key: cord-0932017-bk4su4jf authors: Camilletti, Elena; Nesbitt‐Ahmed, Zahrah title: COVID‐19 and a ‘Crisis of Care’: A Feminist Analysis of Public Policy Responses to Paid and Unpaid Care and Domestic work date: 2022-02-08 journal: Int Labour Rev DOI: 10.1111/ilr.12354 sha: 3f1d89005b0127f79679f45f76785ec353817417 doc_id: 932017 cord_uid: bk4su4jf The COVID‐19 pandemic has shone a light on gender inequalities, including increased time women and girls spend caring for household members, and vulnerabilities faced by paid care workers, often women working informally. Using a global database on social protection responses to COVID‐19, focusing on social assistance, social insurance and labour market programmes, this paper asks if and how these responses have integrated care considerations. We found that while many countries addressed at least one aspect of care (paid or unpaid), primarily through social assistance measures, very few address both types of care. Implications for the current policy response to COVID‐19 (and beyond) from a care lens are discussed. First, we offer and discuss a framework for analysing public policy responses to crises and the extent to which they address both paid and unpaid care and domestic work and needs. This analytical framework draws on conceptual, theoretical and empirical research rooted in feminist economics and other feminist social science disciplines. A feminist lens, which acknowledges inequalities and power relations at individual, collective and structural level, enables us to examine and understand current responses to the pandemic and probe the dynamics and biases through which care is recognised or not. While we apply this framework to the case of COVID-19, it can be usefully applied to other contexts and crises and inform evidence-based policy and programming in future crises. Second, we focus on unpaid care and domestic needs within homes, as well as the needs and issues faced by paid care and domestic workers. We thus adopt a holistic approach to care, considering paid care and unpaid care and domestic work as interlinked. While this holistic conceptualization of care has been proposed in the past (see for instance ILO 2018), the literature that has emerged since the onset of COVID-19 has tended to focus more on either unpaid or paid types of care and domestic work, with less consideration on the interconnectedness between the two. Finally, we draw on a global database of social protection, including social assistance, social insurance and labour market responses to COVID-19. In using a feminist lens, we thus add to the existing literature by providing a broad picture of if, how and where these responses have addressed unpaid and paid care work issues and needs in their design features. This article is protected by copyright. All rights reserved. Following on from this introductory section, data and methods employed in this analysis will be described in the next section. Section 3 will briefly define and discuss the concept of care as it relates to this research. It then provides an overview of the existing literature on the gendered nature of care work (both paid and unpaid) from before and after the COVID-19 pandemic. Section 4 and 5 present a framework that elaborates the effects of COVID-19 on women's and girls' care and domestic work and paid care and domestic work, and the findings of our analysis. The paper concludes in Section 6 by discussing the main findings, drawing evidence-based programming and policy recommendations for integrating care and domestic work in current social protection responses to , and proposing future research avenues. To address our research objective, we analyse the social protection responses to COVID-19 through a feminist lens, to understand if, how and where they have integrated gender considerations related to care and domestic work, focusing on the first six months of the pandemic. We employ a publicly available database 2 titled "Global Database on Social Protection and Jobs Responses to COVID-19" compiled by Gentilini and colleagues published in September 2020. This database collects information on social protection responses to COVID-19 announced, planned or implemented by Governments around the world between 20 th March and 18 th September 2020, thus covering the first wave of the COVID-19 infections around the world. These 2 Since the start of the pandemic, a range of organizations and researchers have compiled databases tracking public policy responses to COVID-19, including both containment and mitigation measures. Databases tracking containment measures include the Oxford Covid-19 Government Response Tracker (OxCGRT) (Hale et al. 2021) . Databases tracking mitigation measures include the UN Women-UNDP Gender COVID-19 tracker (UN Women and UNDP 2020); the ILO Social Protection Monitor (ILO 2020) ; the IMF Policy responses to responses include social assistance , social insurance, and labour market measures, shown in Data from 212 unique countries and territories and 1177 unique social protection measures, was included for analysis 3 (see Figure 1 ). This is an average of 5.5 social protection measures per country, with 25 countries having announced or implemented only one social protection measure, and Russia on the other extreme having announced or implemented 23 social protection measures. In-kind support This current COVID-19 crisis has brought to light the critical and essential role played by paid and unpaid care work to households, the economy and society (Bahn et al. 2020; Power 2020 ). Yet