Credits UNDP Dominican Republic
Published on February 23, 2023

Demand for care: a crisis that worsens with each decade

This year the UN published the World Social Report 2023 which deals with this issue with concern, while the Dominican government also launched a pilot program of communities of care in Azua.

Santo Domingo. A routine day can become real chaos with a simple incident: the person who takes care of the care at home is missing. The routine changes places and for a moment we do not know what to do with cleaning, food, children, older people or people with disabilities who require care at home.

Probably someone in our family or close circle is dedicated to caring work and, at some point, we have all taken this role for granted, the demand for which increases over the decades. This often falls on women who, on average, spend 3.25 hours more than men on unpaid care work and housework, according to 2018 data from the National Statistics Office (ONE)

According to the World Social Report 2023 (World Social Report 2023), recently published by the United Nations (UN), the demand for long-term care is increasing due to the ageing of the population and changes in life. 

The number of people aged 65 and over worldwide is projected to more than double, according to the document titled “Leaving no one behind in an ageing world ”, from 7.61 million in 2021 to 1.6 million in 2050. The explanation for this irreversible trend is relatively simple: longer lives and smaller families. 

At the national level, the ONE estimated that by 2025 people over 59 years of age will represent 12.5% ​​of the national total, a percentage that, following the trend, would increase by 21.4% by 2050.

Beyond the numbers, the UN report indicates that the absence of accessible and equitable long-term care services exacts a heavy toll on older people, their families and entire societies. In addition, it highlights a known reality for the Dominican Republic, which is that women bear most of the challenges since they represent the majority of paid and unpaid caregivers.

Specifically, in the Dominican Republic, women dedicate 31.2 hours of their weekly routine to care compared to 9.6 hours in unpaid work dedicated to men, analyzed the ONE. The difference of 21.6 hours is evidence of the great gender inequalities at the disadvantage of women, in the performance of tasks that are carried out without pay and without social recognition. 

Data from Wave 2 of the High-Frequency Telephone Survey (HFPS), from the World Bank and UNDP, show changes in the care burden for both men and women, and how this relates to changes in employment during the pandemic. “On average, 43% of women reported an increase in time spent caring for children in 2021, 10 percentage points more than the share of men who reported an increase in child care (33%) ”.

The reality revealed by the data is what motivates the UN to encourage us to rethink how we provide long-term care to benefit both the people who benefit from it and those who care for it.  

Anticipating a response, the Dominican Republic has the ambition to implement a Comprehensive National Care Policy that can organize and meet the demand for care for children, older adults and people with disabilities who require care. 

Through the Joint Fund for the Sustainable Development Goals (SDG), and the agencies, funds and programs of the United Nations System, UNDP, UNFPA, UN Women and ILO, support the country in the design and implementation of a pilot program called Care Communities which contributes to the implementation and expansion of this National Care Policy in the Dominican Republic. 

This policy aims to find comprehensive solutions to the care needs of vulnerable households, the promotion of women's economic autonomy and the right to care for children, people with disabilities who require care, people in a situation of dependency and older adults. Two territories, Azua and Santo Domingo Este have been prioritized for the implementation of the pilot.

We start this 2023 with the launch of the Pilot Program in Azua, a province where 36% of poor and vulnerable households demand care; and 34% of women of productive age report that they are not looking for a job because they are dedicated to caring at home, according to data reported by Supérate. 

To achieve the presentation of this initiative, months of work were spent where local actors constituted the pillar that made possible the start of the territorialization of a public policy. Its objectives are clear: 

1. Institutional strengthening of the local care board and the social movement in favour of care in the municipality 
2. Promotion of cultural change in favour of care 
3. Professionalization of paid care work and promotion of formal and decent employment opportunities 
4. Expansion and strengthening of the coverage and quality of care services 

The suggestion of the recently published UN report is the path that is being traced from Azua and where we should aim as a society: to pursue a more equitable approach, with a gender and human rights perspective, centred on the person, which involves and makes responsible to governments, companies, civil society, communities and households to advance in the implementation of Comprehensive Care Systems and to move towards a Care Society that prioritizes the sustainability of life, placing it at the centre of policies for the achievement of the 2030 Agenda for Sustainable Development (UN Women and ECLAC. 2021).

Azua became the first province in the country that seeks to implement "Communities of Care" with the commitment of the central government and more than 10 public institutions that will be in charge of its management, but above all with the support of its leaders who have demonstrated a firm commitment to continue advancing in this task so as not to leave anyone behind.