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How a new law in Uruguay boosted care services while breaking gender stereotypes

Its innovative care system is cited as a model for the future of care, in the ILO’s latest report on the care economy.

Feature | 27 August 2018
Rossana Antúnez caring for Catalina, a 7-year old suffering from a severe form of epilepsy
MONTEVIDEO, Uruguay (ILO News) – Life has not always been easy for Rossana Antúnez. She is divorced and lives with her mother, and her 23-year old son here.

She takes care of Catalina, a 7-year old girl who suffers from West Syndrome, a severe form of epilepsy. "Catalina has a severe dependency and I assist her in everything she needs,” Antúnez explains.

She was one of the first to join the new Uruguayan care system, which was launched in 2016. Under the new law – cited by the ILO as a model for care work in the future – all children, persons with disabilities and elderly persons, have the right to access care services. The state does not only provide those services but also guarantees their quality by providing training to care workers.

"Becoming part of the care system has been positive in every way, both for the family and for us, the care workers, because, in my case, I was able to formalize my work, which in turn improved my salary," Antúnez says.

She also received special training to take care of Catalina. “The training was very important… people with disabilities require a very specific and different kind of care, depending on their disability,” she adds.

Angélica Laco is another, though very different beneficiary of the new care system. The 91-year old lives alone in her home in Montevideo and benefits from another component of the system, Teleasistencia.

"This system has helped me a lot, because if anything happens to me, I can call Telecare and they will answer right away. They help people who live alone, they talk to us and they are constantly available."


In case of emergency, they would come to her house, and also alert the neighbours, so that she could get immediate help.

The Care Act – President Tabaré Vázquez’s flagship policy – was introduced to avoid a care crisis in the country. It also recognizes the right of care givers to perform their work in decent working conditions and aims to change the prevalent gendered division of labour.

The issues addressed by Uruguay’s new care law exist on a global scale and were highlighted in the recent ILO’s report Care work and care jobs for the future of decent work, which was published in June. According to the report, a global care crisis could result from the increasing demand for paid care work and the current service deficits if investments are not made in the care economy.

“Uruguay’s Integrated National Care System represents a new model to expand social protection to the 21st century needs,” says Bertranou, the Director of the ILO Office for the Southern Cone of Latin America, and a social security expert. “This and the child care systems of Chile, Costa Rica and Mexico could also serve as an example of good practice for other countries in the region and beyond.”

A bold step to reduce gender inequalities

The new system is also considered as a bold step towards reducing gender inequalities in the world of work.

President Vazquez is one of the champions of Impact 10x10x10, a pilot initiative which engages key decision makers in government, businesses and universities around the world to make gender equality an institutional priority.

His government supported surveys by UN Women, UNFPA and other development agencies in Uruguay, which showed that women spent two-thirds of their week doing unpaid work, and only one-third on paid work. For men, the reverse applied.

It was this data that led to the drastic policy change on care: civil society and academia in Uruguay proposed a re-conceptualization of “care” as a collective and societal issue, taking it out of the private and family sphere and positioning it as a human rights issue.

Global research supports the national survey results, showing that women across the world subsidize care work by quitting paid work to look after children and elderly parents and for managing household chores.

A 2017 ILO-Gallup report found that, globally, a majority of women would prefer to work in paid jobs, including those who are not in the workforce, and that men agree. This implies that a large share of this potential labour force could be brought into paid employment through universal access to care policies, services and infrastructure.

With its double focus on addressing the growing care crisis and reducing gender inequalities, Uruguay’s new care system leaves the country well prepared for the future of work and social protection. “The care system not only has to be looked at in relation to present rights, but also in relation to future sustainability of our societies”, concludes Julio Bango, the National Secretary of Care from Uruguay.