care work, even when paid, continues to be undervalued (ILO 2018; Folbre et al. 2020 ). The perceived devaluation of care work, and the fact that the responsibility to do this work falls less public provision, support and investments in societies. At the same time, in some parts of the world, childcare and the care of the elderly are provided and/or financed privately, and are becoming more expensive (Samman et al., 2016) . This has added extra economic and emotional stress to many women, families and communities. This 'care gap' in richer countries -and among more privileged women -is often filled by migrant workers -typically racialised, often rural women. However, these migrant women often transfer their own family, household and community responsibilities to other, still poorer women (or other family members, such as grandparents or older adolescent children ), who in turn do the same to form 'global care chains' (Hochschild 2000) . Research has also distinguished different forms of care work depending on their relationship to the market, characteristics of the labour process, and types of beneficiaries . , for example, distinguishes four categories of care work: unpaid services, unpaid work that helps meet subsistence needs, informal market work, and paid employment. Each of these may be further divided between direct care, involving a process of personal and emotional engagement, and indirect care activities, which support direct care activities . In this paper, unpaid care and domestic work is defined as "activities related to the provision of services for own final use by household members, or by family members living in other households" (UNSD 2019: 2). Activities include shopping, cooking, cleaning, and care for children, the elderly or other members (UNSD 2019: 2). The 'unpaid' in this concept refers to the fact that activities are carried out "without any explicit monetary compensation" (ILO 2018:6). Paid care and domestic work is defined as care and domestic work activities "performed for profit or pay within a range of settings, such as private households (for example, by domestic workers) and public or private hospitals, clinics, nursing homes, schools, and other care establishments" (ILO 2018:7). As indicated by the ILO (2018:165) the "global care workforce" encompasses "care workers in care sectors (education, health and social work), care workers in non-care sectors and domestic workers 5 (employed by households)", and non-care workers in care sectors, as they support the provision of care services. Combined, this amounts to 381 million workers globally, or 11.5 percent of total global employment (ILO 2018: 165) . Crucial to conceptualising care and addressing the workload, is the 'Triple R Framework" of recognising, reducing and redistributing care and domestic work, proposed by feminist researchers and activists to address care and domestic needs (Elson 2017 ; see also Power 2020). Recognition acknowledges that this work is often invisible in households and the economy, and requires its inclusion in analysis and policies (Samman et al. 2016 (ISPA n.d.) . However, in this paper, we refer to social protection as encompassing three categories of programmes, namely social assistance (non-contributory programmes), social insurance (contributory programmes), and labour market programmes, due to data availability (see Section above on data and methods). The importance of social protection was already recognized prior to COVID-19, as evident in international legal and policy frameworks 6 acknowledging its role in addressing multidimensional poverty, improving well-being outcomes, and contributing to achieving gender equality. The Sustainable Development Goals (SDGs) make specific reference to social protection as one of the public policies that States must set in place to end poverty (SDG 1), achieve gender equality (SDG 5) and reduce inequalities (SDG 10). The SDG Target 5.4 calls on States to recognise and value unpaid care and domestic work "through the provision of public services, infrastructure and social protection policies and the promotion of shared responsibility within the household and the family as nationally appropriate" (United Nations 2015: 18). Such recognition presents an opportunity for social protection to be extended or adapted to cover for care needs that have arisen or intensified due to COVID-19 pandemic. The ILO (2018) suggests that social protection benefits related to care could include providing transfers in cash or in kind to persons in need of care or to carers, to cover the costs of pregnancy, childbirth and adoption, bringing up of children and caring for other family members. They may also take the form of programmes supporting unpaid carers to re-enter the work force, and they include care 6 See for instance the International Labour Organization's (ILO) Social Security (Minimum Standards) Convention, 1952 (No. 102) , and the Convention on the Rights of the Child (1989). credits in pension schemes, and social security to paid care and domestic workers, to recognise care work. In recent years, important steps forward have been made to make care visible in social protection, perhaps the most emblematic is the inclusion of the valuing and reduction of unpaid care and domestic work through social protection as one target in the SDGs. However more remains to be done in social protection policy and programme design to consider paid and unpaid care (see for instance Camilletti et al. 2021) . We now turn to discussing the existing literature on