ahead, though uniquely daunting, is by no means impossible. Indeed, many of the potential problems can be addressed through sensible and thoughtful policies that can be enacted over the next few years. The only danger likely lies in complacency, in not being proactive in addressing the challenges. This report finds, first, that some of the concerns about aging in Eastern European and Former Soviet countries are probably misplaced. Second, the analysis in the report validates concerns about future fiscal strains in some of the region's aging countries, but finds that many of the drivers of higher future public expenditures are unrelated to aging. This report is particularly focused on the future-a future in the region that is critically dependent on actions that countries and societies take now, and over the next few years. The report sends two central messages, which are analyzed against the different patterns of aging across the region. Red light to green light: Growing older does not have to mean growing slower. Aging is not a stop sign for growth-if countries enact policies that boost productivity and labor force participation. Red ink to black ink: Waging sensible policies can ease aging's spending impact. The policies needed to manage much of the expected jump in public spending-especially the impacts on pensions and on health care-are well known. They need only to be enacted and implemented.Publication Russian Federation : The Demographic Transition and Its Implications for Adult Learning and Long-Term Care Policies(Washington, DC, 2011-01)This report describes the demographic transition in the Russian Federation and its implications for adult learning and long-term care policies. The population of Russia is aging and declining rapidly compared to other European nations. Russia's current age structure results from decades of complex demographic trends that have created a population structure with increasingly fewer young people. Women are having fewer children and are waiting longer to have children. Russia's mortality remains higher than in other developed societies. This high mortality is due to an unusually high incidence of non-communicable diseases (NCDs) and injuries among adult men. Two key challenges face Russia. The first challenge is whether public expenditure on pensions and health care will become unsustainable as the size of the elderly population increases. The second challenge is whether declining population sizes will reduce the size of the labor force and hence reduce economic growth.
Users also downloaded
Showing related downloaded files
Publication The Container Port Performance Index 2020 to 2024: Trends and Lessons Learned(Washington, DC: World Bank, 2025-09-22)The Container Port Performance Index (CPPI) provides a global benchmark of how container ports perform in handling vessel calls. Developed jointly by the World Bank and S&P Global Market Intelligence, it measures the time ships spend in port and relates this to the number of containers moved during that time. This approach makes the CPPI a unique diagnostic tool that can highlight patterns in port operations and shed light on global and regional supply chain dynamics. Now in its fifth edition, the CPPI report covers the period from 2020 to 2024. It builds on a well-established methodology to generate scores for more than 400 container ports worldwide. Over time, the CPPI has become a trusted reference point for policymakers, industry stakeholders, and researchers who seek to understand how ports adapt to shocks, recover from disruptions, and identify opportunities for investments, reform and modernization. A major innovation in this edition is the introduction of multi-year trend analysis. Rather than presenting annual snapshots, the report now tracks how CPPI scores have changed across five years. This longitudinal perspective reveals shifts in port performance, showing where scores have risen, fallen, or remained stable. By linking these movements to external factors, the CPPI offers insights into how global and regional supply chains evolve under pressure. The results clearly mirror the crises that have shaken global trade. During the COVID-19 pandemic, CPPI scores in different regions declined sharply as congestion, equipment shortages, and delays overwhelmed many ports. By 2023, global averages rebounded in parallel with easing freight markets and reduced congestion. Yet 2024 brought new challenges: the Red Sea crisis disrupted major trade lanes, while climate-related constraints at the Panama Canal added further stress. These shocks were reflected in lower global and several regional average scores, underscoring the vulnerability of maritime transport to geopolitical and environmental events. The CPPI is not about comparing one port against another, but about understanding changes in performance over time. Ports that improved their scores often did so by reducing time at anchor, optimizing berth operations, investing in digital tools, and strengthening coordination across logistics partners. The evidence confirms that improvements are possible across ports of all sizes, and that rising scores are linked to deliberate actions to minimize time in port relative to containers moved. By consolidating five years of results, this edition transforms the CPPI into a long-term reference point. It shows how global crises have affected shipping, how different regions have adapted, and what lessons can be drawn for future resilience. The World Bank and S&P Global Market Intelligence remain committed to maintaining the CPPI as a global public good, providing transparency, comparability, and practical insights to support more reliable and sustainable maritime supply chains.Publication Global Economic Prospects, January 2025(Washington, DC: World Bank, 2025-01-16)Global growth is expected to hold steady at 2.7 percent in 2025-26. However, the global economy appears to be settling at a low growth rate that will be insufficient to foster sustained economic development—with the possibility of further headwinds from heightened policy uncertainty and adverse trade policy shifts, geopolitical tensions, persistent inflation, and climate-related natural disasters. Against this backdrop, emerging market and developing economies are set to enter the second quarter of the twenty-first century with per capita incomes on a trajectory that implies substantially slower catch-up toward advanced-economy living standards than they previously experienced. Without course corrections, most low-income countries are unlikely to graduate to middle-income status by the middle of the century. Policy action at both global and national levels is needed to foster a more favorable external environment, enhance macroeconomic stability, reduce structural constraints, address the effects of climate change, and thus accelerate long-term growth and development.Publication The Container Port Performance Index 2023(Washington, DC: World Bank, 2024-07-18)The Container Port Performance Index (CPPI) measures the time container ships spend in port, making it an important point of reference for stakeholders in the global economy. These stakeholders include port authorities and operators, national governments, supranational