The State of long-term care (LTC) toolkit is designed to support policy- and decision-makers in their efforts to reform and transform LTC systems by promoting learning, collaboration and trust. It proposes a conceptual framework and a methodological approach to knowledge generation, grounded in participatory governance.

Rooted in a person-centred approach and emphasizing that individual care needs, preferences and expectations should inform system design and reforms, the toolkit links available resources in the system to outputs and system-level outcomes through a causal chain structure. The toolkit is a key deliverable of the European Care Strategy and supports the implementation of the Council Recommendation on access to affordable high-quality LTC.

In addition to the conceptual framework, the toolkit includes a glossary of terms, an implementation guide and a data collection template. Together, these components offer a structured approach to help policy-makers at national, regional, and local levels to make LTC systems more inclusive, responsive and sustainable.

Developed by the WHO Regional Office for Europe, in collaboration with the European Commission’s Directorate-General for Employment, Social Affairs and Inclusion, the toolkit aims to help countries to reshape their LTC services. It can guide Member States through complex reforms, ensuring that resources and delivery processes are effectively organized to deliver outcomes that matter – health, dignity, independence and well-being for older people with care needs, as well as their families, caregivers and communities.  

Across the WHO European Region, 1 in 10 people aged 65 or more and 1 in 3 people aged 85 and more require LTC. As populations age and the gap between life expectancy (i.e., years in our lifespan) and healthy life expectancy (i.e., years lived in good health) persists, the demand for long-term care services continues to grow. Countries across the Region must invest in high-quality, equitable, innovative and responsive LTC services and systems to meet these evolving needs.

Strengthening LTC is essential not only to safeguard quality of life, dignity and well-being for people with care needs and their families, but also to ensure resilience of health systems and promote gender equity, social cohesion and economic development.

The toolkit promotes broad stakeholder engagement – both as a balanced and comprehensive analysis of the existing knowledge base and as a mechanism to foster trust, dialogue and consensus. It can be used by policy- and decision-makers at all governance levels to track progress, identify priorities for improvement and build alliances that can facilitate change and implementation.

More specifically, the State of LTC approach can:   

• support decision- and policy-making on priority areas for reform and investment;
• guide development and monitoring of national strategies and action plans;
• strengthen and expand national efforts to monitor LTC system performance and outcomes; and
• inform targeting of European, national and international investments and technical support, and more.

The WHO Regional Office for Europe continues to support countries in implementing the toolkit by providing technical guidance, policy expertise and evidence-based recommendations throughout the process.

For more information, please contact euroltc@who.int.

The EU and WHO: partners for global health

Q&A on long-term care