the gendered nature of care work (both paid and unpaid) before and following COVID-19. Prior to the pandemic, women and girls were already largely responsible for most of the unpaid Deeply rooted inequalities in income, education, age, race, among others, intersect with gender and further increase the unpaid care and domestic work burden for certain groups of women This article is protected by copyright. All rights reserved. and girls (Dugarova et al. 2017) . For example, women and girls living in low-income households in rural areas in low-income countries might experience greater care workloads due to poorer access to basic services and infrastructure or labour-saving equipment (ILO 2018; Dugarova 2020). As called for in SDG 5.4, social protection can reduce poverty and provide access to universal services, which can help reduce the amount of unpaid care and domestic carried out by women and girls. However, while increasing attention have been posed on this issue by researchers, activists, and in some cases policymakers, even before the COVID-19 pandemic progress had been limited. In 24 out of the 37 countries with comparable trend data over the period 2001-2018, only a small decrease in the amount of time spent by women on unpaid domestic and care work relative to that spent by men has been observed (UNDESA 2020). This suggests that reducing and redistributing unpaid care and domestic responsibilities within the household, also requires shifting harmful gender norms placing the burden of this work on women and girls. While comprehensive evidence of COVID-19 effects on women's and girls' unpaid care and domestic work is still emerging, evidence from past pandemics and epidemics, and preliminary evidence from the current one, suggest that a pandemic like COVID-19 increases the time that women and girls spend on this type of work (Kenny and Yang 2021; UN Women 2020). Additionally, the greater susceptibility to COVID-19 among the elderly not only limits their mobility and social contact with family members but also reduces the provision of care provided by older women, further increasing the workload on younger, working-age women, and girls. School closures and the closures of childcare services due to COVID-19 have meant that many households have had to look after and homeschool their children, an increased workload that has fallen disproportionately on women and girls (Enguita-Fernandez et al. 2020). Evidence from past crises further indicates that in the face of prolonged school closures, girls are also particularly vulnerable to increased unpaid care and domestic work, which compounded with other inequalities, such as the gender digital divide, risks limiting the time available for girls to learn at home, making them vulnerable to school drop-out (Bakrania et al. 2020; UNESCO et al. 2020 ). Social protection programmes, such as cash transfers or educational stipends that incentivize school participation, especially girls', and access to childcare services, could be particularly beneficial to reduce women's and girls' unpaid care and domestic work and ensure they can participate in education and employment (see for instance Bastagli et al. 2016; Camilletti 2020) . The COVID-19 pandemic is also impacting the entire food system, including supply chains, processing and production, with nearly 265 million people facing acute food insecurity in 2020 alone (WFP 2020), with implications for women and girls and their role in procuring and processing food as part of their care responsibilities (Dugarova 2017) . Evidence indicates how by reducing poverty and income insecurity, social protection can facilitate access to nutritious food and thereby reduce food insecurity, and the time women's and girls' spend on unpaid care and domestic work, such as procuring food and collecting water (FAO 2015) . At the onset of the COVID-19 pandemic, researchers and activists predicted two scenarios: while it became clear that care and domestic needs would increase, on one hand some researchers and activists predicted that such burden would fall even more on women and girls, while others optimistically suggested that this may be accompanied by an increase in the time spent on unpaid care and domestic work by men relative to that of women. This latter scenario was hypothesised at least for those households where both men and women had the privilege of working from home (e.g. middle-class workers). By spending more time at home, men could realise how much time and efforts it takes to carry out unpaid care and domestic work, thus slowly changing their attitudes, This article is protected by copyright. All rights reserved. perceptions and norms, and taking up more of that care and domestic burden 7 (see also Bahn et al. 2020 ). However, even if these social norms and behaviour changes are happening, something that still needs rigorously collected and cross-country data and research to prove, the question is whether this would be lasting change. Emerging evidence at least partly confirms both hypotheses: preliminary data from five developed countries on the activities of working parents during the COVID-19 pandemic, show that while both women and men spent twice as much time on unpaid care and domestic work during the pandemic, women are still spending about two more hours per day than men on these activities (UNDESA 2020). Paid care work inside and outside the home has also been impacted by the current crisis. Women In the current COVID-19 context, these personal and intimate caring jobs may also mean paid care