Sustainable long-term care services

Financing needs and options for sustainable needs-based long-term care services in lower-middle income countries

Research area to investigate


Understanding the financing needs and options for financing of sustainable and equitable long-term care services responsive to health and care needs of elderly in lower middle-income countries.


Debates on economic and social implications of population aging among policymakers, public and private sectors and civil society has intensified across the globe. Aging populations impact productivity, labor markets, health and social security systems and societal development. Efforts to understand and respond to key challenges are central concerns in high-income countries as well as emerging economies.

In many low and middle-income countries (LMICs), the care-giving burden is affected by changing family structures, and rapid increase in chronic diseases that require complex care interventions. This creates challenges in availability and quality of long-term care (LTC) for elderly. With few exceptions, no organised LTC provision has been developed in LMICs. However, new forms of elder-care are emerging, mostly in the private market and NGO sector, but access and affordability is limited, largely due to absence of organized LTC financing.

The development of sustainable and equitable care systems is essential for the health and well-being of the increasing number of elderly in LMICs. Development of methods to analyze financing gaps and options, where there is no current system is important. Understanding how different interventions could be developed to influence the use and financing of LTC is particularly important for LMICs with fiscal problems that limit government support to LTC.

Potential approach

One approach could be development of simulation models to analyze scenarios of demand and supply of heterogeneous individuals for various types of organized care to determine the financing gap. E.g. LTC use may depend on age, functional characteristics and socio-economic background including employment histories during one’s working life, while expenditures to  large extent depends on institutional/organizational factors related to how the LTC is financed, organized and designed with regard to coverage and target groups.

Survey data from Ghana regarding health and care needs (measured by instrumental Activities of Daily Living) among care-dependent elderly, the care they currently receive, and data from small scale prototype testing of care models will be available could be used to estimate parameter inputs to the simulation model. In addition, information from various larger repeated national survey data could be used.

It could also be considered to develop a simulation model in a Danish setting, providing the basis for rethinking organization and financing of care systems in Denmark.

Our new MSCA Postdoctoral Fellow should have these skills

We are looking for someone with skills in econometric analysis and microsimulation analysis of public policies in health or social care, and with expertise in social protection and public finance in developing countries.

Host group expertise

The host group includes expertise in health economics and demography as well as financing of health and social care systems, global health, population health and development of interventions.

The host collaborates with University of Ghana on a project regarding Ghana's care economy.

Host department

Host supervisor

Ulrika Enemark

Associate Professor

Are you interested?

Send your resume and a short description of your motivation for this project to the host supervisor before 31 March 2023.

The application process

Provisional timeline

  • 31 March 2023: Deadline for international postdocs’ enquiries concerning the published project description.
  • Mid-April 2023: The supervisor selects an applicant. 
  • 2 May 2023: Online workshop with writing consultants - supervisor and applicant start to write an application together.
  • June-July 2023: Online meeting between writing consultants, the supervisor and the applicant.
  • Mid-September 2023: EU deadline for applications to the MSCA programme. 
  • February 2024: The European Commission announces the recipients of the MSCA grants, with start in summer 2024.