Frustrated with decades of inaction at the national and state level, residents of Multnomah County, Oregon put a measure on the ballot this past November to create a free, year-round, universal preschool program for all three and four year-olds in the county.  Approval was resounding, the vote nearly two to one in support.

Despite years of compelling evidence for universal preschool as a powerful economic development strategy that improves educational outcomes while fighting poverty and inequality, as well as gender and racial disparities, the U.S. lags far behind many nations in the provision of early childhood education and care.  But – unlike other desperate needs such as affordable housing and health care – early childhood education is relatively inexpensive, making it possible for a city or county to mount its own program.

The preschool model being created for the city of Portland, and the rest of Multnomah County, should set a new standard for public preschool programs in the U.S., meeting the needs of children, their families and preschool staff.  To help children thrive and obtain the most from their later education, Multnomah County will work with a range of providers to offer a high quality program, in different languages and cultures, and in a variety of settings, including schools, centers, and family child care.  The program will attain full universality within ten years, prioritizing the enrollment of children from communities of color and families with lower incomes in the early years as the program builds.

To ensure that the program works for families, they’ll also have a choice of schedules, including full and part-time, school year or year-round, and weekends as well as week days, for up to five days a week.  All children may attend without cost for up to six hours a day, with ten hours a day free for families in the lower half of the income distribution.

To retain the skilled, experienced, dedicated – and almost entirely female – staff so critical to quality, teachers’ salaries will double the going rate, to equal those of kindergarten teachers.  The wage floor for all classroom workers, including aides and assistant teachers, will be significantly above the minimum wage, starting at just under $20 an hour in the autumn of 2022 when the first children will be enrolled.

No public preschool system in the U.S. has yet paid a living wage to all staff members, despite cripplingly low levels of staff retention.  Economist Catherine Weinberger has shown that, in the U.S., four of five employed women with college degrees in early childhood development and education do not work with young children.  By contrast, high proportions of college graduates educated as nurses, accountants and others work in jobs that draw directly on their academic training.

Further, Multnomah County’s new universal preschool program will be funded by a county income tax levied on approximately eight percent of the county’s highest income households, addressing skyrocketing economic inequality and the forty-year concentration of income at the very top.

The Multnomah County ballot measure campaign was supported by an undeniable coalition of teachers, unions, organizations representing communities of color, civic and feminist groups, small business owners and environmental advocates– not to mention galvanized parents, child care workers, preschool providers, public health care workers, doctors, economists, school board members and elected officials. Two separate campaigns worked independently for years to prepare a ballot measure, emerging to find themselves aimed at the same election.  The more ambitious was led by the Portland chapter of the Democratic Socialists of America while the other was headed by a philanthropy, called Social Venture Partners, working with an elected County Commissioner.  The two campaigns were able to merge on their strongest combined program, after the bolder plan gathered thirty-two thousand signatures, more than enough to qualify for the ballot.

Key to our success, I believe, was creating a program that works for children, parents and workers.  Too often in the U.S., fear of raising taxes has led to small, part-time and ill-paid programs serving only the least advantaged, and supported by a limited base of advocates for children from lower-income households.  High quality, universal programs are not only more successful at improving educational outcomes for disadvantaged children, but enjoy the popularity necessary to sustaining funding into the future while allowing parents to work more hours or gain additional schooling.

 

This blog was contributed by Mary C. King who is Professor of Economics Emerita at Portland State University, Vice-President of the Oregon Center for Public Policy, Co-Chair of the Oregon Scholars Strategy Network and a founding board member of Family Forward Oregon.  She has spent the past three years campaigning for universal preschool in Multnomah County, where voters decisively approved the creation of a free, year-round, full-day universal preschool program on November 3, 2021.

The 2018 fieldwork for the CWE-GAM project aimed to understand and measure care work in the South Korean context in order to inform gender-aware care macroeconomic models. The fieldwork consisted of both quantitative and qualitative surveys. The quantitative surveys include two sets of questionnaires for paid care workers in eldercare and childcare (Paid Care Worker Survey) and two sets of questionnaires for the unpaid care providers in the households for eldercare and childcare (Care Work Family Survey). The qualitative component consists of two sets of in-depth interview questionnaires for care providers and care recipients.