workers are more likely to have higher exposure to the virus (van Barneveld et al. 2020). Nursing, for example, faces risks "due to an increased exposure to airborne or bodily fluids" no access to social security, including maternity protection, have worsened women's social and economic situation. Ensuring paid care and domestic workers have access to social protection is critical to safeguard their rights and prevent them from falling even further into poverty and exclusion (Lund 2020) . For example, sick and annual leave, and cash transfers to address temporary income insecurity and reductions in living standards. Universal child grants can support those women workers with young children with child care costs, while maternity benefits can financially support them during periods when they are unable to work (Nesbitt-Ahmed 2020). Public policies, including those designed through a feminist perspective (namely gender- First, COVID-19 is likely to increase the immediate health needs of households, with infected household members, who are more likely to be old, in need of care. This is likely to increase the time spent on care by women and girls, also putting them at risk of being infected. Preventing or controlling COVID-19 infections in one's household implies increased requirements for cleaning, which women and girls are likely to be responsible for. We propose two ways through which social protection, including labour market, measures can address the increased care and domestic needs. The first is providing PPE, hygiene kits and cleaning products, and the second is providing water, electricity and other goods. By providing PPE, hygiene kits and cleaning products, either in-kind or via cash and voucher schemes to face the costs of these products, social protection can reduce care and domestic needs, and therefore the time needed for households, and especially women and girls, to address them. In our analysis of 1177 social protection measures, we found that only 24 measures were announced or implemented that either directly provide PPE or hygiene kits -all of them being social assistance, especially in-kind transfers (21 measures), or cash transfers or vouchers to be spent on such goods (two measures), or levied taxes or duties on such goods (one measure). For example, Algeria implemented a nationwide in-kind distribution of both food and hygiene items for vulnerable families, living in isolated areas, in April 2020. Armenian authorities collaborated with the Red Cross to provide food, hygiene and PPE packages to citizens, including elderly people living alone, households with unemployed persons age 50 and older, people with disabilities, among others. While lower-income countries are those often lacking safe drinking water and adequate sanitation, these 24 measures are geographically concentrated in higher-income regions, especially in Europe and Central Asia and in Latin America and the Caribbean (see Figure 4 ). By directly or indirectly providing for electricity, safe drinking water and adequate sanitation, social protection can support family members with costs of utilities during the pandemic and can indirectly address care responsibilities, which have likely increased due to increased need for hygiene and cleaning (in turn due to stay-at-home requirements, school and non-essential business closures, among other containment measures). In our analysis of the 1177 social protection measures, we found that 82 measures were announced or implemented to provide support to households with goods and services such as water and electricity, all social assistance measures. Specifically, 76 measures were utility and financial support, followed by cash transfers and in-kind transfers (three measures each). For example, Colombia provided water services free of charge for low-income families, Chad and Mali covered the cost of electricity and water for vulnerable households for three to six months, and El Salvador granted a waiver for bill payments for utilities, including electricity and water (Gentilini et al. 2020 ). Similar to those measures providing PPE and hygiene kits, these 82 measures seem to be geographically concentrated in Europe and Central Asia and in high-income and upper-middleincome countries, as it can be seen from Figure 4 . waiver on the payment of utilities for the most vulnerable was announced in its COVID-19 economic response plan April 2020 (Gentilini et al. 2020 For example, Italy, as part of the "Cura Italia" stimulus package, provided a childcare voucher of up to €600 for workers with children below the age of 12 who decide not to take the parental leave -reaching up to €1,000 for workers in the health sector (Gentilini et al. 2020 ). Spain introduced a family benefit to pay for parents who have to take care of their children during school closures and when their company cannot offer them alternatives (Gentilini et al. 2020) . South Africa increased the benefit size of the Child Support Grant, paid to about seven million caregivers. Geographically, these measures seem to be concentrated in higher-income settings (see However, the design of social protection measures to reduce unpaid care and domestic work should also account for unintended negative effects. While meeting households' childcare needs via social protection is critical to recognise and reduce unpaid care work, COVID-19 is an opportunity to change social and gender norms around care provision, a long-term goal that needs consistent attention. Some of this change may be happening as a result to COVID-19 