Unsung Health Heroes at Home

Home caregivers provide a major portion of all health care but need more support in their work. © Armando Waak/PAHO

These home-based caregivers are mostly, though not exclusively, women, and their patients are generally family members. Home care is a deeply rooted tradition in nearly all human cultures, but it should not be taken for granted, say advocates for these unsung health heroes at home.

"It's very difficult to measure their contribution, but some estimates put it at around 85 percent of all health care," says Lilia Jara, PAHO advisor on women in health and development. "One of our key priorities is to measure the contributions of unpaid health workers Unsung Health Heroes at Home to their countries' health systems and economies.This is a key step toward getting them the recognition and support they deserve."

Jara and other experts on unpaid caregivers say the load on these women has increased in recent years, thanks to an aging population, the growing incidence of chronic diseases that require more long-term care, and cutbacks in government spending for the health sector. Many health systems encourage patients to convalesce at home to cut down on hospital costs.

The greater workload for home caregivers comes at a time when a record number of women are working outside the home. To address the problems created by these trends, Jara and other experts advocate the following initiatives:

• Measuring and assigning value to the time women spend at home caring for those who cannot care for themselves, and integrating this information into countries' national accounts.
• Providing technical assistance to home caregivers on basic forms of care.
• Providing some form of respite and recuperation for home caregivers, whose work often exacts a significant physical and emotional toll.
• Getting official recognition of their unpaid work to qualify them for government benefits and services, such as social security.
• Developing policies that encourage a fairer distribution of this unpaid work between men and women, and between the family, the community, and the state. These include, for example, paternity leave for men.

"It's also important that the state and the private sector share responsibility for social reproduction and the needs of the family," says Jara. "This can be, for example, through social funds to support the care of children, the sick, and the elderly."