PAID CARE WORK SURVEY

The Care Work and the Economy Paid Care Work Survey includes two sets of questionnaires for eldercare and childcare workers and a 24-hour time use diary. A purposive sampling method was used to sample 600 paid care workers, 300 eldercare workers and 300 childcare workers, because the exact size and distribution of paid care workers in Korea are unknown. Paid care workers are defined as those working in institutional settings, at the care recipients’ home, and informal workers working without formal contracts. The sample targeted those providing care of the elderly and children’s daily lives, excluding kindergarten teachers and  health care workers at hospitals and medical eldercare facilities. The sample of paid care workers associated with institutions were allocated to reflect the national distributions of eldercare facilities and daycare centers, and the sample of informal care workers were equally allocated across regions.

The Paid Care Worker Survey collected detailed and comprehensive information on the care work provided by paid care workers. The stylized questions and time use diaries of paid care workers collect information on the type, intensity, duration, and evaluation of care work from the perspective of paid care providers. The survey aimed to investigate the characteristics and working conditions of paid care workers, including their background, condition of contract, working environment, task arrangement, and subjective evaluation of the working conditions, and their well-being. The 24-hour time use diaries were collected to provide insights on how the day of a care worker is constructed and how care work is associated with other domains of daily life and time use, which can be analyzed in tandem with the stylized questions on the well-being of care workers.

FAMILY CARE WORK SURVEY

The Care Work Family Survey also consists of two sets of questionnaires for main care providers in the household engaged in childcare and eldercare respectively. 1,000 cases of main care providers in the household were interviewed (500 cases for childcare, 500 cases for eldercare) using a stratified cluster sampling method. Because it is not possible to know the distribution of the population of people who provide unpaid care in a society, children aged below 10 and the elderly aged over 65 were treated as the target population from which to draw the sample. Based on the distribution of the 2018 National Resident Registration Data in Korea, we allocated the number of target households to each area, identified eligible households with elderly or children in need of care, and then selected eligible respondents within the selected households.

The Care Work Family Survey was developed to provide a detailed and comprehensive picture of the care arrangements in South Korea. The survey aimed to investigate how care provision is arranged for the children and the elderly and why it is arranged in such ways. Therefore, the survey collects information from the main care provider, not the care recipients themselves, as it is often the case that the main care provider is the one who knows most about the care arrangements.

After screening for eligibility, respondents were asked questions on their demographic characteristics and information on the respondent, care recipients and other household members. Respondents were asked about the specific activities involved with their care work including frequency, subjective intensity, preferences and willingness to engage in the activities. Information on care arrangements were collected as well including how the care work is shared within the household, whether there are any gaps of care provision, the history of caregivers, use of care services, and decision-making of using care services. Other information such as financial responsibility and burden, experience and evaluation of care work, dual care burdens and well-being of caregivers were collected.

IN-DEPTH INTERVIEWS

The purpose of the in-depth interviews of paid and unpaid caregivers was to provide useful care narratives based on the Korean context to inform macro-modelling. The qualitative research team intervened 25 family caregivers of the elderly, 20 family caregivers of children, 20 paid care workers for elderly, and 31 paid care workers for children. The interviews of family caregivers focused on the decision-making process and evaluation of care arrangements for the elderly and children. Interviewees were also asked about their experiences with caregiving. The interviews of paid caregivers focused on dual care burdens in terms of paid care work in addition to unpaid care work in the home.

SIGNIFICANCE AND LIMITATIONS

The fieldwork for paid and unpaid care work in Korea was designed and conducted to investigate the nature and context of care work in Korea. The Paid Care Worker Survey and Care Work Family Survey have distinct characteristics that contribute to enhancing our understanding about the experience of caregiving in Korea. First, the set of questions that have been developed can be commonly applied to caregivers regardless of the type of care work or the subject of care to enable comparative analysis on the experience of caregiving. Second, not only the caregiving situation, but also the broader aspect of the caregiver’s life including the preferences and attitudes of the caregiver have been studied. Third, the surveys collect detailed information on how care is arranged. Lastly, a caregiver focused 24-hour time use diary has been developed to understand which activities could be considered as care.

