Long-Term Care Market Analysis

The Middle East & Africa long-term care market is one of the most diverse and rapidly evolving regional markets globally, defined by extreme demographic contrasts, varied policy maturity, and the coexistence of advanced long-term care insurance systems alongside emerging markets with minimal formal care infrastructure. The region encompasses Israel, which operates a universal long-term care insurance system providing up to 20 hours per week of free home health care for all but its most affluent residents, alongside South Africa, where most long-term care for older persons is provided quietly within households, carried largely by unpaid family members and under-resourced community organisations. The market is characterised by a pronounced divide between mature systems in Israel and South Africa, and developing frameworks in the Gulf Cooperation Council (GCC) states and Sub-Saharan Africa, each at different stages of demographic transition and institutional development. According to the research report, "Middle East & Africa Long Term Care Market Outlook, 2031," published by Actual Market Research, the Middle East & Africa Long Term Care Market is anticipated to grow at more than 7.10% CAGR from 2026 to 2031. The region's demographic transition is accelerating, with the older population in South Africa growing from 3.6 million (7.7% of the total) in 2002 to 6.6 million (10.5%) in 2025, an increase of 3 million people over 23 years. The United Arab Emirates, despite having one of the lowest shares of seniors globally at 1.8% of its population, recorded a 6.3% increase in its 65+ population in 2025, reflecting the rapid pace of demographic change in the Gulf. The World Bank has published a phased approach for long-term care development in the Middle East and North Africa, organised around four pillars including governance, financing, workforce, and service delivery, drawing on international evidence from countries such as Germany, South Korea, China, and Chile. South Africa dominates the regional market with 6.6 million people aged 60 and above, representing 10.5% of the total population, and a well-established network of registered long-term care facilities governed by the Older Persons Act of 2006. Israel represents the most mature long-term care market in the region, with a universal insurance-based system established in 1988 that provides in-kind service provision through home caregivers rather than cash benefits, and national long-term care expenditure of approximately NIS 24 billion in 2022 (about 1.25% of GDP). The UAE represents the fastest-growing market, with the launch of the National Framework for Healthy Ageing 2025–2031 targeting individuals aged 60 and above, and the Barakatna initiative providing comprehensive community care services including temporary alternative care for senior citizens. Nursing homes remain the largest service segment across the region, while home healthcare is the fastest-growing segment, driven by government policies promoting aging in place and the strong preference of older persons to remain in their communities. .

Market Dynamic

 Long-Term CareSegmentation

Middle East & Africa Long-Term Care Market By Service Type



Nursing Care / Skilled Nursing Facilities is the largest service segment because institutional care remains the predominant formal care model across the region, with high-acuity residents requiring 24-hour supervision in countries like South Africa, and Saudi Arabia.

Nursing care and skilled nursing facilities represent the largest service segment in the Middle East & Africa long-term care market, driven by the predominance of institutional care models across the region. South Africa operates a network of registered long-term care facilities governed by the Older Persons Act of 2006, with the Western Cape Department of Social Development registering frail care facilities where frail older persons who are not physically or mentally fit to perform activities of daily living independently are cared for on a 24-hour basis. Israel's long-term care system includes institutional care options, with the national expenditure on long-term care reaching approximately NIS 24 billion in 2022. Saudi Arabia provides comprehensive care for the elderly through 12 social care homes across the Kingdom, covering health, social, and psychological aspects. The segment faces significant workforce and financial challenges, with South Africa's care services for older people described as chronically underfunded, and the country's elder-care policies existing but implementation being fragmented and uneven.

Home Healthcare is the fastest-growing service segment because the strong preference for aging in place and government policies promoting community-based care are driving demand across the region.

Home healthcare represents the fastest-growing service segment in the Middle East & Africa long-term care market, driven by the strong preference for aging in place and government policies promoting community-based care. In Israel, most long-term care services are provided in the community rather than in institutions or nursing homes, reflecting the perception that aging at home or in one's social and family environment is preferable. Every resident of Israel who pays into the social insurance system is eligible for coverage of 20 hours of home health care per week. In the UAE, the Barakatna initiative seeks to improve the efficiency of home care provided to senior citizens in a suitable family setting, aiming to ensure a stable, healthy, and fulfilling life for senior citizens within their families. In Saudi Arabia, the home care program is designed to ensure continuous follow-up for elderly individuals within the family environment. In South Africa, the National Policy Dialogue on Elder Care examined home-based care services as one of five key themes, recognising the need for stronger support for caregivers and community services. The segment faces significant workforce shortages, with the demand for caregivers projected to increase substantially across the region.

