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Programme Director’s August 2021 Message

The cost of caring

Figure 1 – More information here

During the last year the difference between ‘the haves’ and ‘the have nots’ has become more apparent to all, and the gap is widening. We cannot allow this to continue whether we consider our own country alone or take the wider world view.

Until the world is vaccinated no-one can assume that the pandemic is over and that we have reached the ‘steady state’ of endemic. Those delivering care have, mostly, been women, often unpaid and undervalued by society. But our wellbeing has depended on the work and dedication of many, such as delivery drivers, cleaners, shop assistants, family carers and all involved in keeping the world moving even though limited individually to prescribed geographical areas and our homes. Not all have had homes and, where there have been schemes to house all, these are drawing to an end. So, what now?

On 8 March 2021 (International Women’s Day) The World Health Assembly declared an ambition to:

  1. increase the proportion of women in health and care leadership;
  2. promote equal pay for equal work and recognise unpaid care work;
  3. protect women in health and care from sexual harassment and violence at work;
  4. ensure safe and decent working conditions for women health and care workers, including provision of PPE and Covid vaccines.

In 2019 the Word Bank estimated that women’s labour force participation fell from 51% in 2000 to 48% whilst women spent three times longer on unpaid care work than men. The Covid pandemic has exacerbated these discrepancies.

People in poor countries suffer more since their governments have debts to richer countries and international agencies, and do not have adequate health services to deliver the help even when supplies are available. The WHO Covax scheme, working with UNICEF, the World Bank, the IMF and others is seeking to make vaccines and other essential health care tools, including tests and medicines as well as oxygen, available everywhere. The International Monetary Fund has stepped in with debt relief packages, approving help for 37 countries. Together, the effort to deliver on SDG 3 (Health and Wellbeing) seeks to:

  • Further strengthen country ownership, engagement and impact on health-related SDGs;
  • Accelerate country progress by ensuring that the SDG3 Global Action Plan responds comprehensively in the COVID-19 era by supporting country-level work across the seven programmatic areas of focus (accelerators), with a commitment to gender, equity and human-rights-based approaches;
  • Align operational and financial strategies, policies and approaches where possible;
  • Account for progress under the Global Action Plan and learning together to enhance a shared commitment to accountability for collaboration.

People living on low incomes or none cannot afford daily essentials, let alone health care, thus the need for Universal Health Care, free or at affordable prices, is needed if we are to deliver on healthcare for all.

Women have provided most of the care in health care systems worldwide. In addition to this they have cared for children, older persons and those with disabilities at home and in isolation even more than usual, mostly unpaid. This work is time-consuming and carried out in crowded and unsafe basic infrastructures without running water and electricity. It has been estimated that this work contributes 2.35% of GDP, the equivalent of USD1.488 trillion.

But the disparities also apply to others not working in the health and care sectors. The pandemic has highlighted how interdependent we are on each other. Without shop assistants, delivery drivers, garbage collectors, plumbers, electricians and many others, how could we survive the isolation and social distancing demanded from us in trying to control the spread of Covid? Low wages make it impossible for many to care for themselves and their families since loss of even those meagre amounts cannot enable them to take the precautions others, on higher incomes whether wages,  social benefits or savings, can do.

Would a universal basic income help to solve these problems? Schemes across the world indicate overall benefits for the individuals and society at large. A review of cash transfer schemes by the ODI (Overseas Development Institute) summarises the evidence for women and girls thus:

  • Cash transfers have a positive impact on the well-being and opportunities of women and girls, particularly in education and employment, and on the whole women and girls benefit as much as men and boys.
  • Cash transfers can increase school attendance for both girls and boys, but this does not always lead to improved learning outcomes.
  • Cash transfers are associated with a decrease in child labour for both girls and boys, though larger reductions are seen for boys.
  • Cash transfers can have different impacts on the way women and men spend their time, with women sometimes increasing time spent on domestic work (alongside a reduction in time spent by girls on domestic chores).
  • There is some evidence that female-headed households make greater productive investments than male-headed households.
  • Cash transfers can increase women’s decision-making power and choices, including those on marriage and fertility, and reduce physical abuse by male partners.

The World Food Programme avers that ‘Where markets and financial sectors are functioning, cash transfers can be an effective path to achieve food security and nutrition outcomes.’

This is also reflected in the benefits of cash transfers as exemplified by micro-credit schemes such as Lendwithcare and Kiva to which SIGBI donates currently. Time will tell how successful this is but the evidence available currently points in the direction of overall benefit.

If you want to join us to help women and girls be the best they can be, come and join us.

Kay Richmond
SIGBI Programme Director