This fieldwork only included certain types of caregivers due to the limited budget, time, and scope of the fieldwork. For instance, the sample did not include caregivers for the disabled, caregivers who work at hospital settings, and migrant care workers, despite their importance. Also, as the family survey for childcare limited the respondents to ‘mothers’, and consequently fathers and grandparents were excluded. We hope that the future rounds of surveys can be extended to have a larger sample size and to include a broader range of caregivers. Questions explored in this fieldwork provide important information about the experience of caregiving in Korea, and we hope the fieldwork in Korea can inform fieldwork in other countries.

Learn more about care arrangements and activities in South Korea based on our analysis on the 2018 Care Work and Family Survey here.

This blog was authored by Bong (Regina) Sun Seo, contributing researcher for the Understanding and Measuring Care group

 

 

Last month, the Prospect released a special issue featuring a series of articles surrounding family care,“Caregiving in Crisis and How to Fix It.”

To accompany this issue, a special event was hosted by the Prospect in which various activists, writers and caregivers discussed family care, child care, elderly care, paid family leave to provide care, and long term support for caregiving services.

This event featured:

David Dayen, executive producer for the Prospect

Ai-jen Poo, co-director of Caring Across Generations,

Lynnea Redmon-Williams, a caregiver working fulltime

Tasmiha Khan, Prospect contributing writer

Rhacel Salazar Parreñas, Professor of sociology at the University of Southern California

Brittany Gibson, Prospect writing fellow

 

See the video below for the entire discussion:

 

The Women’s Budget Group Commission on a Gender-Equal Economy, launched in February 2019, is an expert-led project aimed at developing economic policies that promote gender equality across the United Kingdom. The Commission utilizes a number of avenues and tools to achieve this objective, one of which is the recent release of the report “Spirals of Inequality: How Unpaid Care is at the Heart of Gender Inequalities.”

This first report released by the Commission seeks to trace the problem of how gender inequalities in the UK are produced and maintained by observing the problem through the following perspectives:

Unpaid Work: Women Continue to do the Lion’s Share

 The unequal division of labor within unpaid care work is at the heart of gender inequality in the UK, with women taking on 60% of the unpaid work on average. This includes care work, cooking, and cleaning among other tasks.

 

This proportion of unpaid work has increased between 2000 and 2015. Seeing that unpaid work is indispensable to both the function of society and the economy, feminist economists have argued for unpaid work to have recognition in systems of national accounting. These campaigns have led to the UK Office for National Statistics to develop estimates; the most recent from 2014 valuing unpaid care work £1.01 trillion.

Limiting Opportunities for Paid Work: Women More Likely to Work Part-Time and Earn Less

 This phenomenon puts a disproportionate strain on women and contributes to gender inequality. Mothers with young children are 3-4 times more likely to work part-time, and women, in general, are far more likely to be in precarious forms of employment such as temporary work. This is especially true for women of color. The part-time work conundrum is driving the gender gap, and on average women earn 43% less than men. Furthermore, a pay gap of 8.9% persists, further exacerbating this issue. Again, this being more predominate with women of color.

Despite women becoming increasingly educated, they persist in being overrepresented in low-wage sectors of the economy such as health and social work. Feminist economists have argued that a reason behind this is such sectors are viewed as an extension of a women’s “natural” work.

These issues create a perpetual cycle that allows for the inequality between men and women to continue.

Life Course Implications: Benefits Make Up a Larger Portion of Income and Austerity Hits Harder

 Among single households living in poverty, those led by women make up for 86%. Furthermore, pensioners living alone are far more likely to be at the poverty level if that individual is a woman. Since tax reforms began in 2010 throughout the UK, women have also been hit hardest. These benefits make up a large portion of women’s incomes and cuts to these benefits and tax giveaways benefit those fitting into a higher wealth bracket.

Public Services: Women Hit Hardest by Cutbacks

 Cuts to public spending throughout the UK have also hit women disproportionately hard, as women are most likely to utilize public services. The poorest families and especially those in poverty-level households led by women have taken a particularly bad hit; many single mothers have had to cut living standards by up to 10% as a result of a cut to public services between 2010 and 2017.

