China has entered a new phase of systematic development for rural elderly care services during the "15th Five-Year Plan" period, following the State Council's release of the "Plan for Accelerating Agricultural and Rural Modernization." This document integrates the construction of rural elderly care service systems into the broader framework of building livable, business-friendly, and beautiful villages, outlining comprehensive measures across service networks, institutional safeguards, and industrial integration.
As the aging population accelerates, the shortcomings in rural elderly care have become increasingly evident, making it urgent to establish a service system tailored to rural realities. Aligning with national top-level design, identifying key priorities for building this system is essential for achieving high-quality development in rural elderly care during the 15th Five-Year Plan period.
The cornerstone of rural elderly care system construction lies in achieving precise alignment between supply and demand. Only by clarifying the needs of rural elderly populations and their priorities can targeted services be provided, ensuring effective service delivery. Currently, the rural elderly population in China is diverse, with significant variations in economic foundations and resource conditions across regions, leading to differentiated service demands. Accurate identification of these needs is crucial.
Two fundamental approaches guide this identification process. First, differentiated services should be provided based on the type of elderly individuals, with a particular focus on key groups such as the disabled, semi-disabled, left-behind, and those living alone. Second, local resource endowments and development conditions must be leveraged to build service systems that are adapted to local realities, exploring localized and distinctive service models and pathways.
Rural elderly care is a comprehensive livelihood project involving multiple departments and a wide range of tasks, making coordination challenging. Historically, rural elderly care services in China have been organized at the administrative village level, leading to a lack of synergy between county and township functional departments, scattered resources, uneven service quality, and difficulty in forming a seamless, closed-loop service guarantee chain. To fundamentally address these challenges, issues such as low planning levels and poor departmental coordination must be resolved.
In this context, county-level coordination for building elderly care service systems has become a key measure to tackle these difficulties. Horizontally, counties serve as a critical hub connecting urban and rural elderly care services, leveraging the functional advantages of county-level governments to coordinate multiple departments and integrate rural elderly care resources. Vertically, the rural elderly care service system spans three levels—county, township, and village—and only through county-level coordination can service resources be optimized across different tiers, enhancing the systematic construction of services.
Building a rural elderly care service system requires not only government action but also the mobilization of endogenous rural vitality. The vast number of rural elderly individuals in China means that relying solely on government resources is insufficient to meet all service demands. A diversified participation framework involving multiple stakeholders is essential. Rural communities possess rich organizational and governance resources that can provide strong support for elderly care system construction.
On one hand, the core role of family-based care should be fully leveraged, establishing a policy support system grounded in family care. Although the function of family care in rural areas is weakening, the family remains the fundamental unit of elderly care, and strengthening family care responsibilities remains necessary. On the other hand, integrating rural elderly care into the entire process of rural governance, utilizing collective economic organizations, elderly associations, and rural elderly care teams, can develop neighborhood mutual aid models where younger seniors assist the older and healthy individuals help the disabled. This gradually builds a rural elderly care network centered on family care and supported by mutual aid.
Enhancing resource utilization efficiency is vital for building rural elderly care service systems. The tension between massive service demands and limited resource supply is a major challenge. This requires improving the quality of service provision, using limited resources to achieve optimal output. To this end, emphasis should be placed on strengthening preliminary planning and evaluation of rural elderly care service projects, starting from meeting the core needs of the rural elderly population, to improve service targeting and precision, ensuring accurate deployment and efficient output.
Simultaneously, institutional innovation should be continuously promoted, refining mechanisms such as point systems and time banks to maximize resource utility under limited investment conditions. Additionally, in the process of advancing rural elderly care system construction, performance evaluation and supervisory accountability for service projects must be strengthened. Projects with poor performance should be adjusted or phased out, gradually establishing a performance-oriented rural elderly care service system.