organizations, development agencies, and other public and private players in trade and logistics. The index highlights where vessel time in container ports could be improved. Streamlining these processes would benefit all parties involved, including shipping lines, national governments, and consumers. This fourth edition of the CPPI relies on data from 405 container ports with at least 24 container ship port calls in the calendar year 2023. As in earlier editions of the CPPI, the ranking employs two different methodological approaches: an administrative (technical) approach and a statistical approach (using matrix factorization). Combining these two approaches ensures that the overall ranking of container ports reflects actual port performance as closely as possible while also being statistically robust. The CPPI methodology assesses the sequential steps of a container ship port call. ‘Total port hours’ refers to the total time elapsed from the moment a ship arrives at the port until the vessel leaves the berth after completing its cargo operations. The CPPI uses time as an indicator because time is very important to shipping lines, ports, and the entire logistics chain. However, time, as captured by the CPPI, is not the only way to measure port efficiency, so it does not tell the entire story of a port’s performance. Factors that can influence the time vessels spend in ports can be location-specific and under the port’s control (endogenous) or external and beyond the control of the port (exogenous). The CPPI measures time spent in container ports, strictly based on quantitative data only, which do not reveal the underlying factors or root causes of extended port times. A detailed port-specific diagnostic would be required to assess the contribution of underlying factors to the time a vessel spends in port. A very low ranking or a significant change in ranking may warrant special attention, for which the World Bank generally recommends a detailed diagnostic.Publication Poverty, Prosperity, and Planet Report 2024(Washington, DC: World Bank, 2024-10-15)The Poverty, Prosperity, and Planet Report 2024 is the latest edition of the series formerly known as Poverty and Shared Prosperity. The report emphasizes that reducing poverty and increasing shared prosperity must be achieved in ways that do not come at unacceptably high costs to the environment. The current “polycrisis”—where the multiple crises of slow economic growth, increased fragility, climate risks, and heightened uncertainty have come together at the same time—makes national development strategies and international cooperation difficult. Offering the first post-Coronavirus (COVID)-19 pandemic assessment of global progress on this interlinked agenda, the report finds that global poverty reduction has resumed but at a pace slower than before the COVID-19 crisis. Nearly 700 million people worldwide live in extreme poverty with less than US$2.15 per person per day. Progress has essentially plateaued amid lower economic growth and the impacts of COVID-19 and other crises. Today, extreme poverty is concentrated mostly in Sub-Saharan Africa and fragile settings. At a higher standard more typical of upper-middle-income countries—US$6.85 per person per day—almost one-half of the world is living in poverty. The report also provides evidence that the number of countries that have high levels of income inequality has declined considerably during the past two decades, but the pace of improvements in shared prosperity has slowed, and that inequality remains high in Latin America and the Caribbean and Sub-Saharan Africa. Worldwide, people’s incomes today would need to increase fivefold on average to reach a minimum prosperity threshold of US$25 per person per day. Where there has been progress in poverty reduction and shared prosperity, there is evidence of an increasing ability of countries to manage natural hazards, but climate risks are significantly higher in the poorest settings. Nearly one in five people globally is at risk of experiencing welfare losses due to an extreme weather event from which they will struggle to recover. The interconnected issues of climate change and poverty call for a united and inclusive effort from the global community. Development cooperation stakeholders—from governments, nongovernmental organizations, and the private sector to communities and citizens acting locally in every corner of the globe—hold pivotal roles in promoting fair and sustainable transitions. By emphasizing strategies that yield multiple benefits and diligently monitoring and addressing trade-offs, we can strive toward a future that is prosperous, equitable, and resilient.Publication Digital Progress and Trends Report 2023(Washington, DC: World Bank, 2024-03-05)Digitalization is the transformational opportunity of our time. The digital sector has become a powerhouse of innovation, economic growth, and job creation. Value added in the IT services sector grew at 8 percent annually during 2000–22, nearly twice as fast as the global economy. Employment growth in IT services reached 7 percent annually, six times higher than total employment growth. The diffusion and adoption of digital technologies are just as critical as their invention. Digital uptake has accelerated since the COVID-19 pandemic, with 1.5 billion new internet users added from 2018 to 2022. The share of firms investing in digital solutions around the world has more than doubled from 2020 to 2022. Low-income countries, vulnerable populations, and small firms, however, have been falling behind, while transformative digital innovations such as artificial intelligence (AI) have been accelerating in higher-income countries. Although more than 90 percent of the population in high-income countries was online in 2022, only one in four people in low-income countries used the internet, and the speed of their connection was typically only a small fraction of that in wealthier countries. As businesses in technologically advanced countries integrate generative AI into their products and services, less than half of the businesses in many low- and middle-income countries have an internet connection. The growing digital divide is exacerbating the poverty and productivity gaps between richer and poorer economies. The Digital Progress and Trends Report series will track global digitalization progress and highlight policy trends, debates, and implications for low- and middle-income countries. The series adds to the global efforts to study the progress and trends of digitalization in two main ways: · By compiling, curating, and analyzing data from diverse sources to present a comprehensive picture of digitalization in low- and middle-income countries, including in-depth analyses on understudied topics. · By developing insights on policy opportunities, challenges, and debates and reflecting the perspectives of various stakeholders and the World Bank’s operational experiences. This report, the first in the series, aims to inform evidence-based policy making and motivate action among internal and external audiences and stakeholders. The report will bring global attention to high-performing countries that have valuable experience to share as well as to areas where efforts will need to be redoubled.