I-7 Is there collaboration with other agencies of the United Nations System or other partners?
Yes
II-1 Justification of the initiative
The initiative addresses the difficulties for women to enter the labour market on equal terms with men. Despite the progress made in Uruguay in the 90s with women's entry into the labour market increasing, in the second half of the 2000s, this trend stagnated. This stagnation is likely due to the disproportionate burden of care responsibilities borne by women, particularly from lower social strata. The 2022 Time Use Survey by INE revealed that unpaid care work accounted for approximately 23.8 per cent of Uruguay’s GDP. Of that total, women contributed 16.0 per cent and men contributed 7.8 per cent. In addition, the initiative responds to a rise in the demand for long-term care services for older persons and persons with disabilities who need care or support due to the increased aging population. According to the National Institute of Statistics (INE), 14.3 per cent of the population was aged 65 and older in 2018, one of the highest rates in Latin America and a steady increase from 12.7 per cent in 1996.
II-10 Focus on other branches of economic activity
No sectoral focus
II-11 Focus on certain categories of enterprises or economic units according to their size
Cooperatives
II-12 Focus on specific status in employment
Employees
II-12 Focus on specific status in employment
Employers
II-13 Focus on other specific categories of workers and employers, not captured elsewhere
Domestic workers
II-13 Focus on other specific categories of workers and employers, not captured elsewhere
Community health and care workers
II-13 Focus on other specific categories of workers and employers, not captured elsewhere
Childcare workers (for children ages 0-start of primary school)
II-13 Focus on other specific categories of workers and employers, not captured elsewhere
Personal care and/or assistance workers
II-14 Focus on specific groups of population / persons prioritized in the initiative
Women
II-14 Focus on specific groups of population / persons prioritized in the initiative
Men
II-14 Focus on specific groups of population / persons prioritized in the initiative
Mothers
II-14 Focus on specific groups of population / persons prioritized in the initiative
Fathers
II-14 Focus on specific groups of population / persons prioritized in the initiative
Persons with other care responsibilities
II-14 Focus on specific groups of population / persons prioritized in the initiative
People with disabilities
II-14 Focus on specific groups of population / persons prioritized in the initiative
Older persons
II-14 Focus on specific groups of population / persons prioritized in the initiative
Children
II-15 Has the initiative been developed through effective social dialogue processes and inter-institutional coordination mechanisms?
Yes, through social dialogue
II-15 Has the initiative been developed through effective social dialogue processes and inter-institutional coordination mechanisms?
Yes, inter-institutional coordination mechanisms
II-2 Objectives and description of the initiative
The definition of the care system in Uruguay is a set of actions and measures aimed at designing and implementing public policies based on a solidarity-based and co-responsible model involving families, the State, the community, and the market. Hence, the main objective of the initiative is to establish a shared care model that involves families, the State, the community, and the market in the fair distribution of care responsibilities. It aims to ensure the provision of high-quality, equitable care for individuals in situations of dependency, while addressing the historically and ongoing unjust gendered division care work. In response to civil society demands, the initiative recognizes caregivers—predominantly women—as active rights holders and promotes a transformative approach by encouraging men to take on an equal share of care responsibilities. Specifically, the initiative aims to expand the coverage and quality of care services for young children and older persons. The Sistema Nacional Integrado de Cuidados establishes care as the fourth pillar of Uruguay's national social protection system, enshrining the 'right to care and be cared for' within national legislation, with social dialogue playing a crucial role in shaping inclusive policies that ensure universal access to quality care services and promote social equity. Changing the division of labour between women and men within households and supporting unpaid carers as well as care workers are also among the SNIC’s stated objectives.
II-3 Type of initiative
National/local law
II-3 Type of initiative
Policy / strategy
II-3 Type of initiative
Plan / roadmap
II-4 Which of the Rs in the 5R Framework for Decent Care Work guides this initiative?
Recognition, reduction and redistribution of unpaid care
II-5 Which is the main policy area of the 5R Framework for Decent Care Work does the practice focus on?
Care policies
II-6 Which other policy areas of the 5R Framework for Decent Care Work does the practice focus on?
Skills policies
II-6 Which other policy areas of the 5R Framework for Decent Care Work does the practice focus on?
Social Protection policies
II-6 Which other policy areas of the 5R Framework for Decent Care Work does the practice focus on?
Labour Protection policies
II-7 Which policies or measures to advance decent work in the care economy does the practice focus on?
Design and implement integrated and coherent care policies and systems for decent work and gender equality
II-7 Which policies or measures to advance decent work in the care economy does the practice focus on?
Mainstream care into relevant public policies
II-7 Which policies or measures to advance decent work in the care economy does the practice focus on?
Formalization of informal care jobs and enterprises
II-7 Which policies or measures to advance decent work in the care economy does the practice focus on?
Promoting active labour market policies, education and training, upskilling and re-skilling, skills recognition and skills certification
II-7 Which policies or measures to advance decent work in the care economy does the practice focus on?
