Abstract:Background: Persistent healthcare inequities disproportionately affect health outcomes among vulnerable older adults, highlighting the urgent need for scalable, community-based prevention strategies. Objectives: This study evaluates the capacity of Hong Kong’s social care sector to implement the WHO ICOPE framework, a structured model for integrated care, as a pathway toward achieving universal health coverage. Materials and Methods: Since 2023, a philanthropic initiative has engaged 44 non-governmental organizations (NGOs, representing 157 community centers, 75% coverage) to implement ICOPE, focusing particularly on screening and preventive interventions for over 50,000 adults aged 50+. The initiative employed a multi-pronged approach comprising: 1) workforce capacity-building through standardized ICOPE training, 2) partnership development for cross-sector referral pathways, 3) digital assessment integration, and 4) financial support through wage subsidies. Implementation capacity was assessed at baseline (January 2023) and follow-up (April 2025) using the ICOPE implementation scorecard, which evaluates service-level capacity (9 actions; 0-26 points) and system-level capacity (10 actions; 0-26 points), with a composite score ranging from 0 to 52. Changes in scores were analysed with paired t-tests. Results: Among 42 NGO representatives completing both assessments, composite capacity scores increased by 22.5% (mean score: 33.4 to 40.9, p<.001). Service-level capacities (mean score: 22.9) consistently outperformed system-level capacities (mean score: 18.0) at follow-up, though both improved significantly (p<.01). Notably, the highest implementation rates were associated with service-level actions, particularly for community engagement (Action 1) and establishing referral networks (Action 6), with over 80% of NGOs sustaining these actions. In contrast, system-level Action 15 (developing financing mechanisms) showed the weakest implementation, with 40.5% of NGOs reporting minimal or no progress. Conclusions: This study empirically demonstrates the growing capacity of Hong Kong’s social care sector to implement ICOPE at the community level. The findings highlight NGOs’ untapped potential as critical partners for advancing equitable healthy ageing strategies.
Keywords: Health Systems and Universal Health Coverage (UHC), Healthy Ageing, ICOPE, Integrated care, Universal health coverage, Social care sector
