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The case for care as essential infrastructure

[By Sharmi Surianarain and Kate Boydell]

Picture this familiar sight: the political leader in a hard-hat on a construction site, promising public investment in basic infrastructure o create new jobs and unlock wider growth. It’s a photo-op and sound-bite we can expect to see repeatedly in the months ahead as governments around the world seek to reboot their economies, post-COVID. 

But before we shovel money into ‘shovel-ready’ projects, we should pause. Because if the pandemic has taught us anything, it is that the critical infrastructure that underpins our societies doesn’t always need a hard hat.

Another overlooked, human infrastructure underpins almost all human economic activity—one that isn’t extractive, that has no negative environmental impact, that doesn’t depend on imports and that’s resilient to macroeconomic forces.

We are talking about the infrastructure of caregiving. This infrastructure—spanning a range of jobs—helps meet society’s most fundamental needs: the physical, psychological and emotional needs of adults and children, old and young, frail and able-bodied.

Caring for our own families might not seem like an economic act, but how we organise it has huge economic and social consequences. These are especially felt by women, since care work (paid and unpaid) is usually performed by them as a routine part of their domestic or even professional roles. This has been acutely felt during the COVID-19 pandemic, which exposed the vital need for the large-scale provision of care—to children, the elderly, vulnerable and sick. School closures forced policy-makers to ask not just ‘how will children learn?’, but also ‘how will parents work?’ And, care giving is often the invisible glue that binds many activities together—strengthening our daily transactions with relational bonds.

Image credit: SmartStart

It is now clear that this “infrastructure of care” is just as vital as roads, ports and data networks, and it plays an important role across the human life cycle. Investing in early childhood care alone multiplies value at a grand scale—improving the health and educational outcomes for a generation of children, creating thousands of jobs, while also enabling caregivers to work outside the home.

So why don’t we talk about and invest in care work this way? There are many reasons.

One is simply a failure of political imaginations shaped by that persistent hard-hat image—and an inability to recognize caregiving as work. Second, due to powerful social norms, the work primarily done by women is tarred with the pernicious low-skill label which lowers the status of those who do it and those who study it.

But there is also a practical and immediately addressable reason we continually overlook the potential of care as an economic lever: we just didn’t know how to pull it.

Economists bring precision and broad consensus to how economic activity is counted and reported. They develop models that value it properly, including wider systemic effects. And they propose new investment mechanisms to shape and unlock that value. In other words, they define economic levers and how to use them. Historically neglected by mainstream economics, care work has as a result, been under-counted, under-valued and under-invested. Indeed, as a result, “care feminism has taken a backseat to career feminism.”

What if care feminism engaged with mainstream economics head on? We suggest three specific actions to recast care using feminist economics: Count it. Value it. Invest in it.

Count it.

“What gets counted, counts,” said data feminist Joni Seager.

Over 16 billion hours are spent on unpaid care work every day – a reality that many of us had to confront during the COVID-19 pandemic, when schools and day-cares were shuttered.

If care work—as priceless as it is—was actually counted in real GDP estimates, this would be valued at over $11 trillion. If “care work” were an economy, it would rank only behind the United States and China.

But it is hard to put a price to something as intangible and priceless as care.

Many of us prickle at the act of counting it—as it relates to an act so fundamentally cherished and so human, one that evokes deep emotions. As if care were something that can be measured by money and economics alone.

But money and economics matter. Especially to the millions of those in this sector who are unpaid and under-valued.

And so, if what gets counted, does indeed count, then the act of “counting” the care economy—in our national accounts, and as “real work”—reveals its value.

Counting care work as work and accounting for it in our GDP is the first step, giving us a language with which to comprehend its many dimensions, to label it, categorise, and regulate it. Drawing on decades of activism for the decriminalization of sex work, for example, it allows for care work to be situated within a broader framework of worker’s rights.

Counting care work can allow for the design of policies that acknowledge that burden of care and allows for the regulation of work in this space. Formal recognition of care work as “work” takes it out of the shadows, where this work can be so easily ignored and exploited because it does not count.

Value it

Even if we did count care work in our national accounts or included this work in broader frameworks of workers’ rights, this still would not be enough. Valuing care work requires a fundamental shift in the way we not just count work—but also how we pay for it and protect it.

Women comprise more than 76% of the total care workforce of nearly 400 million—and this work is some of the least paid and most precarious in the world.

Care responsibilities often come at a cost—professional, and personal. The most well-known of these being the motherhood penalty—where women with young children record the lowest employment rates in the world. Care work is also exhausting, demanding, and fraught with physical and emotional complexities.

Image credit: SmartStart

As Ai-jen Poo reminds us “caregiving is most definitely work: physically strenuous, rigorous work that requires discernment and flexibility. As with all forms of labour, you put in a hard day’s work and you expect to be appreciated and compensated.”

What if we valued this work at a structural, systemic level, as well as paid for it, and protected it the way we should?

Recent insurance and divorce settlements in India and China point to a slow shift towards greater monetary valuing of the work done by women in the home. We need to amplify and institutionalize these trends.

Paid family leave for caregiving responsibilities has been shown to help women stay in the labour force and improve well-being for caregivers across the world. Including care and domestic worker rights in national frameworks for labour legislation, imposing minimum floors and clear frameworks to reduce abuse and exploitation can also make a difference.

Invest in it

The ILO estimates that over 2 billion people will need care by 2030—as a result of a growing and ageing population. Unlike many other economic sectors where jobless growth is the norm, the care economy represents huge possibilities.

Demographic trends of ageing and population growth suggests that over 400 million jobs could be generated across the world. Expanding the early childhood development infrastructure, to meet the need worldwide for early childhood care, could alone generate up to 43 million jobs.   

Organisations like Silver Angels in India are trying to focus on the elder care market and investable ideas and opportunities that can be harnessed. Early childhood is a growing focus area for investment by countries, donors, and private investors alike—with the World Bank alone committing over $6 billion in ECD and related investments over 15 years.

Indeed, if we truly valued the things we said we did, we would invest our resources in ideas that strengthen our support for those who need care without compromising its intrinsic value.

All the recent efforts to quantify care work, to evaluate investment in caregiving versus other industries, and to reimagine how it is provided show that the tide may be turning on how care work is viewed, spurred by the aftershocks of COVID as well as long-term demographic shifts.

We can choose to ignore the value of caregiving in our plans, or we can strengthen this invisible infrastructure and empower the millions that carry its weight.

It’s time to lay aside the hard hats and take a hard-headed approach to investing in caregiving – so it can become an engine of economic growth and human thriving.


Sharmi Surianarain serves as the Chief Impact Officer, Harambee Youth Employment Accelerator in South Africa.  Harambee Youth Employment Accelerator develops African solutions for the global challenge of youth unemployment. Sharmi is an activist for opportunity creation for young people, particularly women. She is an Aspen African Leadership Initiative Fellow, Class of 2020 and sits on the Boards of Emerging Public Leaders, Ongoza, Metis, Instill Education and is on the Advisory Council for the NextGen Ecosystem Builders Africa 2020. Sharmi holds a B.A. from Harvard University, a master’s degree from the Harvard Graduate School of Education and a master’s degree from Northwestern University’s Kellogg School of Management.

Kate Boydell is a writer and advisor with 25 years’ experience using the power of strategic stories to help leaders, movements and organisations bring about systems change. She has a particular focus on the future of work and of education, gender and parenthood, and purpose-driven leadership. She is a Fellow of the RSA, an Unreasonable Impact Mentor, a former Head of Strategy at change consulting firm SYPartners and former WPP Fellow.