Furthermore, these cuts have put a greater burden on family members to provide care for the elderly members of their family, much of this falling onto female members. This often comes at the expense of their own employment.

Violence Against Women: “Cause and Consequence” of Women’s Economic Equality

 All of the factors that lead to the economic disparity between men and women also make it increasingly difficult for women to leave abusive partners. Furthermore, poorer households have higher rates of domestic abuse, and this perpetuating poverty limits women’s options while increasing their vulnerability.

Moving Forward: Next Steps for the Commission

 The WBG Commission on a Gender-Equal Economy is striving to develop an alternative economic approach aimed at addressing these issues. Through this initiative, they aim to build an economy that is desirable, economically feasible, and necessary for fairness, sustainability, and resilience. To learn more about the Commission and its work, sign up to attend the upcoming webinar “Creating a Caring Economy: A Call to Action” on September 30, 2020.

In the U.S., states and localities are beginning to ease social distancing policies resulting from the pandemic. With many workplaces calling Americans to return to work, the nation’s care services system, what was already broken, is now in dire need of repair or replace.

According to a recent analysis by the Center for American Progress (CAP), the lack of adequate child care services in the U.S. negatively affected communities of color before the pandemic, as parents of color were more likely than their non-Hispanic white counterparts to experience child care-related job disruptions that could affect their families’ finances.

The analysis uses the National Survey of Children’s Health (NSCH) to show that before the pandemic, Black and multiracial parents experienced child care-related job disruptions—such as quitting a job, not taking a job, or greatly changing their job—due to problems with child care at nearly twice the rate of white parents.

For Black workers and workers of color, decades of occupational and residential segregation has translated to less access to telework, and therefore less flexibility within their responsibilities for young children or elders. In fact, most Black workers and workers of color (especially those who are women) have had to work through the pandemic in essential frontline occupations.

The analysis shows that prior to the pandemic, adequate and affordable child care services was short in supply, particularly for Black, Latinx, and Indigenous families. In fact, more than half of Latinx and American Indian and Alaska Native (AIAN) families have experiences living in a child care desert – which is an area suffering from an inadequate supply of licensed childcare.

Using child care services as an example, the analysis shows that disparities will likely worsen in the aftermath of the pandemic. A previous CAP analysis estimated that nearly 4.5 million child care slots could disappear permanently as a result of COVID-19, effectively cutting an already inadequate child care supply in half. Recent data suggest that this impact is already being felt, with more than 336,000 child care providers—many of whom are immigrants, African American, or Hispanic—losing their jobs between March and April.

Allowing care services to flounder should not be an option; a broken and inadequate care system would slow the nation’s economic recovery and in addition to deepening existing economic and racial inequalities.

 

 

 

A recent report on Basic Demographic Profile of Workers in U.S. Frontline Industries by the Center for Economic and Policy Research (CEPR) looks at six broad industries, employing grocery store clerks, warehouse workers, bus drivers, and care workers – including nurses, care workers at child care and residential care facilities, as well as household and community service workers.

Based on CEPR’s analysis using the American Community Survey (2014 – 2018), over half of all essential workers in the industries examined are employed in care services. More than a third of these workers are over the age of 50; and before the pandemic, nearly a quarter were living in low-income households and about half lived with a child or a senior at home.

 

At the national level, women workers are overrepresented in frontline industries. About one-half of all workers are women, but nearly two-thirds (64.4 percent) of frontline workers are women. Women are particularly overrepresented in care-work related industries – Healthcare (76.8 percent of workers) and Child Care and Social Services (85.2 percent).

Black and Hispanic workers, as well as other people of color are also overrepresented in many frontline industries occupations. Black workers are most overrepresented in Child Care and Social Services (19.3 percent of workers). Hispanic workers are especially overrepresented in Building Cleaning Services (40.2 percent). Immigrants are also overrepresented in Building Cleaning Services and in many frontline occupations in other frontline industries.