Addressing the undervaluation of care work by raising public awareness
II-7 Which policies or measures to advance decent work in the care economy does the practice focus on?
Addressing the unequal gender distribution of paid and unpaid work, and promoting women’s economic inclusion and autonomy beyond caregiving
II-7 Which policies or measures to advance decent work in the care economy does the practice focus on?
Collecting and disseminating data on unpaid and paid care work
II-8 Which beneficiaries in the care economy does the practice focus on?
Unpaid carers (workers or persons with care responsibilities, parents, other family members, etc.)
II-8 Which beneficiaries in the care economy does the practice focus on?
Paid care workers (nurses, domestic workers, teachers, childcare workers, personal assistants, etc.)
II-8 Which beneficiaries in the care economy does the practice focus on?
Care recipients (children, older persons, persons with disabilities, etc.)
II-9 Geographical scope
Urban and rural
III-1 In a short paragraph, summarize the main results and impacts obtained
The initiative led to the creation of the National Integrated Care System (SNIC), the enactment of the Care Law No. 19.353, and the implementation of the National Care Plan 2016-2020. The establishment of the National Care Secretariat has resulted in the expansion of care services and the execution of awareness campaigns across various territories, coordinated by the National Directorate of Territorial Management. Notably, the availability of early childhood care services has increased, extending coverage to children aged 0 to 5 years. Additionally, personal assistants have been integrated into the system.Results from the Care policy package: ChildrenLeave policies: increase maternity leave to 14 weeks and paternity leave to 13 days in 2016 and mandatory coverageParental Care Allowance: half-time employment for 6 months fully paidEarly childhood education: highest 0-3 coverage in the region: from 33 per cent in 2015 to 50 per cent in 2020.People with long-term care needs:6,125 with a personal assistant, 1,533 with tele-home assistant, 229 in day community services and 343 in residential care services.Care Training, Certification and Collective Bargaining for Care WorkersDevelopment of a care training curriculum on long-term care30 certified entities by the Ministry of Education to provide care trainingMore than 100 long-term care workers certified; + 3,400 have finished studies. 19,000 people signed for training in early childhood care.Collective bargaining agreements between 2013-2015: Increase minimum wage for domestic workers
III-2 Explanation of the innovative element of the initiative for advancing decent work in the care economy
It was the first National Care System implemented in the Latin American region, featuring a comprehensive territorial approach to be applied across different parts of the country. Additionally, a consultative council was established, involving diverse societal sectors such as workers, businesses, academia, and civil society organizations.
IV-1 What were the main challenges or difficulties during the design and implementation? How were they faced/ addressed?
One of the main challenges was reaching agreements on care certifications and competencies, largely due to the limited capacity of training institutions to implement hybrid learning modalities and ensure broad territorial coverage.For care workers, particularly domestic workers without proper representation and access to collective bargaining processes, this presented significant barriers. In addition to the challenge of integrating domestic care workers into conditions of decent employment, alongside other categories of care workers. In the area of early childhood care, traditional education structures needed to be adapted to allow for more flexible schedules and shifts, while still maintaining quality standards and integrating a gender perspective.There have been additional challenges in the system to offer a comprehensive service to people with disabilities in need of care and support. The system offers the service of personal assistance for people with disabilities, but it is limited to people younger than 29 years older and above 80 years of age. The exclusion from coverage leaves a lot of people between the ages of 29 and 79, relying on family members for care and support.
IV-2 Lessons learned and good practices, including room and opportunities for improvement
The initiative generated several key lessons, beginning with the critical role of social dialogue, which led to the creation of a consultative council comprising representatives from various sectors to oversee the initiative. Implementation at the territorial level underscored the complexity of building care systems in partnership with existing social organizations and revealed the importance of strong coordination and communication mechanisms. Expanding and aligning basic services with the care needs identified through local analyses emerged as both a challenge and an opportunity for improvement. Overall, the initiative demonstrated the importance of tailoring services to better address specific care needs.
IV-3 Key conditions for success
Key conditions for success include securing adequate financing and establishing an enabling legal and normative framework that considers all the dimensions of the 5R Framework for Decent Care Work.
IV-4 Key conditions for sustainability
Secure adequate financing and obtain political support from various governments.
IV-5 Potential for transferability, expansion and replicability in other countries and contexts
It has the potential to be replicated in other countries, and this has already begun, considering that this is the first Care System in the Latin America and Caribbean region.
V-1 Sources of information and documents used on the characteristics of the initiative, including links to websites, news items, toolkits, policy documents or reports
Sistema de Cuidados de la República Oriental del UruguayPlan Nacional de Cuidados 2016-2020Uruguay: Experiencia pionera en Sistemas Integrales de CuidadosHacia la universalización de los cuidados: Los desafíos del SNIC en su tercera etapa de implementación
V-2 Contact information of ILO focal point
Guillermo Montt, Spec. Social Protection ([email protected])Paz Arancibia, Sr Spec, Gender Equality and Non-discrimination ([email protected])