Until recently, few have identified ‘care work’ – or caring for children, sick people, and the elderly – as economically productive. I remember encountering the concept of the ‘care economy’ in an undergraduate gender and economics course more than a decade ago. At the time, I knew that care work was important, but thought my lecturer was being dramatic: why make such a big deal over housework?
But now that I’m a mother, I think about the value of care work all the time. When my baby was born in 2022, I chose to be a 'stay-at-home mom' for her first couple years of life. The experience was equally enriching and exhausting: I had so much to do, but I was always tired because I didn’t get quality sleep. The role required me to work seven days a week, with no sick days or holidays.
Of course, I had the privilege of choosing to pursue this ‘job,’ while most of the billions of unpaid care workers around the world, especially in low-income settings, don’t have that luxury. Until becoming a full-time care worker myself, I had never fully recognized how undervalued they are.
Care work is undervalued – but essential & productive
In Malawi, where I’m from, domestic workers – who are predominantly women – are colloquially referred to as antchito, literally 'someone who works.' They are routinely belittled and face exploitation, low wages, and long hours, typically amid poor working conditions.
Care workers face these conditions around the world. For instance, time-use surveys reveal that women tend to spend more time on unpaid care work and rest less compared to men, which has implications on wellbeing. In India, studies find that women balancing unpaid caregiving with paid work feel like their work never ends, resulting in high levels of physical exhaustion, ‘time poverty,’ and stress. Utilizing microdata across 25 countries, other reports have examined the interplay between household income, gender dynamics, and care work.
Despite how undervalued it is, care work is undeniably essential and productive. Intuitively, nothing is more essential than raising children or caring for the sick and elderly – yet there is a widespread tendency to regard it as unproductive. In the health sector, this is particularly evident for community health workers (CHWs), who play an integral role in the health systems of most low- and middle-income countries but are often under-recognized. True, the value that care work generates often can't be easily measured or expressed in terms of currency. But different studies find that the monetary value of care work is significant, with estimates ranging from 0.5% to 7.5% of GDP – a range that reveals the inherent methodological gaps and data shortages involved, but nonetheless underscores the large role care work plays in the global economy. Yet the idea persists that care work is economically unimportant. This mindset is particularly prevalent in Africa, where a 2022 UNDP-led report measured ten metrics and identified low social recognition and state support for the care economy across the continent.
The research on unpaid care work makes the case for recognizing its inherent value, implementing policy interventions to alleviate its burdens, and fostering a more equitable distribution of caregiving responsibilities between genders – while also strengthening global data collection and improving “time use” surveys to build a better evidence base. These challenges could not be more urgent, given the personal toll they so often take on care workers’ lives.
Agency & care work
By failing to recognize, support, invest in, and fairly remunerate the services performed by care workers, we make their work even harder. Care workers often face mental health challenges, reflecting the considerable emotional and physical demands of their roles, especially when they also need to care for their own loved ones outside work. Care workers also have limited opportunities for professional development and career progression. Offering training and capacity building to CHWs, for instance, has been shown to improve their skills while also empowering them and building their confidence.
So how can we expand care workers’ agency?
One example is Rocket Learning, a nonprofit The Agency Fund supports that focuses on early childhood care and education (ECCE) in India. Rocket Learning focuses on dynamically engaging parents (primarily mothers) and employees (primarily women) of the world’s largest government-run daycare network. At its core, this means providing training and skill development programs to help caregivers gain confidence in their work. By delivering these programs through customized WhatsApp groups comprising just 10-15 participants each, they have also created an online peer support network that builds communities for emotional support. Additionally, Rocket Learning’s intervention has contributed to changing perspectives on ECCE and the nature of care work. Workers at the daycare centers, for instance – once referred to disparagingly as ‘porridge ladies’ – are now called (and call themselves) ‘teachers.’
Another example is our partner Living Goods, a nonprofit that supports CHWs in Uganda and Kenya by equipping them with smartphones, enabling them to make more accurate diagnoses and deliver on-demand healthcare. Living Goods also advocates for CHWs' rights and recognition, including efforts to integrate them into national health systems to expand their opportunities for advancement and professional growth. Similarly, The Centre for Impact, Innovation and Capacity Building for Health Information Systems and Nutrition (ClIC-HIN) – another grantee – supports CHWs in Rwanda through actionable research aimed at improving health policies, programs, and operational procedures. Based on this evidence, CIIC-HIN develops free online courses, provides training, and conducts workshops focused on enhancing the effectiveness of frontline workers.
Towards a better horizon
Just as becoming a mother helped me recognize how essential but undervalued care work is, my experience of returning to work gave me a glimpse of how things could be different and better. After 17 months of being a full-time stay-at-home mom – or 'work-within-the-home mom,' to use a phrase I find preferable and more accurate – I started working with The Agency Fund, which went above and beyond to make my transition as comfortable as possible. I started part-time while still juggling childcare, which allowed me to gradually transition to a full-time role; everyone was extremely supportive and regularly checked in on how I was coping; and remote work with flexible hours enabled me to balance work with my child’s schedule and other housework – I even attended video meetings while babywearing and could go off-camera whenever needed. I feel incredibly fortunate to collaborate with a team that acknowledges the importance of care work and made it possible for me to balance these two distinct roles. I only wish every woman could have the opportunity and autonomy to make these types of choices.
Beyond being an understanding employer, of course, The Agency Fund also supports organizations like the ones I mentioned above – which are actively working to design a better future for care workers all around the world. Now that I am fully back in formal employment, I am excited to join the growing global movement to restore dignity, respect, admiration, and agency for the billions of often unseen caregivers who help raise our children, support the sick and injured, and care for the elderly – so that all members of society can thrive.