Women globally are facing a high burden during the crisis raised by the COVID-19 pandemic. In the U.S., women account for 52% of the essential workers, 78% of social workers, and 77% of health care workers. At home, things aren’t different. Women are more likely to be in charge of the sick, minors, and elders, providing care while still working full time. But this is hardly a new story; women have historically borne a disproportionate impact of health crises, environmental disasters, conflicts, and violent situations. There is an urgent need for formal care systems to protect communities and those in need during a health crisis, but also to protect women as caregivers.
Women as caregivers inside and outside the health system
According to a WHO report released in 2019, about 70 percent of global health workers are women, and women health workers are concentrated into lower status, lower-paid, and often unpaid roles, facing harsh realities of gender bias and harassment. The Food and Agriculture Organization reported that women, on average, comprise 43% of the agricultural labor force in developing countries, and in the least developed countries, 79% of economically active report agriculture as their primary source of livelihood. As the protagonists of the caring systems during the pandemic, women face additional demands that require them to work longer hours, placing physical and psychological strains, while juggling this additional workload from their household. If we consider that 24 million of the 28.5 million nurses and midwives globally are women, talking about how women’s increased workloads limit their access to social support does not seem out of place.
Women who work on formal health care systems also face occupational segregation as men. According to a recent U.N. report are more likely to be physicians and specialists and to reach leadership positions, leaving women underrepresented in senior roles and unable to make decisions about their working conditions, a crucial issue, especially during a pandemic. This situation also feeds into the larger gender pay gap and is exacerbated during a financial crisis. In the long term, the wage gap translates into poverty for older women who have dedicated their lives to the care of others. The system is punishing women for caring about the most vulnerable in society.
There are also the women who work outside the formal labor market, including the health system, whose work in health and social care is not even recognized and usually unpaid. It is not hard to understand how health systems are currently subsidized by the unrecognized work from millions of women globally. As Nahla Valji, the senior gender advisor to the Secretary-General of the United Nations, put it recently “(o)ur formal economy is only possible because women’s unpaid work subsidizes it.” Informal care needs to be recognized as a work that contributes to the economy, not as a worthless resource that is usually available and assigned within unpaid domestic care.
Impact of COVID on women: (self)care at risk
As crises amplify existing inequalities, it was expected that women were affected more severely than men. The COVID outbreak, while deadlier in men, has had a harder economic hit on women. As the International Labor Organization recently found, 41% of women were employed in sectors at high risk of financial loss from the pandemic, compared to 35% of men as women dominate in industries less susceptible to cycles (e.g., health care and education). In the U.S., women account for 55% of job losses during the crisis. In India –according to a recent survey conducted in May- women have lost more jobs than their male counterparts, and U.K. data from April showed women were more likely than men to work in a sector that had been closed due to coronavirus. Bloomberg recently showed how data by gender and race shows a gloomier scenario for black women and Latina women in the U.S. Unemployed, still with the same care-related responsibilities, women are suffering a significant economic downturn.
The pandemic is also making women work longer. Care-at-home activities, like cooking, cleaning, and taking care of children and the elderly, have grown dramatically during the pandemic, and women are taken a huge part in it. Women do more of the housework than men, and the load gets disproportionally higher on single mothers- while working the same or more hours for paid jobs. Generation X women -defined as those born between 1965 and 1980- who provide care to both younger and older relatives were already inundated long before the pandemic. Homeschooling, keeping seniors safe, facing possible job loss and financial insecurity, and having a reduced social network to rely on will soon impact women physically and mentally. Unable to lighten their responsibilities, women are using sleep time to reach daily duties. When the time to rest finally arrives, anxiety and stress-related to COVID-19 affect their normal sleep-related behavior. A recent report on “U.S. trends in medication use for depression, anxiety, and insomnia” revealed that the increase in anti-insomnia medication and anti-anxiety medication use has been much higher in women than the man during the pandemic (March 15 data).
As the U.N. Population Fund found, women under lockdowns also face limitations in accessing medical treatments -including sexual and reproductive health services- and expose them to negative social factors –induced marriages to secure economic stability of young women and girls and gender-based violence at home. As governments deal with overloaded health care systems, policing lockdowns and curfews, closing borders, among many other measures, their response to women’s physical and mental health needs, has been hindered. The lack of formal and well-financed care systems and robust social protection schemes in most countries has hampered the possibility to secure some relief for women. I have talked about the crucial role of social protection systems in this blog -especially during economic recessions- but today I am focusing on care systems, a not that popular term but a pith part of the safety nets responses.
Care as a right that needs to become a reality
Informal care has been a challenge historically taken by women as a response to the social organization founded on the unequal gender division of labor and the deficit of quality public responses on social protection. Assuming the responsibility for dependents care results in several harmful impacts for women: unable to consider care work as a formal and productive activity, become a barrier to women’s economic autonomy, and leave families and communities unprotected when facing a crisis.
United Nations had stated that the care, together with social protection, is a public good and a right. However, few countries had established structured, comprehensive, and reliable care systems with a gender perspective. For instance, although during the last two decades most of Latin America and the Caribbean countries have incorporated the right to care in their constitutions and ratified various instruments of international law containing care-related rights, only a few countries like Uruguay (Integrated National Care System), Chile (Chile Crece Contigo), and Costa Rica (Red Nacional de Cuido) have incorporated care-related systems and policies.
Recognizing care as a right is an important step. Still, it must be materialized in policies that understand the care as a social and State responsibility rather than an issue solely handled by families, and more specifically by women. In a real-time review of social protection measures countries are issuing to face COVID-19, Gentilini et al. showed that while over 133 countries (as of April 17, 2020) have planned, introduced or adapted 564 social protection measures to mitigate some of the socio-economic costs of the pandemic, only nine childcare measures and twelve social pensions policies were identified. Also, short-term measures alone will be insufficient to address the pandemic’s long-term impacts; governments need to integrate the current responses to lasting systems that can overcome the pandemic’s adverse outcomes. This crisis is widening the gaps and the structural inequalities in society that affect women but is also an excellent opportunity to mobilize resources, interests, and political will to de design sound care systems and gender-responsive social protection policies. Maternal, paternal, and parental care leave, strategies for balancing family life – work, cash transfers to recognize care work, labor, and social security recognition of caregivers, are a few options.