32

There are now 42 million dependent elderly people in China whose long-term care needs can no longer be met by the family system that has prevailed until now. The state at all levels encourages the production of nursing homes ( yanglaoyuan), but there is an acute shortage of caregivers. This article analyzes the characteristics of the supply of caregivers in the yanglaoyuan facilities of two large provincial capitals with a population of 10 million (Hangzhou, a thriving coastal city, and Zhengzhou, a developing inland city), and discusses public and private initiatives that have been launched to develop professional care. The survey covered 31 nursing homes in Hangzhou and 27 in Zhengzhou. It reveals a low level of qualification of caregivers due to the predominance of rural migrant women between 45 and 55 years of age, a lack of nursing skills, and a generally low level of remuneration. However, there has been an increase in caregiving skills in Hangzhou, due to two main drivers: financial support from the municipal government for the training of care assistants and an increase of their salaries, and foreign operators contributing to the dissemination of knowledge and care techniques. These characteristics have no equivalent in Zhengzhou, where yanglaoyuan provision is still low, mainly due to the less advanced stage of economic development of this inland metropolis.