Our Communication Manager, Liberty Kituu caught up with Evelyne Opondo, Africa Regional Director at the International Center for Research on Women (ICRW) and a 2022 WomenLift Health East Africa alumna, to discuss the disproportionate burden of care on women leaders in global health, where Evelyne sheds light on the hidden weight women bear as they ‘balance’ leadership roles with caregiving responsibilities.
Can you explain what the “disproportionate burden of care” means, especially in the context of women’s roles in both formal and informal settings? What are the statistics like in Kenya and East Africa?
Care work, both paid and unpaid, is essential for human well-being and economic productivity. However, women disproportionately bear the burden of unpaid care and domestic work, which limits their participation in formal and informal economic activities and restricts career advancement opportunities.
The “disproportionate burden of care” refers to the unequal distribution of caregiving responsibilities, with women shouldering most of the unpaid care and domestic work, leaving them with fewer opportunities for paid employment and career advancement. This imbalance forces women to juggle between caregiving and formal jobs, often at the cost of their economic progress.
In Kenya, the 2021 found that women spend an average of 5 hours daily on unpaid care work, compared to 1 hour for men. Women also spend 7 times more time on unpaid care work and 5 times more on domestic work than men. Young women aged 15-17 do three times more unpaid work than boys. Elderly women (60+) dedicate about 3 hours daily to care, while men spend only 1 hour.
Women in Rwanda, especially those with dependents, bear most of the unpaid care work. Rural women spend 6 hours daily on care tasks, while urban women spend 2 hours. Men contribute significantly less, averaging 2 hours a day in rural areas and 1 hour in urban areas.
In Uganda, women spend 5.5 hours daily on unpaid care, while men spend only 3.5 hours. However, men engage more in paid employment, working 7.4 hours compared to women’s 5.3 hours.
Sub-Saharan Africa differs from high-income countries in household dynamics, with more children, additional caregivers, and older siblings playing caregiving roles. Nonetheless, women remain disproportionately affected by unpaid care responsibilities across the region.
According to research conducted by the International Labour Organisation, women perform nearly 76% of the world’s unpaid care work. How does this data impact the way we view women’s contributions to both the economy and society?
Evidence shows that improving access to quality, affordable care services can advance women’s economic empowerment, justice, and rights. However, the ILO notes it could take 210 years to close the gender gap in unpaid care work, as many countries still lack data on relevant indicators.
When state-provided care is insufficient, the burden shifts to households, predominantly borne by women and girls. To alleviate this burden, governments must invest more resources in care services, redistributing responsibilities from households to the state.
Gender roles and social norms also hinder demand for external care solutions and affect market development. The reliance on unpaid care complicates the establishment of a paid care market, which requires changing perceptions about who can and should provide care.
In East Africa, an increasing number of care enterprises, mostly women-led, face challenges such as lack of capital and inadequate regulation. The investment shortfall in women-led enterprises highlights the double disadvantage of catering to women.
ICRW Africa is addressing knowledge gaps related to women-owned childcare enterprises and the needs of marginalized households in Kenya. Funded by Co-Impact Philanthropic Funds, this project reveals challenges like weak government support, unclear policies, insufficient supervision, and poor infrastructure, underscoring the urgent need for improved child and elder care services, especially for vulnerable households.
How does the burden of care affect women’s career progression, particularly in leadership and decision-making roles?
The unequal distribution of unpaid care work is a significant barrier to women’s social, political, and economic empowerment. This burden leads to time poverty and opportunity costs, particularly for marginalized women and girls, affecting their ability to enter and remain in the workforce and impacting the quality of jobs they can secure. Women often leave or struggle to advance in formal workplaces, especially in leadership roles, due to gender biases, rigid work schedules, insufficient parental leave, and a lack of quality childcare services.
However, the modern workplace increasingly values leadership qualities associated with caregiving, such as empathy, adaptability, and calmness under pressure. Skills gained from caregiving, like multitasking and respect for others’ time, can foster a more inclusive and resilient work environment. There is a growing recognition that women can excel in leadership by embracing their femininity and innate strengths, rather than conforming to traditional male leadership models.
What are some examples of how women’s caregiving responsibilities have impacted their opportunities for advancement, both personally and professionally?
Women often find it physically exhausting to balance unpaid care work with paid employment, leaving them with little time for leisure or self-care. This burden increases their dependence on men, heightening their vulnerability and risk of violence. Despite being employed, women are still expected to handle most of the unpaid care work, such as cooking and childcare, which limits their professional opportunities.
Research indicates that women with young children experience a “motherhood employment penalty,” leading to lower employment rates. The demands of childcare often force women to leave the labor market, making it difficult to return when responsibilities ease. In formal workplaces, caregivers may be seen as less committed, hindering their chances for advancement. Additionally, women health workers faced intense pressure during the COVID-19 pandemic, managing both professional and caregiving duties, resulting in increased stress and fatigue. This dual burden also limits their ability to attend networking events, thereby restricting professional connections essential for career growth. Furthermore, extensive caregiving responsibilities can prevent women from prioritizing their health, leading to poorer health outcomes as they struggle to access necessary medical care.
How does the disproportionate burden of care impact women’s physical and mental health? How does this burden manifest in professional environments such as global health or other sectors, and what are the long-term effects?
While caregiving can be personally rewarding, for many it can create cumulative physical and psychological strain that is health damaging. Compared with non-caregivers, family caregivers, especially women, experience increased emotional distress, depression, anxiety, and social isolation; impaired physical health; decreased preventive and self-care behaviors; greater acute care use; and even increased mortality. There is however major evidence gap on the impact of care giving on mental health in Africa.
The “double burden” of paid and unpaid work has differential effects, with household stress seeming to affect women more than men. For example,
How can global health organizations better support women who carry the burden of care through policies or programs? And What strategies can be implemented to support women’s health as they balance both caregiving and professional roles?
Caregiver-friendly workplace policies can help men and women manage their caregiving responsibilities without compromising financial security or career advancement.
Global health organizations should work to ensure equal pay for women in the health and social sectors and increase their representation in leadership roles while prioritizing access to comprehensive health services for women, including reproductive health, mental health support, and services for survivors of violence.
Strategies to Support Women’s Health:
- Rewrite job descriptions to include caregiving qualities. Research finds that people with soft power skills such as being nurturing, collaborative and empathetic make better leaders.
- Create flexible work arrangements such as telecommuting, flexible hours, or compressed workweeks to provide the flexibility needed to attend to caregiving responsibilities while fulfilling work duties.
- Encourage women caregivers to seek mental health services and provide access to counseling and support groups. This can help them manage stress and avoid burnout.
- Establish community-based support networks where women can share resources, advice, and emotional support. This can reduce the isolation often felt by caregivers.
- Raise awareness about the challenges faced by women caregivers and advocate for laws and policies that support their well-being.
- Provide childcare support within work environment.
What changes do you hope to see in the near future regarding the burden of care women face, both at home and in the workplace?
I hope we can prioritise and invest in gender disaggregated data to inform national policies, develop national policies that recognize and value unpaid care and domestic work through the provision of public services, infrastructures and social protection policies and the promotion of shared responsibilities within household and family.
Invest in gender norm shifts to recognize, reduce, redistribute, reward and represent unpaid care work.
What message would you like to send to younger generations of women who might be navigating similar caregiving challenges while pursuing their careers?
Try and find sometime for yourself. Self-care is a feminist strategy to ensure that women prioritize their own well-being, reclaim their time and energy, and resist the societal pressures that often place the burden of caregiving solely on their shoulders.
