Por Marcela Achinelli.*
Given that the country is in the midst of a change of government, it is essential to take into account some of the challenges that remain in order to achieve a National Care Policy in Paraguay. In fact, already during the electoral campaign, the main candidates for the presidency echoed care-related issues. While Santiago Peña promised “free day care centers”, Efraín Alegre claimed “day care centers for all”. It is not by chance that this proposal has crossed the different political groups. Within the framework of what is called the “care economy”, there is an agenda on social protection in general and on national care policy in particular, which must be urgently addressed.
The care economy analyzes both those who demand care services and those who offer them, taking into account that the care of dependents (children, people with disabilities and the elderly) requires a social organization such that the responsibility cannot fall exclusively on families. From this approach, the need for a co-responsibility scheme involving the State, companies, civil society and families is proposed.
When speaking of co-responsibility for care, the aim is to make visible the unfair distribution of reproductive tasks, given that up to now these tasks have fallen on women. Data from the Time Use Survey (2016) show that it is women who spend more time on unpaid work (care and housework), which represented 22.4% of the Paraguayan economy’s Gross Domestic Product that same year. Also, Paraguayan households in extended and single-parent families are mostly headed by women, making care arrangements a fundamental decision for those who head the households.
The professionalization of care work is one of the first measures to promote the take-off of the National Care Policy. For this, it is important to make it visible that care is directed to our dependent family members and therefore we must value it under a vision of equity and equality, where the responsibility is shared between the State, civil society, companies, and families.
Initially, this problem was addressed by the Council of European Communities in 1992. As a result of the demographic change taking place in the countries of that region (fewer children per woman, population pyramid with many older adults), the importance of organizing care was raised. The professionalization of these tasks was seen as the way to achieve their social and then economic hierarchization, based on decent work. This implied the possibility of access to salaries commensurate with the service rendered, pension contributions and health insurance. Another advance was the possibility of adapting family homes for formal dedication to these activities, with adequate guarantees and conditions. One example was the Nordic countries that began to train caregivers, who were then given a government-issued caregiver’s license to provide this service. To these caregivers, governments gave them the possibility to readapt their homes according to regulations established for each type of care through soft loans. These steps have been essential to generate a cultural change with respect to the valuation of the provision of these services in European countries.
In Latin America, countries such as Ecuador, Argentina, Chile and Uruguay have implemented care policies, with the Uruguayan system being the first to be established as such. This experience helped Paraguay to develop its own National Care Policy, whose law should be dealt with by the government of Santiago Peña. This policy seeks to establish the principle of equality and non-discrimination by gender in the practice of caring for dependents, implement measures to facilitate the reconciliation of paid work and family, and promote co-responsibility for the care of dependents among the different strata of society. This policy is also based on the sociodemographic transformations that bring us face to face with an accelerated aging of the population, as well as a challenging relationship to accommodate between segments of the population of working age and those who are still dependent.
Care policies include a series of measures such as maternity, paternity and/or parental leave, care centers attached to work, teleworking, flexible entry and exit permits, home care centers, home and in-home caregivers, homes for the elderly, adaptation of space for people with disabilities, among others. The document, which refers to the Paraguayan case, presents advances in these terms and raises the professionalization of care-related work as a major challenge.
In Paraguay there are some experiences of professionalization of the care sector, some of them supported by the Ministry of Labor, Employment and Social Security and the Social Security Institute, such as Corazón de Mamá, Canguro en Casa, Taita. These private initiatives develop services in the care area. Corazón de Mamá, based in Ciudad del Este, provides breastfeeding consulting services, gestational pilates, physiotherapy and kinesiology, psychology and psychopedagogy, a school for nannies and caregivers, and bereavement groups for parents. Canguro en Casa offers, through a platform, the services of specialized caregivers in Asunción whom the company trains in childcare (babysitting). Taita, an initiative that is also being developed in Asunción, is a service focused on older adults that includes residence, home physiotherapy, day care, club for autonomous older adults, and home caregivers.
However, these initiatives are not part of a public policy but are private MSME-type enterprises that, although they are focused on providing care services for infants and the elderly, the training component is aimed exclusively at the people recruited for this work.
Much remains to be done. The public offer of out-of-home care services has been limited to basic education and health, focused on early childhood. Little or no care services have been offered for infants, the elderly, or people with disabilities. A community-based solution for families is the home care scheme. With this, care would be provided in the same areas where the people who need it are, as an alternative to conventional day care centers. The difference is that, for example, a father or mother who lives in the same neighborhood as us and has young children, and is unable, or unwilling to work outside the home, could be willing to care for an additional child at home. This would avoid, among other things, moving from one place to another with the infant which means time and money. But the key point of this approach to caregiving is that it is not done on a favor basis but on a paid basis.
As a first step, the National Government could professionalize the care sector and then create a National Care Registry that would allow those who make up the registry to access soft loans from financial entities to adjust their homes in order to provide services to their community.
In addition, a National Care Registry would encourage those who are usually left out to enter the formal financial scheme. Oversight and regulation would be the responsibility of public entities such as the Ministry of Labor, Employment and Social Security, the Ministry of Children and Adolescents, the Ministry of Urbanism, Housing and Habitat, Senadis, among others, depending on the type of care required. The Ministry of Information and Communication Technologies could also intervene by creating an application that concentrates the data of caregivers so that they are publicly accessible.
The professionalization of care work is one of the first measures to promote the take-off of the National Care Policy. For this, it is important to make it visible that care is directed to our dependent family members and therefore we must value it under a vision of equity and equality, where the responsibility is shared between the State, civil society, companies, and families.
If the new president-elect has real intentions to improve the living conditions of women and to guarantee the care of children, he should prioritize the implementation of the National Care Policy.
Cover image: Yuki Yshizuka
* Economist, Researcher in Economics and Gender