Care work — both paid and unpaid — is critical for the wellbeing of society. It ranges from raising children to looking after the sick and elderly. But in India, this essential work is overwhelmingly carried out by women, largely unpaid, and often invisible in economic statistics and policy debates. With India’s population ageing rapidly and growing urbanisation weakening traditional family support systems, there is an urgent need to address the country’s deepening care deficit.

By 2036, India’s elderly population (60+ years) is projected to reach 227 million. Many of them will require physical, emotional, and medical care. Simultaneously, women continue to shoulder the burden of child and family care, often at the cost of their economic opportunities and wellbeing.

Significant gender and social inequities occur due to inadequate care infrastructure and lack of recognition of unpaid care work. Most care work in India — cooking, cleaning, child-rearing, elder care, fetching water or firewood — is unpaid and done by women. When a family member cooks a meal or looks after a sick parent, it doesn’t count in the GDP. But when this is done by a paid domestic worker or nurse, it is recorded as labour and contributes to economic activity.

Unpaid Care Work

Globally, women spend 4 hours 25 minutes daily on unpaid care work, compared to 1 hour 23 minutes by men. In India, this gap is even wider.

Time Use Surveys (2019 and 2024) show that Indian women spend almost 10 times more time than men on unpaid domestic tasks. Yet, this important work remains unrecognised in labour force surveys and official economic data.

One estimate by SBI Research (2023) valued women’s unpaid labour at ₹22.7 lakh crore —₹14.7 lakh crore in rural areas and ₹8 lakh crore in urban India. Recognising and valuing this unpaid contribution is not just a gender issue — it is a national development imperative.

ILO estimates that the global care workforce comprises 248.9 million women and 132.1 million men. This includes care workers in care sectors (education, health and social work), support staff and care workers in non-care sectors and domestic workers (employed by households).

Correspondingly, based on analysis of unit-level survey data from the Annual Periodic Labour Force Survey (PLFS) 2023-24, 36 million people in India are employed in paid care work — 56.6 per cent of them are women.

However, while women are overrepresented in care-giving roles, they are often employed in low-paying, informal, and unprotected jobs. More than half the paid care workforce is in education, followed by healthcare and personal services. Women dominate personal care services (like domestic work), where over two-thirds of workers are female.

Unfortunately, this sector also sees the worst working conditions — nearly 99 per cent of jobs are informal. Marginalised communities — Scheduled Castes (SCs), Scheduled Tribes (STs), and Other Backward Classes (OBCs) — make up over two-thirds of the care workforce, reflecting the historical and structural barriers that confine them to difficult and underpaid roles.

Regular but Precarious Work

A majority (88.7 per cent) of paid care workers in India are “regularly employed.” However, regular employment doesn’t necessarily mean job security or fair pay. Nearly 43 per cent of these workers are in the unorganised sector, where benefits like paid leave or social security are rare.

Even in the organised sector, informality persists. About 41.4 per cent of jobs in this sector are informal, with women again disproportionately affected.

In personal care services, 99.5 per cent of jobs are informal, and 97 per cent lack written contracts. Only around half (52.3 per cent) of paid care workers receive paid leave.

In the education sector, 73.6 per cent receive this benefit, but in personal services, just 19.5 per cent do.

Care workers’ earnings show striking gender disparities. Self-employed workers earn more than salaried or casual workers, but there is a 61 per cent gender wage gap even among them. In education, men tend to occupy better-paid positions like administrators or senior faculty, while women are concentrated in early childhood education or support roles. In health, men dominate better-paying roles like doctors, while women work mostly as nurses or caregivers.

In domestic and personal services, the earnings are lowest, and the gender wage gap is widest. These are mostly unregulated and informal jobs, with little protection or social security — again, mostly held by women.

The root of this inequality lies in occupational segregation, gender norms, limited access to education, and the burden of unpaid care work that prevents women from moving into better-paying roles.

Policy roadmap for a better care economy

India’s care economy is at a critical juncture. Addressing the rising care deficit due to ageing, combined with persistent gender and social inequalities in care provisioning, requires urgent reforms. The following policy measures can help transform this landscape:

Recognise and measure unpaid care work

Most care work is unpaid. Time Use Surveys must be supplemented with a dedicated national survey on unpaid care. This is essential for crafting policies that truly reflect women’s contributions to the economy and society.

Invest in public care infrastructure

High-quality, affordable childcare, eldercare and community health services must be scaled up to ensure universal access to care. Public investment in care facilities and physical infrastructure (such as water and sanitation) will ease the burden on women and create new jobs.

Redistribute care within households

Promoting shared caregiving responsibilities through paid parental leave, eldercare leave, and awareness campaigns can help shift social norms and promote gender equality at home.

Formalise and strengthen paid care jobs

Care work should be recognised as skilled labour. Steps must be taken to formalise employment, ensure fair wages, and provide legal protections.  Skilling and upskilling programmes must target women in health, education and personal services to improve career opportunities.

Close gender gaps in pay and opportunities

Equal pay for equal work must be strictly enforced. Career pathways must be created for women to transition into supervisory or professional care roles. Access to adult education and vocational training must be expanded.

Plan for India’s future care needs

With a rapidly ageing population, India must forecast future care requirements and align training and employment policies accordingly. Public-Private Partnerships and CSR investments can help expand care infrastructure and services.

Collaborate for systemic reform

Governments must take the lead but also engage civil society, the private sector, and communities in building a responsive, gender-sensitive care system.

Care work sustains life, society, and the economy. Yet it remains invisible, undervalued, and unequally distributed. Recognising, reducing, and redistributing care work—both paid and unpaid—must become central to India’s development agenda.

Balwant Singh Mehta is Professor, Institute for Human Development (IHD), New Delhi. Aasha Kapur Mehta is Chairperson, Centre for Gender Studies, and Visiting Professor, Institute for Human Development (IHD), New Delhi

Published on May 27, 2025