There is a broad misperception that there are very few long-term care facilities (LTCFs) in low and middle-income countries (LMICs). In fact, there are large and rapidly growing networks of residential care services for older people in Latin America, many parts of Asia, South Africa and other middle-income settings (Camarano et al, 2010; Cheung Wong and Leung, 2012; Lloyd-Sherlock, 2019). In high-income countries, there is a substantial body of evidence that LTCF populations have been the most high-risk group for COVID-19 mortality and this is generating (belatedly) a strong policy focus on this issue (Comas-Herrera et al, 2020; Cousins, 2020).

This paper draws on available evidence to assess the COVID-19 vulnerability of LTCFs in different LMICs, taking note of specific features of provision before and during the pandemic. Based on this assessment, it sets out a broad framework for guiding emergency interventions to address these vulnerabilities. Drawing on stakeholder engagement in different LMICs, the paper reviews ongoing interventions by different government agencies and situates them within our policy framework.


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Lloyd-Sherlock, P., Bastos, J., Duarte, M., Frank, M., Geffen, L., Giacomin, K., Rojo, A., Saddi, F., Kelly, G., Montes de Oca, V., Redondo, N., Sasat, S., Sempe, L. & Vivaldo, M. 2021, An emergency strategy for managing COVID-19 in long-term care facilities in low and middle-income countries: the CIAT Framework (Version 3*), Global Platform. Available at: https://eresearch.qmu.ac.uk/handle/20.500.12289/13533

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Last updated: 07 November 2023
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