Middle East & Africa Long-Term Care Market By Payer Type



Public is the largest payer type because government financing through national health systems and social insurance schemes dominates long-term care funding across mature Middle East & Africa markets.

Public sources are the dominant payer for long-term care services across the Middle East & Africa region, particularly in mature markets. In Israel, about 70% of the national expenditure on long-term care of approximately NIS 24 billion in 2022 was public expenditure, with the rest private. In South Africa, grants are the main income source for 60.1% of older-person-headed households, followed by salaries and wages at 21.0%, while public hospitals and clinics remain the main source of care, used by 68.5% of older persons. In Saudi Arabia, the Ministry of Human Resources and Social Development provides comprehensive care for the elderly through 12 social care homes, and extends financial and in-kind assistance to needy elderly persons and their families through the Social Security Agency. In the UAE, the National Framework for Healthy Ageing 2025–2031 represents a significant public investment in elderly care, with the framework targeting individuals aged 60 and above and offering comprehensive healthcare alongside social and psychological support systems.

Private represents a growing payer type because private equity investment in senior living and the expansion of private care home operators are increasing across the region.

Private sources account for a growing portion of long-term care spending in the Middle East & Africa region. In Israel, the private long-term care insurance market has faced significant challenges, with insurance companies not submitting proposals to renew group policies for members of the Clalit health fund in December 2024, raising concerns about the continuity of coverage for policyholders. The Capital Market, Insurance, and Savings Authority intervened in 2023-2024, tightening the conditions for recognizing insurance claims and reducing payouts, and the implementation of the continuity clause was postponed by two years to the end of 2026. In South Africa, formal housing among older persons increased from 75.8% in 2002 to 91.3% in 2024, and access to electricity, sanitation, and internet advanced sharply, with internet access reaching 86.6% in 2024. In the UAE, the Barakatna initiative brings together multiple government entities and private sector participants, creating a comprehensive ecosystem for senior living and care services.

Middle East & Africa Long-Term Care Market By Age Group



The 85 years and above cohort is the largest age group because the highest per capita utilisation of long-term care services is concentrated among the oldest-old population, with the vast majority of institutional residents aged 80 and above.

The 85 and above age group accounts for the largest share of long-term care spending across the Middle East & Africa region, driven by the highest per capita utilisation of services. In Israel, the proportion of those aged 80 and over, who constitute about 57% of those eligible for first-tier payments, is expected to increase from about 3% in 2022 to about 5% in 2040. In South Africa, older women continue to outnumber older men, with just 65 older men for every 100 older women in 2025, down from 67 in 2002, and older women are more likely to be widowed, live alone, or head extended households with heavier caregiving responsibilities. In the UAE, the population aged 65 and above reached 206,350 in 2025, representing a 6.3% increase from the previous year and a 61.25% increase over a decade, with the oldest-old cohort growing most rapidly.

The 75 to 84 years cohort is a significant age group because it represents the transition phase for many long-term care users moving from home-based services to institutional care.

The 75 to 84 age group represents a significant share of long-term care spending. In South Africa, the older population has grown from 3.6 million (7.7% of the total) in 2002 to 6.6 million (10.5%) in 2025, an increase of 3 million people over 23 years, with ageing indices climbing across all population groups. In Israel, the proportion of those aged 65 and over in the population is expected to grow from about 12% in 2022 to about 14% in 2040, with most long-term care services provided in the community rather than in institutions. In the UAE, the National Framework for Healthy Ageing 2025–2031 targets individuals aged 60 and above, offering comprehensive healthcare alongside social and psychological support systems. This cohort is in the transition phase for many long-term care users, moving from home-based services to institutional care as functional decline accelerates.

Middle East & Africa Long-Term Care Market By Gender



Female is the largest gender segment because higher life expectancy and higher rates of disability in advanced age drive greater long-term care utilisation among women, who also dominate the caregiving workforce.

