ILO Calls for Urgent Action to Transform Pakistan’s Care Economy and Empower Women

As Pakistan joins the world in observing the International Day of Care and Support, the International Labour Organization (ILO) has renewed its call for the recognition, investment, and protection of care and domestic work — a sector that remains the backbone of family and community life yet is chronically undervalued and unsupported.

According to new ILO estimates, 117.4 million women and men in Pakistan are engaged in unpaid care and domestic work, including childcare, elder care, and household management. Of this number, 66.7 million are women, highlighting the profound gender imbalance in unpaid labour that sustains households and communities.

Women Bearing the Burden of Unpaid Care

Women in Pakistan carry a vastly disproportionate share of the nation's care responsibilities. Around 60 per cent of women spend over 15 hours a week on domestic tasks, compared to fewer than 7 per cent of men. Beyond household chores, women are also responsible for livestock management, cooking, cleaning, and caring for children, the elderly, and the sick — tasks essential to daily life but often invisible in economic statistics.

This unequal division of labour translates into what experts describe as "time and opportunity poverty." It limits women's ability to participate in paid employment, education, and entrepreneurship, perpetuating cycles of economic dependency and reinforcing the gender pay gap.

"Care work sustains families, communities, and economies — but for too long, it has been undervalued and unprotected," said Geir Tonstol, ILO Country Director for Pakistan. "Transforming care work into decent work is key to ensuring dignity, fair wages, and comprehensive social protection for millions of women."

Global Inequalities Reflected in the Health Workforce

The care gap extends beyond homes and into professional settings. Globally, women make up two-thirds of the health workforce, yet they earn on average 20 per cent less than men and remain underrepresented in decision-making and leadership roles. In Pakistan, nurses, midwives, and community health workers — many of whom are women — often work long hours in unsafe conditions for low pay and without access to benefits.

The ILO's Decent Work Country Programme (2023–2027) has identified domestic workers, home-based workers, sanitation workers, nurses, and community health workers as priority groups for strengthened labour rights and protection. The programme promotes gender-responsive workplaces, fair wages, and social protection systems that recognize the value of care work.

Strengthening Health and Safety Through Global Partnerships

Pakistan's care economy reforms are being advanced through global initiatives such as the ILO–OECD–WHO Working for Health (W4H) programme, which supports efforts to integrate occupational safety and health (OSH) into healthcare regulations, improve working conditions, and build workforce capacity.

Under the government's National Health Vision, Pakistan aims to increase health sector spending to at least 3% of GDP by 2030 — a move that could generate jobs, reduce inequality, and improve health service delivery. The ILO is also collaborating with the Ministry of National Health Services, Regulations and Coordination (MoNHSR&C) to develop a national OSH policy that enhances worker safety and supports the transition toward Universal Health Coverage (UHC).

Giving Voice to Domestic Workers

At the provincial level, the ILO's Promoting Rights and Social Inclusion (PRS) Project, funded by the Government of Japan, has been instrumental in giving voice and representation to domestic workers in Punjab. In 2025, the province achieved a historic milestone with the registration of the United Domestic Workers Federation (UDWF) — the first of its kind in Pakistan — representing domestic workers across Punjab.

"The PRS Project has given voice and visibility to domestic workers," said Arooma Shahzad, General Secretary of the UDWF. "The establishment of the Domestic Workers Employers Association and the creation of a Code of Conduct are groundbreaking steps that show both sides are ready for constructive dialogue and lasting change."

Towards a Fair and Inclusive Care Economy

To sustain this momentum, Pakistan must make coordinated and sustained investments in its care infrastructure. This includes:

• Establishing minimum education and training standards for care workers.

• Ensuring lifelong learning and professional development to retain skilled workers.

• Providing decent wages and safe, healthy working environments.

• Guaranteeing maternity benefits and protection against non-standard work arrangements.

• Expanding comprehensive social protection to all care workers, paid and unpaid.

Such measures would not only uphold workers' rights but also contribute to inclusive growth, gender equality, and social stability.

The 5R Framework: A Roadmap for Change

The ILO advocates adopting its 5R Framework for Decent Care Work — a comprehensive model built on Recognizing, Reducing, Redistributing, Rewarding, and Representing care work. The framework provides governments with practical strategies to integrate care policies into national development plans and economic reforms.

For Pakistan, the adoption of this framework could serve as a catalyst to transform unpaid and undervalued labour into dignified, decent work, enabling millions of women to access new opportunities while strengthening the country's social and economic resilience.

As Tonstol emphasized, "Investing in care work means investing in people — it's not just a social imperative but an economic necessity. By valuing the work that sustains life, Pakistan can create a fairer, more inclusive, and more resilient future."