itself. For example in Bangladesh, Maldives, Pakistan, and the Philippines, it was found that while women were more likely than men to report an increase in both care and domestic work since COVID-19, more than half of women noted that their partners help them more at home, compared to prepandemic times, and 35 to 80 percent (depending on the country) also noted that their sons help more than before (UN Women 2020b). Programmes should also, at a minimum, avoid perpetuating stereotypes around care, and ideally encourage a transformation of harmful social and gender norms. For example, programmes that specifically target only women risk reinforcing the stereotype of women as caregivers and of care as a woman's business. Governments could use the opportunity of designing social protection measures that contribute to change gender stereotypes, for example by encouraging fathers in dual households to take up paid parental leave or other care and domestic activities. In our analysis, we assessed whether the 159 measures that seek to support households in addressing childcare needs were specifically targeting to mothers, or they avoid mentioning the gender of the recipient. If measures are specifically targeted to mothers, this may reinforce existing social norms around care provision, while targeting measures to parents or caregivers regardless of their gender may contribute to shifting social norms around unpaid care work and encourage This article is protected by copyright. All rights reserved. fathers' uptake of childcare provision. We found that the majority of these measures (143 measures) do not specify the gender of the caregiver 9 . Of these, 64 are cash transfers, 26 are school feeding programmes, 18 are paid leave policies, 14 are in-kind transfers, whereas the remaining consist of different types of social assistance, social insurance or labour market measures. For example, Austria allowed employees with childcare responsibilities to take up to three weeks of care leave on full pay, without specifying the gender of the caregiver (Gentilini et al. 2020 ). Some countries have also expanded flexible working options specifically to help parents combine work and care. For example, Cabo Verde offered teleworking arrangements for one of the parents to enable them to care for children (Gentilini et al. 2020 ). However While these examples are promising, two caveats must be noted: first, even if a programme is not specifically mentioning the gender of the recipinet in its design, the mother or other female caregivers in the household may still be the ones responsible for collecting the benefit. Evaluations For example, Armenia provided support to pregnant women who are not employed and whose husband lost the job with a lump sum payment. South Sudan provided direct grants to those who are unable to work, including people with disabilities, the elderly and pregnant or breastfeeding women, among others, via the South Sudan Safety Net Project (SSSNP). Contrary to other pathways above, these measures do not seem to be more prevalent in higher-income settings. Nine are from Sub-Saharan African countries, and another seven from Latin American and the Caribbean countries, and only one measure is from a high-income country, whereas the majority are from upper-middle-income or lower-middle-income countries (see Figure 5 ). This may reflect the increasing attention posed to pregnant and lactating mothers in lowerincome settings in recent years. Social protection, even before COVID-19, has in most cases left out workers in the informal economy -including those in paid care and domestic work -who do not have access to contributory social protection programmes, such as health insurance and old-age pensions. Nor do they often have access to non-contributory programmes aimed at tackling poverty, as informal workers are often 'not poor enough' to be eligible for such measures. The COVID-19 pandemic is shedding a light on these inequalities, with significant impacts on 1.6 billion informal workers around the world, with women over-represented in most hard-hit sectors (ILO 2020). Further, paid care and domestic workers, who are often women, are also often working in the informal economy. In many low-and middle-income countries, healthcare workers may be left with limited social protection, if any, and may also be more likely to be exposed to COVID-19 infections. Even in high-income countries such as Italy and Spain, data suggests that female healthcare workers infected with COVID-19 outnumbered that of men (UN Women 2020c). Some Governments have enacted policies to protect such workers from the socio-economic consequences of the pandemic and its containment measures. In our analysis, we found that only 21 measures out of the 1177 reviewed, specifically mentioned paid care or domestic workers, such as healthcare workers or domestic workers. Nine of these measures are cash transfer programmes, providing these workers with additional income support. For example, El Salvador pledged to provide cash transfer to up to 1.5 million households who work in the informal economy, such as house cleaners and street vendors, lacking a financial safety (Gentilini et al. 2020) . Germany provided cash transfers to support healthcare workers, and teachers (Gentilini et al. 2020 ). An additional four of the 21 measures are paid leave support, granting care and domestic workers with paid sick leave. For example, Australia's national Government offered paid sick leave to aged care workers (Gentilini et al. 2020) . A further three