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India in Transition

Expanding Care Economy in South Asia

Francis Kuriakose & Deepa Kylasam Iyer
October 7, 2019

Care work has been the focus of policy debates after the International Labour Organization (ILO) published a report titled “Care Work and Care Jobs for the Future of Decent Work” in 2018. The ILO observed that care work involves a range of skills that are often not formally recognized or remunerated, and involving working conditions that are not regulated. Furthermore, care work has an undisputable gender burden with two-thirds of all care workers being women who dedicate themselves to unpaid care work 3.2 times more often than men. The 2019 ILO report “A Quantum Leap for Gender Equality” identified unpaid care work as the biggest impediment to women’s formal employment, as it engaged 21.7 percent of women between 18-54 years of age, as opposed to 1.7 percent of men.

Care work and care economy—a system that consists of activities and relationships involved in meeting the physical, emotional, and psychological aspects of care—remains an integral but undervalued component of economies all over the world, ensuring the welfare of communities. Care work can be direct or indirect, paid or unpaid, short-term (maternity needs) or long-term (care for the disabled and elderly). Care work also encompasses a range of sectors such as education, health, and social work involving teachers, nurses, community health workers, social workers, and domestic workers. Care workers perform the important function of providing care through their sustained relational engagement with the care receiver. In particular, unpaid care workers contribute dependable quality care as a “public good” from which communities benefit, without having to pay for it.

The unpaid care work burden is severe in middle-income countries such as those in South Asia, where women are married with children, have lower education qualification, and reside in rural areas. As per ILO estimates, South Asian women’s participation in wage employment is 19.5 percent less than that of those in Sub-Saharan Africa. For example, a woman in Bangladesh spends 41.4 percent of her total time in unpaid care work, with little time for paid work, rest, or leisure. Women’s unpaid care burden also has intergenerational consequences. Globally, 54 million children perform excessive household work for more than 21 hours per week, compromising their education and health.

Increasing Care Demand
The demand for care work is set to surge by 2030 due to a number of factors. First, demographic transition in low and middle-income countries will lead to a higher proportion of the elderly at the expense of the working-age population. Second, urbanization is changing the traditional joint-family structure in these regions to nuclear, single-parent, and transnational households, alienating them from community care bonds. Third, climate change has accentuated water scarcity and rural food distress which increases care burden on women and children. In these circumstances, excessive and strenuous unpaid care activities can compromise the quality of care received.

There is an urgent need to increase investment in the care economy. The ILO estimates that doubling investment in care relative to 2015 levels would generate 117 million additional jobs by 2030. According to the International Trade Union Confederation (2019), an investment of 2 percent GDP in care in India would create 11 million jobs, of which 32.5 percent would be garnered by women. The relational nature of care also implies that these jobs are less likely to be automated.

Comprehensive Policy Intervention
There is a case for comprehensive policy intervention in the care economy that meets the Sustainability Development Goals (SDGs) in education, health, and decent work. This also ties with the South Asia Association for Regional Cooperation (SAARC) social charter objectives and development goals. Comprehensive care policies can be rooted in ILO’s “Decent Work Agenda” principles that begin with recognizing the value of unpaid care work, reducing drudgery of work, redistributing responsibilities of care work between women and men, remunerating care workers, and representing their concerns. In order to achieve these objectives, comprehensive care policies for South Asia should be anchored along two axes: transformative care policy and labor regulation.

The first axis on transformative care policy includes direct provision of child-care, elderly care, disability services, and care-related social transfers that are target-based and means-tested. In 2016, out of 204 countries in the ILO, only 38 countries had free and high-quality state-sponsored child care services, whereas only 103 countries had contributing disability benefits. Furthermore, the quality and adequacy of care services is determined by care-related infrastructure of clean drinking water, sanitation, and access to energy.

The second axis of comprehensive care provision is labor policy. The care-component of labor policy such as comprehensive maternity and paternity paid-leave as part of terms employment, is an integral component of family-friendly working arrangements. Flexibility in the employment structure is the second aspect of labor policy related to care providers who intend to join formal employment. Non-standard work schedules such as part-time, flex-time, and remote working are already emerging as types of employments. The provision of pro-rata social benefits for such employees would be an integral part of care investment in the future. Additionally, skilling, training, and certification of care workers would be important steps in formalizing and regulating care work.

In recent years, South Asian countries such as India and Bangladesh have begun investing in physical infrastructure which would improve the provision of care services indirectly. India’s Economic Survey 2018-19 anticipates three major shifts in public policy, auguring increased attention to the care economy. First, the declining size and share of the working-age population has called for suitable regional policies to accommodate inter-state migrant labor, increasing the retirement age in a phased manner, and provisioning pensions and other types of retirement benefits. Second, the declining school-going population has shifted the focus of the National Education Policy 2019 on merger and consolidation of existing elementary schools and emphasizes quality of school education. Third, an increase in healthy life expectancy has also called attention to developing geriatric care in public health.

Role of State
Comprehensive care policies demand increased state-involvement in investing, formalizing, and regulating the care economy. In addition to providing care benefits, national accounts should also be sensitive to the contribution of unpaid care to economic growth. Gender-sensitive budgeting, satellite accounts, and tax policy are some of the ways in which economic policy can acknowledge and reward care work. Finally, the state would be an important arbiter in engaging with care workers to realize and expand their rights.

The benefits from sustained investment in the care economy cannot be overstated. First, care policies have the potential to improve female labor force participation and reduce the gender wage-gap over time. Second, care policy has intergenerational benefits by liberating children from household care work and reducing their compounded intersectionality. Third, comprehensive care policies are transformative in nature with positive impacts on gendered attitudes toward care, with more men sharing in care work. Fourth, comprehensive care policies also benefit employers by increasing labor productivity, reducing staff absenteeism and attrition, as well as bringing equity and efficiency to the work place. Most of all, affordable and high-quality care transforms care as a social entitlement, ensuring the dignity and independence of care receivers.

Francis Kuriakose is an advisor to Cambridge Development Initiative, University of Cambridge.

Deepa Kylasam Iyer is a Ph.D. candidate at the Department of Land Economy, University of Cambridge. 

India in Transition (IiT) is published by the Center for the Advanced Study of India (CASI) of the University of Pennsylvania. All viewpoints, positions, and conclusions expressed in IiT are solely those of the author(s) and not specifically those of CASI.

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