Women account for the largest share of long-term care spending across the Middle East & Africa region, driven by higher life expectancy and higher rates of disability in advanced age. In South Africa, older women continue to outnumber older men, with just 65 older men for every 100 older women in 2025, down from 67 in 2002. Women live longer than men, with life expectancy at 69.6 years compared with 64.0 years. Older women are more likely to be widowed, live alone, or head extended households with heavier caregiving responsibilities, while older men are more often married and living with a spouse. Women account for 60.7% of the older population in 2025. In Israel, women constitute the majority of long-term care recipients and caregivers, with the national expenditure on long-term care reaching approximately NIS 24 billion in 2022. Women also dominate the long-term care workforce, comprising the majority of nurses, direct care workers, and family caregivers. The National Policy Dialogue on Elder Care in South Africa recognises the need for social protection for family caregivers, who are predominantly women, and argues that recognising caregiving as a public good is essential if older persons are to age with dignity.

Male is a smaller but growing gender segment because the gender gap in long-term care utilisation is gradually narrowing as male life expectancy increases.

Men account for a smaller but growing share of long-term care spending. In South Africa, older men are more likely to be married and living with a spouse, which provides informal care support and reduces their reliance on formal care services. Older men are also more likely to work in skilled occupations, while older women are concentrated in domestic work. In Israel, men represent a growing share of long-term care recipients as male life expectancy increases. In the UAE, the National Framework for Healthy Ageing 2025–2031 provides benefits to both male and female senior citizens without gender-based discrimination, with the framework targeting individuals aged 60 and above and offering comprehensive healthcare alongside social and psychological support systems. The caregiving workforce remains predominantly female, with women providing the majority of unpaid family care across the Middle East & Africa region.

 Long-Term Care Market Regional Insights

South Africa dominates the Middle East & Africa long-term care market because the largest older population in the region, the most extensive network of registered care facilities, and the most comprehensive legal framework under the Older Persons Act create the largest and most developed demand base for services.

South Africa represents the largest contributor to the Middle East & Africa long-term care market, with 6.6 million people aged 60 and above in 2025, representing 10.5% of the total population an increase of 3 million people from 3.6 million in 2002. The country operates a network of registered long-term care facilities governed by the Older Persons Act of 2006, with the Western Cape Department of Social Development registering frail care facilities where frail older persons who are not physically or mentally fit to perform activities of daily living independently are cared for on a 24-hour basis. The Act provides for a range of services including the provision of beds for the temporary accommodation of older persons at risk and respite care services. The National Policy Dialogue on Elder Care, convened in June 2025, brought together government departments, civil-society organisations, researchers, service providers, and caregivers to examine the realities of elder care and explore practical pathways for policy reform, highlighting the urgent need for coordinated national leadership, sustainable financing, and stronger support for caregivers and community services. Despite progressive legislation, most long-term care for older persons is provided quietly within households, carried largely by unpaid family members and under-resourced community organisations, and the country's elder-care policies exist but implementation is fragmented, uneven, and underfunded.
The UAE represents the fastest-growing long-term care market supported by the launch of the National Framework for Healthy Ageing 2025–2031, the Barakatna initiative, and a rapidly expanding elderly population.

The UAE's population aged 65 and above reached 206,350 in 2025, representing a 6.3% increase from the previous year and a 61.25% increase over a decade. The country's National Framework for Healthy Ageing 2025–2031, developed by the Ministry of Health and Prevention in collaboration with the World Health Organization, targets individuals aged 60 and above and offers comprehensive healthcare alongside social and psychological support systems. The framework harmonises with the WHO's Global Strategy and Action Plan on Ageing and Health and aligns strategically with the UAE's forward-looking national agendas including UAE Centennial 2071. The Barakatna initiative, launched by UAE President His Highness Sheikh Mohamed bin Zayed Al Nahyan in April 2025, aims to enhance the quality of life for senior citizens within Abu Dhabi's comprehensive community care ecosystem, with key services including temporary alternative care for senior citizens and extension of housing loan repayment periods by an additional five years to ease financial burdens on caregivers. The initiative brings together multiple government entities including the Department of Community Development, the Family Development Foundation, the Abu Dhabi Housing Authority, the Department of Municipalities and Transport, the Department of Government Enablement, and the Abu Dhabi Real Estate Centre. The "Ambassadors of Healthy Ageing" programme, developed in partnership with the Abu Dhabi Public Health Centre and the Ministry of Sports, recruits socially active, middle-aged individuals who embody healthy lifestyles to serve as community advocates promoting positive health messages. The country is positioned for continued rapid development as the National Framework is implemented and as private sector investment in senior living grows.