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Ministry of Health | Ministry of Social Affairs
ADB report titled Developing Innovative Community-Based Long-Term Care Systems and Services: Lessons from a Pilot Project in Indonesia outlines the development and implementation of innovative community-based long-term care (LTC) systems and services for older adults in Indonesia.
Indonesia is undergoing a significant demographic shift, with people aged 60 and above projected to account for nearly 20% of the population by 2045. To address the inadequate formal care infrastructure, the Asian Development Bank (ADB), in collaboration with Bappenas, piloted a community-based long-term care (LTC) model across five sites in Yogyakarta and Bali between 2022 and 2024. This pilot introduced Community Care Hubs (CCHs) as a single-source integrated care system designed to galvanize existing services and provide holistic, person-centered support while enabling “aging in place”.
Operationalizing Integrated Care through CCHs The core of the CCH model rests on integrated case management and community engagement:
Case Management and Risk Stratification: CCHs conduct universal data collection through the SILANI platform to stratify older adults into three levels based on their care needs, ranging from minimal support for healthy individuals to comprehensive, coordinated care for the frail and vulnerable.
Diverse Service Offerings: Hub activities are categorized into active aging (e.g., yoga, traditional dance), care and support (personal care and home visits), and information and referral to government health and social resources.
Capacity Building: Specialized training programs for both government staff and local cadres cover clinical care issues like dementia, sarcopenia, and palliative care, ensuring a minimum standard of safe and professional service delivery.
Lessons in Sustainability and Replication The pilot demonstrated that community-based care can thrive even with limited resources if supported by strong local leadership and multi-source financing. A key finding was the importance of ownership at all levels of government and the need for a professional “case manager” to bridge the gap between social and medical services. However, for effective national scale-up, gaps in transport, assistive devices, and dedicated governance within a lead ministry must be addressed to ensure consistent service standards across diverse regional contexts.
What is the “SILANI 2.0” system in the context of Indonesia’s long-term care? SILANI 2.0 is an advanced digital case management and information system integrated with Indonesia’s “One Data” initiative. It enables 24/7 data analytics and real-time monitoring of older adults’ care journeys, providing a unified ecosystem for screening, risk stratification, and service intervention. This digital backbone is critical for informing evidence-based policy and ensuring transparent service delivery across the network of Community Care Hubs.
Policy Relevance
The Indonesian CCH model provides a strategic template for India as it navigates its own rapid aging in states like Kerala and Tamil Nadu.
DPI for Elderly Care: India can adapt the SILANI model to build a robust Digital Public Infrastructure (DPI) for elderly care, integrating disparate health and social security datasets to improve beneficiary targeting.
Formalizing Informal Care: By training local “cadres” and recognizing prior learning, India can institutionalize its vast informal care network, creating a professional workforce to support home-based aging.
Inter-Ministerial Coordination: The pilot underscores the necessity for a “lead sector” to prevent the fragmentation and duplication of efforts between ministries of health, social justice, and urban affairs.
Sustainable Financing: Leveraging local governance (similar to Indonesia’s Dana Desa) and supplemental community fundraising offers a decentralized financing model for scaling elderly care in rural India.
Follow the full report here: Developing Innovative Community-Based Long-Term Care Systems and Services: Lessons from a Pilot Project in Indonesia