Public-Private Partnerships in Home- and Community-Based Services for Older People in China: The Case of Guangzhou

Abstract

This study examines public-private partnerships (PPPs) in home- and community-based services (HCBS) for older adults in Guangzhou, China, amid growing efforts to increase non-state actor participation and market mechanisms in welfare provision. Based on semi-structured interviews with non-state actors, this research examines both contractual and relational dimensions of PPPs and why achieving their full potential remains challenging. Findings reveal that state actors maintain a leading role in PPPs, with nonstate actors primarily positioned as implementers of predefined welfare objectives. The power imbalance embedded in China’s sociopolitical context blurs the boundaries among the Party, state, and society, shaping coordination challenges in PPPs. These structural constraints hinder integrated service delivery and limit the extent to which PPPs can meaningfully leverage the expertise of various actors. This study enhances understanding of PPPs in China’s authoritarian, state-led market context and offers insights into the evolving landscape of welfare socialisation reforms.