Beirut, Lebanon: 29 October 2022 –The provision of care is changing in many different and profound ways around the world. Perhaps nowhere has the scale of change been as rapid and dramatic as in Lebanon where, traditionally, families have relied on under-paid workers through Lebanon’s kafala system to meet their care needs – but where this is increasingly difficult with the country’s economic collapse.

Lebanon is the fastest ageing country in the Arab States with the highest proportion of older people and the highest life expectancy. Many among this population require access to long-term care, as does the sizeable proportion of persons with disabilities and households with young children. However, public investment in care has historically been low and has further plummeted. For example, from 1990 to 2019, Lebanon’s health expenditure as part of GDP has decreased from 12.6% to 8.65%. Moreover, social protection spending is just 6.2% of GDP (and only 0.17% on non-contributory social protection). Thus, households have been pushed into a position of providing unpaid or paid home-based care for loved ones, but without the foundations to ensure decent work in the sector.

The ILO’s ‘5R framework for decent care work’ calls on transformative action in the policy areas of care, macroeconomics, social protection, labour and equality, migration and, more recently, environment. The framework recommends the need to (1) recognize, reduce and redistribute unpaid care work; (2) provide decent work for caregivers; and (3) ensure representation, social dialogue and collective bargaining of care workers. A study by the International Trade Union Confederation (ITUC) launched today shows that investment in the care economy can be a powerful economic stimulus that creates jobs while recouping this investment through increased tax revenue.

On this Global Day of Action for Care, the ILO and UN Women call on the Lebanese government, social partners and Lebanese society to address the urgent need for decent work in home-based care. Already a pillar of home-based care, women’s unpaid care work has increased since the start of the economic crisis in Lebanon, with few policies in place to recognize, reduce and redistribute care work. Moreover, paid migrant and national care workers have experienced increased exploitation and lack of decent work, given the absence of minimum labour protections and opportunity for organization, representation, social dialogue and collective bargaining.

Based on a multi-stakeholder consultation that took place on 3 October 2022 to discuss the home-based care economy in Lebanon, which was attended by academics, government, trade unions and workers organizations, private sector and civil society, the ILO and UN Women call on the government to:

1.    Develop mechanisms to extend labour and social protection to home-based care workers, thus formalizing the occupation and creating minimum decent work standards

Lebanon’s labour and social protection systems are in need of urgent reform. In making these important changes, the inclusion of domestic workers should not be forgotten. Because they are excluded from the labour law, domestic workers (whether migrant or national) are not eligible to benefit from contributory social protection systems, making them extremely vulnerable. Being excluded from the labour law, they lack basic labour protections and assurance of a minimum wage. Removing Article 7 of the Labour Law (which excludes domestic workers) and incorporating domestic workers in social security should be urgent priorities, as is the dismantling of the kafala system.  

2.    Ensure that the rights of care workers are reflected in national strategies and action plans on older persons, disabled persons, child care and social protection

A number of strategies and action plans on care aim for the provision of “good quality care”. Whilst taking the perspective of the care recipient seems self-evident, and has dominated the discourse and policy agenda on care provision, ensuring quality care must also consider the rights and voices of the care givers. From this viewpoint, “quality of care” should refer both to the needs of the care recipient, and the needs and circumstances of care workers. These twin objectives should be systematically considered whenever quality care is referred to in national strategies, objectives and action plans. For example, the National Strategy for Older Persons in Lebanon and the Social Protection Strategy create a number of recommendations with respect to supporting paid and unpaid home-based caregivers, including, in the case of the Social Protection Strategy, progressively extending legal and effective coverage of contributory system to all workers and their families on the basis of equality of treatment and solidarity. It is equally important that all national strategies and action plans relating to care which are currently being designed, are developed through participatory engagement with care recipients and care givers including both migrant and national paid and unpaid workers and their representatives.

3.    Address social and cultural norms that relegate care and domestic work to women only and refer to it as ‘unskilled’ and low-value work

It is undeniable that some of the poor working conditions experienced by home-based care workers are due to the devastating economic crisis that has impoverished households. At the same time, the low salaries may be influenced not only by a limited capacity to pay but also because of the low social status of domestic work and domestic workers. Since domestic work has for so long been associated with migrant women workers, the intersectional discrimination faced by these workers reinforced the social stigma of domestic work and their labour was seen as a cheap and acceptable substitute for work that the family could provide themselves without pay. Changing social norms that promote women in traditional gender roles will require a complex range of interventions to redress stereotypes and show the skill and value of domestic and care work – whether performed by nationals or non-nationals, men or women. This might include advocacy campaigns, changing the portrayal of care workers in the media, promoting men as care and domestic workers to normalize the idea among the general public and quantifying/measuring unpaid care work. Additionally, it should ensure that (linked to domestic workers’ inclusion under the labour law) workers are assured a minimum wage and that there is progressive alignment of remuneration according to qualifications, working conditions, and responsibilities that care workers hold.

4.    Professionalize the sector but without creating unnecessary fragmentation and hierarchy

Because the skills necessary for high-quality care often go unrecognized given the sector’s informality and the devaluation of care work earlier noted, professionalizing the sector through targeted skills trainings and certification programmes is welcome. This would challenge the unrecognized value and contributions of care workers specifically in the field of elderly care, long-term health care and support for persons with disabilities and could also help to challenge the low pay and often highly exploitative labour conditions of care workers by empowering them to claim their rights as skilled workers. However, professionalization of the sector must account for the potential social hierarchies to which professionalization can contribute. Specifically, such trainings should be made universally accessible for care workers irrespective of nationality or social status in order to prevent already vulnerable workers from becoming even more vulnerable. Workers who have not had access to trainings or certification programmes should not immediately subjected to lower pay or worse working conditions.

All of us need care at different times in our lives. We need care to survive in infancy, when we suffer an accident or illness, to support families and households, and to ensure the best possible quality of life as we age, including at the close of life. Given that women perform the majority of unpaid care in households – in Lebanon women, on average, do 3 to 10 times more unpaid care and domestic work than men - paid care work offers possibilities to grow the economy, and for women to enter, advance and remain in the workforce. It is time to prioritize care work and decent work for home-based care workers.  

For more information, please contact:
Salwa Kanaana, Regional Communication Officer, ILO (kanaana@ilo.org)
Roula Rached, Communications and Advocacy Specialist, UN Women (roula.rached@unwomen.org)