The report calls on U.S. congress to include important protections for frontline workers in its response to COVID-19 – including comprehensive health-care insurance, paid sick and family leave, free child-care, student loan relief and other labor protections related to workers’ health, safety and immigration status.

 

About the report:

 A Basic Demographic Profile of Workers in Frontline Industries. Hye Jin Rho, Hayley Brown, and Shawn Fremstad. Center for Economic and Policy Research. April 2020.

Unpaid Work, Animated

About half of all the time devoted to work in the U.S. is devoted to unpaid work in the home. The Institute for New Economic Thinking has created an adorable animation of some comments I made in an interview with them on this topic a while back.

It’s quite a lot of fun, and basically accurate. Just don’t pay too much attention to the numbers they inserted into my discussion of two families, each with a market income of $50,000–the animation seems to imply that leisure should be assigned a monetary valuation–not something I advocate. Still, the main point comes through just fine: conventional measures provide a misleading picture of living standards.

The animation provides a great introduction to the topic for students, and you can find a more academic version of the basic argument in a short briefing paper I wrote for the Washington Center for Equitable Growth.

Original blog published on CARE TALK: FEMINIST AND POLITICAL ECONOMY on June 11, 2020. See here for the original posting.

Reposted with permission from Dr. Nancy Folbre from University of Massachusetts Amherst and an expert researcher for the Care Work and the Economy Project within the Rethinking Macroeconomics working group.

How much time do people spend on doing paid and unpaid care work? How do women and men spend their time differently on unpaid care work? Are there any differences in time use among the regions? How do socioeconomic factors influence people’s choices to do paid and unpaid care work?

Jacques Charmes addresses these questions in recent ILO report by providing a comprehensive overview of the extent, characteristics and historical trends of unpaid care work. The report is based on the analysis of the most recent time-use surveys carried out at the national level across the world, revealing the differences in time spent on unpaid care work between women and men and among people with different socioeconomic characteristics, such as geographical location, age and income groups, education level, marital status and the presence and age of children in the household. An insightful discussion of the concepts and methodological approaches underlying the analysis of time-use data is also offered.

Chart 7 in the ILO Working Paper the Unpaid Care Work and the Labour Market. An analysis of time use data based on the latest World Compilation of Time-use Surveys illustrates the time spent by women and men in various categories of unpaid care work across Sub-Saharan African countries including Cameron, Ghana, Benin, Madagascar, South Africa, Tanzania, Mali, Mauritius, Ethiopia and Cabo Verde. As with the case around the world, women in Sub-Saharan African countries are providing significantly more unpaid care services in households and communities. Read the report to learn more about time-use analysis concepts and methodologies, gender variations in paid and unpaid work across the world and across various socio-economic levels:

Unpaid Care Work and the Labour Market. An analysis of time use data based on the latest World Compilation of Time-use Surveys.

 Jacques Charmes

International Labour Organization

Gender, Equality and Diversity & ILOAIDS Branch

“Shelter in place” mandates in the early stages of the U.S. Covid-19 pandemic required many people to stay home, cook their own meals, school their own children, and entertain themselves.  Unpaid work served not only as a social safety net, but also as an automatic stabilizer. While it didn’t dampen fluctuations in official Gross Domestic Product, as did unemployment insurance, it clearly helped stabilize consumption.

Just imagine what would have happened if most people had not had refrigerators, stoves, and computers—or just read reports of the plight of homeless people.

By mid-March 2020, many states and localities shut down restaurants for any services other than take-out. Home-produced meals increased of necessity. Many such meals probably consisted of convenient processed foods that could be popped into a microwave oven, but a renaissance of home cooking also became apparent, along with reliance on long-lasting, easily stored items such as rice and beans.  Analysis of Google Search terms showed a sharp spike in questions concerning food preparation and storage. As one newspaper put it, America began baking its heart out. Yeast suddenly became as hard to come by as toilet paper.

In 2018, according to the American Time Use Survey, adult civilian women spent an average of .8 hours a day, and their male counterparts .4 hours a day in meal preparation. How much more did they spend in the months of March and April, and what was the monetary value of this unpaid labor, based on what it would have cost them to hire someone to plan, cook, and clean up? How much did they save on eating-out?

