New USAID-Ford initiative aims to care for care workers

Care workers are an integral, though often invisible, part of society. They care for children and the elderly, provide health services to their communities, and do housework for little to no pay — even though such work is vital to keeping economies humming. So who cares for the care workers? A new partnership between the U.S. Agency for International Development, the Ford Foundation, and the CARE Fund will direct $4.8 million over two years to help care workers in five countries — Brazil, Colombia, the Dominican Republic, Ghana, and the Philippines — mobilize and advocate for stronger wages, safer working conditions, and gender equality. A memorandum of understanding announcing the initiative was signed on Thursday at the United Nations Commission on the Status of Women Summit in New York, and the goal is to bring on more donors in the future. “This is just a start, and we really do have a lot of room to grow in this space of investing in care infrastructure worldwide,” Bama Athreya, USAID’s deputy assistant administrator in the Bureau for Inclusive Growth, Partnerships, and Innovation, told Devex. “We know that around the world, community care has been underpaid and undervalued. Community health workers have been underpaid and undervalued, and economies can't run without these workers,” she added. “And so investing in systems that provide quality, paid care … that allows women, in particular, to be able to leave their homes and engage in other types of economic activity — it's just huge.” Why women in particular? Because they disproportionately bear the burden of care work. Women and girls provide more than three-quarters of unpaid care work in the world and make up two-thirds of the paid care workforce, according to Oxfam. While a lot is done for free at home or in the community, women and girls working as cleaners, or in services like health care or childcare, often do so for poverty wages, the group added. According to UN Women, such work “subsidizes the cost of care that sustains families, supports economies, and often fills in for the lack of social services. Yet, it is rarely recognized as ‘work.’ Unpaid care and domestic work is valued to be 10 and 39 per cent of the gross domestic product and can contribute more to the economy than the manufacturing, commerce or transportation sectors.” Even in the health care sector, where lives are at stake, women often work for meager wages, if not for free. “There are approximately around 3 million community health care workers globally responding to pandemics like HIV/AIDS, like COVID, working at the front lines deploying vaccines, like measles vaccines, like polio vaccines, but continue to be minimally paid and in many cases unpaid,” Ghada Abdel Tawab, the senior program officer leading the initiative for the Ford Foundation, told Devex. She added that “86% of community health workers in Africa are unpaid and we're already starting to see movements and organizing by community health workers demanding … to be compensated, and decently compensated, since they're basically saving the world whenever a pandemic erupts.” Abdel Tawab also noted that nearly 80% of domestic workers in the global south are part of the informal economy. “And they're not covered by any form of labor or social protections. They're unable to afford the same services that they provide to others — they cannot afford it for their own families.” The trend of migrant workers crossing borders to provide care services for middle-class and upper-middle-class families also leaves behind a care gap in their own countries, Abdel Tawab said, adding that “care workers are predominantly women, migrants, refugees, very often disabled themselves as well, and indigenous, so [it’s] a clear recipe for exploitation and gender-based violence and harassment.” To that end, the initiative, dubbed Together We Care, seeks to bolster wages and improve working conditions, including occupational safety and health for workers, which could help curb gender-based violence. It also aims to strengthen the representation of health and care workers by forming unions and increasing membership, as well as training and lifting up women leaders. "Through initiatives tailored to the contexts of each region, Together We Care could help one million care workers — overwhelmingly women — transform their lives,” Christy Hoffman, general-secretary of UNI Global Union, one of the initiative’s implementing partners, told Devex via email. But forming unions to fight for collective bargaining rights and better pay is bound to face some pushback from employers and governments. Vivek Trivedi, strategic communications officer at the Ford Foundation, pointed out that according to the International Trade Union Confederation, “87% of countries have violated the right to strike [and] 79% of countries violated the right to collectively bargain.” In addition, “Since March 2020, 155 countries across the globe placed new restrictions on public assemblies. And so there are massive headwinds, but those massive headwinds won't be addressed by lying down. It requires actually building up the power of workers to organize,” he told Devex. “That's why philanthropy working in partnership with government to bolster and strengthen women-worker-organizing is so important right now, particularly as this democratic backslide continues to be entrenched.” Athreya of USAID acknowledged that “anything that is a civil society-strengthening activity of any kind always has the potential to be seen in a negative light. Politically, we have to be careful with the sensitivities.” But she said she was encouraged by a recent visit to the Philippines, where legislation has been introduced to create a pathway to formalization for community health care workers currently working in the informal sector. “What they do for these communities is huge,” Athreya said of care workers in general. “These are people who are trusted as the front-line primary care providers for health care services, for social care services, in their communities around the world. And it's hard work. “And particularly through COVID, this was a workforce that was very heavily stressed — and they are a workforce, but because they're often seen as volunteers, there's not a lot of support or investment for them,” she added. “So by investing in improving their incomes, and their working conditions, and their voice, their collective voice, that's a huge step forward for women's economic security.”