measures are wage subsidies, as in the cases of Haiti and Turkey, both providing wage subsidies for teachers (Gentilini et al. 2020 ). Finally, one measure targeting paid care and domestic workers is a utility support measure: Ghana's Ministry of Finance announced a tax waiver scheme for healthcare workers (Gentilini et al. 2020) . Geographically, these measures seem to be concentrated in few regions, especially Europe and Central Asia, and East Asia and the Pacific (see Figure 6 ). However, when looking at the distribution of such measures by income, we found that the majority of these 21 measures targeting paid care and domestic workers are in middle-income countries (see Figure 6 ). This may reflect a higher prevalence of informal, care and domestic workers in such settings, as well as heightened policy attention to this category of workers. While 140 addressing the increased childcare needs (Pathway 2), and provided paid "pandemic" leave to aged care workers (Gentilini et al. 2020 ). COVID-19 is not only a major economic and health shock, demonstrating the dangers of retrenched public service provision, and rising global inequality. It is also a major shock to gender inequalities. The intersections of the pandemic with the containment measures put in place to contain it have resulted in harsh socio-economic consequences for many households. Evidence from past epidemics and pandemics, and emerging evidence from the COVID-19 one, suggests women's and girls' unpaid care and domestic workload has increased within the homes. Women employed as paid care and domestic workers are also heavily impacted. Mitigation measures such as social protection, including labour market programmes, and fiscal stimuli, have sought to minimize these negative effects. However, if these measures are not designed to address gender inequalities, such as those related to paid and unpaid care and domestic work, they risk reinforcing them. Hence, this pandemic provides a critical window of opportunity to build more effective and inclusive social protection systems based on a feminist framework that emphasises care and domestic work as an integral part of societies. This includes recognising, reducing and redistributing care and domestic work (unpaid and paid), but also improving the representation and reward of care and domestic workers. This paper reviewed the social protection measures (social assistance, social insurance and labour market programmes) announced, designed or implemented in response to COVID-19 through a feminist lens, with a focus on paid care and unpaid care work. The findings suggest while many countries, mostly concentrated in richer regions of the world, have recognised and addressed household care and domestic needs, few countries have addressed the needs and issues that paid care and domestic workers face, and even fewer address both paid and unpaid care and domestic work issues. To address the current and future crises, countries could: (i) improve the support provided to working parents and carers with childcare responsibilities by expanding access to paid family leave and sick leave, in a way that does not stereotypically reinforce women's roles as caregivers in the households and, on the contrary, encourages men's uptake of care responsibilities; (ii) provide quality care services, including for children, the elderly and persons with disabilities, to be considered as essential services that can remain open in case of future pandemics and epidemics, while also providing PPE to such services to prevent the risk of contagion; (iii) increase financial support through family and child benefits, cash, vouchers or in-kind, including to pay for childcare for working parents; (iv) invest in infrastructure to ensure adequate access to electricity, water and sanitation. Additionally, labour market programmes can (i) improve flexible work arrangements for workers with care responsibilities, including (where feasible) the option of remote work, paid reductions in working time, and flexible hours; (ii) legislate to protect the rights of all workers including care and domestic workers in both formal and informal sectors, and secure living wages. Future research is needed to build on this evidence and address three outstanding gaps. First, more evidence is needed on if and how these social protection measures can contribute to the redistribution of unpaid care and domestic work within the households (between women and men, girls and boys) and the society, as well as if and how these measures have been effective at protecting the poorest and most vulnerable segments of the populations -those who not only were hardest hit by the pandemic but who also bear the biggest burden of unpaid care and domestic work. Secondly, evidence is needed to explore whether social protection responses with integrated care (paid or unpaid) considerations into their design, were financially sustainable and adequately implemented, a research objective that was beyond the scope of this paper. Emerging evidence from two case studies of South Africa and Kerala, India, has identified implementation bottlenecks that have prevented positive effects on care issues (Holmes and Hunt 2021). Thirdly, future research is needed to explore the factors behind the integration, and lack thereof, of care considerations into social protection responses by policymakers. This can help inform effective policy, programming and advocacy in case of future crises, including pandemics and epidemics. 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