Many childcare centers and schools were closed, leaving parents with responsibility for home-schooling, supervising children, and keeping them from going confinement-crazy.  The American Time Use Survey averaged the amount of reported time that married mothers and fathers living with children under the age of 18 spent in primary activities of caring for and helping household children  over the 2013-2017 period—an average of 2.6 hours per day for mothers not employed and 1.4 hours for fathers not employed.

Under sequestration, both active care and supervisory care (defined as the time in which an adult reported that a child under the age of 13 “in their care” ) ballooned. How much did these two forms of childcare increase? How much did households save on childcare costs?

Video streaming and gaming increased dramatically, especially during afternoon hours, and people began to rely more heavily on streaming for instruction and exercise as well as entertainment. So, while they spent less money (and less travel time) on entertainment away from home, they substituted forms of entertainment that were probably less expensive, on average. How much less expensive?

Between March and May, average household income plummeted as a result of job furloughs and unemployment. The increase in time devoted to household production buffered this loss to some extent—but without answers to the questions above, we can’t know how much. Most recent impromptu household surveys have focused primarily on women’s unpaid work relative to men’s—an important, but different topic.

For years, I have protested economists’ lack of interest in total consumption—defined as the sum of money expenditures and the consumption of home-produced services.

Let me will repeat one example that I have written about in more detail elsewhere: Compare two couples, each with two small children, each earning $50,000 after taxes. Conventional measures treat them as having exactly the same income. Yet one couple may include an adult earning $50,000 and a full-time homemaker/caregiver, while the other includes two adults earning $25,000 each and obviously has less time to devote to unpaid work. If we assigned any positive value to unpaid work, the first household would obviously be better off in terms of both income and consumption.

Market income is just not a very good indicator of total consumption among households with differing inputs of unpaid work. Also, the value of unpaid work is greater in households with more than one person, because of economies of scale in food preparation and childcare. Standard equivalence scales used to adjust household income for household size and composition completely ignore these issues.

Obviously, the additional unpaid work performed while sheltering in place was a source of great stress, especially for those simultaneously telecommuting, zooming, or otherwise trying to fulfill paid employment responsibilities at home. Yet, it’s hard to deny that this work also “added value,” enabling an important form of social provisioning.

The worst-case scenario for a household with children was almost certainly one in which all adults (e.g. mother and father) were essential workers, required to keep working (often at risk to their health) but unable to work from home. Federal and state agencies tried to provide “resources” for these workers, but no guarantees were forthcoming.

In many cases, one of the adults (probably the mother) was forced to quit or take a leave of absence from paid employment. While new federal legislation gives states flexibility to pay benefits where an individual leaves employment to care for a family member, not all states do so.

Such a policy is effectively a paid family leave—something that most states have shied away from for years, making this country an international outlier. The complexity of the new legislation, plus the difficulty of actually filing for and receiving unemployment benefits, has probably kept take-up pretty low even in states that allow this option.

Just one more reason to consider policies such as federal paid family and sick leaves and a universal basic income that could help the stabilizers known as households do their job.

Original blog published on CARE TALK: FEMINIST AND POLITICAL ECONOMY on May 19th, 2020. See here for the original posting.

Reposted with permission from Dr. Nancy Folbre from University of Massachusetts Amherst and an expert researcher for the Care Work and the Economy Project within the Rethinking Macroeconomics working group. 

When crisis hits, longer-term thinking can easily, and understandably, be cast as a distraction or a luxury—even when it relates to tackling critical issues like gender inequality, climate change, or extreme poverty.

Speaking personally, I’ve felt a bit silly trying to push forward projects that focus on gender lens investing or women’s economic empowerment in the last few weeks, given that my colleagues’ and collaborators’ attention, and frankly much of my own, lies elsewhere, and with something that seems much more pressing.

But for those of us who are in the position of privilege to continue thinking long term, it’s our responsibility to do so. Working towards structural changes that will take longer to come to fruition, especially those that relate to reducing global inequality, is the only way to radically decrease the extent of harm caused by moments of crisis, especially for vulnerable populations.

Dismantling unequal power structures, and in turn ensuring that every individual—regardless of gender, age, income level, national origin, and so on—has a safety net protecting them from vulnerability to health scares, income loss, and threats of increased violence, will allow us to focus on crisis without fearing fallout across every dimension of life.

In times of pandemic, the economically vulnerable cannot afford to stay home. Women in quarantine are facing increased risks of intimate partner violence. Girls staying home from school in some parts of the world may not have the opportunity to return. And none of this would be the case if we more effectively tackled the forms of inequality that underlie these realities. Then a virus could be a virus — assuredly deadly and destructive from a health perspective – but without inciting increased abuse, poverty, and lost prospects.

My colleague David Evans, drawing upon work by Claire Wenham, Julia Smith, and Rosemary Morgan in The Lancet, recently highlighted a range of problems stemming from the COVID-19 pandemic that disproportionately impact women and girls. In hopes of continuing to move the conversation forward, I propose some solutions to those problems here, and welcome others to add to this initial list. To be clear, these actions should not distract from immediate measures to address the pandemic. But we also can’t afford to risk forgetting about them when the focus on COVID-19 has faded; otherwise history is doomed to repeat itself.

1. Promote a Gender-Equal Health Workforce

Because the health workforce is disproportionately women (67%), women are at a higher risk of exposure to the virus within medical facilities.

More doctors worldwide are still men. But the vast majority of the global health workforce consists of nurses, community health workers, and others who are less highly compensated. All health workforce jobs need to become increasingly well-compensated, high-quality jobs. Not only will this incentivize men to seek these positions, destigmatizing their current positioning as “feminine” and dismantling occupational sex segregation within the healthcare sector, but it will also ensure that those on the frontlines of protecting populations from pandemics don’t also have to fear economic fallout on a day-to-day basis.

The number of women doctors is rising. Research from other sectors tells us what works to combat occupational sex segregation, including men acting as mentors supporting women to “cross over” into higher-paying occupations. These efforts will have to be paired with those that increase the perceived (and actual) value of work in sectors, including nursing and other frontline health work, where women dominate. More research is needed on this front, both on what works to incentivize men to take up traditionally “feminine” roles and how to avoid unintended displacement of women from those occupations.

2. Protect (and Expand) Existing Health Resources

With all hands on deck to fight COVID-19, particular groups of women and girls face other health risks.

Health facilities should not have to choose between providing lifesaving care in the face of pandemics and continuing to provide support for those in need in other areas, including pregnant women, adolescent girls (who have the highest prevalence of HIV infection, and in need of life-saving medication to keep their immune systems strong), and all women and girls in need of contraceptive access.

Increased investments in health are needed to ensure critical day-to-day care is not compromised during times of crisis. Establishing a Global Health Security Challenge Fund would help ensure countries are prepared to balance day-to-day needs with additional burdens in the face of pandemic, and evidence-based prioritization strategies are needed for when resources cannot be expanded.

3. Reduce and Redistribute Unpaid Care Work Burdens

As schools close and people fall ill, women and girls will assume increased unpaid care work burdens.

Under business-as-usual scenarios, women and girls do more than their fair share of unpaid care work, which limits their educational attainment, workforce participation and advancement, and leisure time. To lessen these burdens in times of crisis and more generally, we need increased investments in child and elder care, and in the poorest countries, gender-responsive energy, water, and sanitation infrastructure that would reduce the time women and girls must spend collecting water and fuel, as well as cooking and cleaning. We also need shifts in household norms that mean men assume more unpaid care responsibilities. Initiatives focused on promoting women’s economic empowerment, such as 2X Challenge and the Women’s Global Development and Prosperity (W-GDP) initiative, as well broader investments in gender equality and economic growth, must prioritize reducing and redistributing women and girls’ unpaid care work.

4. Address Gender-Based Violence

With quarantine measures imposed and stress heightened, women are at increased risk of violence committed by their partners and family members, and essential support services are absent.

Early reports suggest that gender-based violence rates are increasing in light of COVID-19 quarantining, consistent with evidence documenting increased violence in other crisis settings. Gender-based violence needs to be elevated as its own public health crisis, and resourced accordingly.

We’re far from meeting this objective, considering that all OECD donors combined allocated less than $200 million to addressing violence against women according to 2016-17 data, and over half of this financing came from just three countries (Australia, Canada, and Norway). Increased resources should target evidence-based approaches, such as Promundo’s MenCare program.

In pandemic contexts, preparations for social distancing should include considerations of how individuals will be able to access social services when faced with violence in their households. The World Bank has taken a step in the right direction in positioning interpersonal and gender-based violence as priorities to address in its new Fragility, Conflict, and Violence Strategy, though time will tell how the bank and other donor institutions finance this priority.

5. Guarantee Girls’ Education

With schools closing as part of social distancing measures, girls who already face pressure to drop out of school may not return.

Even absent crisis, tens of millions of girls globally face pressures to drop out of school to care for siblings and do other unpaid domestic work, contribute to supporting their households financially, and/or marry and have children when they are still children themselves. These pressures may be heightened due to interruptions in their education, as observed when Ebola hit West Africa. School closures, especially those impacting adolescent girls, should be weighed against longer-term risks related to girls’ school drop-out and limited school-to-work transition prospects as a result. Where possible, efforts should be made to incentivize parents to allow their children to return to school and to ensure consistent access to sexual and reproductive health services in the interim, as unintended pregnancy is cited as a reason for girls’ failure to return to school.

6. Promote Women’s Economic Opportunities

Across the globe, women are more likely to work jobs that are low-paid, informal, and lacking in benefits.

In large part due to the disproportionate unpaid care work women take on, they are less likely to be employed full-time, in the formal workforce, or in jobs that provide paid sick leave, unemployment insurance, and other protections.

We must continue to invest in evidence-based programs and policies that improve women’s economic opportunities and support organizations such as the Self-Employed Women’s Association and Women in Informal Employment: Globalizing and Organizing—organizations that are well-positioned to provide and advocate for dignified work.

Cash transfers should be considered as a means of ensuring a social safety net for those most in need. Critical to transfers’ success will be (1) ensuring that delivery mechanisms (through digital technology or otherwise) are properly designed and implemented and (2) that those in need, including low-income populations and workers vulnerable to economic backslides because of the virus, are prioritized.

7. Ensure Women’s Representation in Decision-Making and Critical Research

Women are not equally represented in decision-making roles responding to the COVID-19 pandemic.

The White House Coronavirus Task Force is over 90 percent men, and the team Prime Minister Johnson just assembled to lead the United Kingdom’s COVID-19 response is all men. As in the contexts of peace and security, international trade, and climate change, an exclusionary approach to decision-making will yield inferior decisions: those that don’t account for the needs and constraints of populations absent from the table.

Going forward, decision-making teams should be equally representative of men and women, and also prioritize other forms of inclusion, such as those based on race and ethnicity, as called for by Women in Global Health’s Operation 50/50 campaign.

Women must also be equally represented in clinical trials as biomedical treatments and other interventions are developed. As my colleague Carleigh Krubiner has noted speaking to the context of Ebola, women who are pregnant or breastfeeding are typically excluded from experimental studies, and in some high-fertility contexts, this means up to 80 percent of reproductive age women are virtually invisible in trial samples. Lack of representation means a lack of essential data on the types of prevention methods, treatments, and other interventions that work for women, risking higher fatality rates and other complications.

Times of crisis magnify the cracks in our systems and highlight disproportionate risks to the most vulnerable among us. COVID-19’s impacts, those already felt as well as those still anticipated, should serve as a wake-up call. They should spur action to address underlying inequalities, including those that disadvantage women and girls worldwide and make the consequences of a pandemic even worse than they would otherwise be. Increased prioritization of women and girls’ health, education, economic opportunity, safety, and decision-making power can help create a world where no one falls through the cracks. Decision-makers should realize this is inextricably linked to today’s pandemic response.

Contributed by Megan O’Donnell Assistant Director, Gender Program and Senior Policy Analyst at Center for Global Development

Original blog published on Center for Global Development website March 18, 2020, see here for the original post

Reposted with permission from Megan O’Donnell Assistant Director, Gender Program and Senior Policy Analyst at Center for Global Development