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Building a System of Care in Uruguay: a new pillar of the Social Protection System

Ec. Maira Colacce – Ministry of Social Development – Uruguay

The document "Towards a solidarity care model", approved by the Uruguayan Social Cabinet last September 20th, defines care as "a social function that involves both the promotion of personal autonomy and care and assistance of dependent persons. This dependency can be temporary, permanent, or chronic, or associated with an individual’s life cycle. These are actions that society carries out to ensure the social and physical survival of those who have lost or lack of personal autonomy and need help from others to perform basic acts of daily living (ECLAC, 2009). Care is a central component in the maintenance and development of the social fabric, both for capacity building and for reproduction."

There are at least four arguments that support the implementation of a care system that leads to corresponsibility not only between men and women but also between the State, families and businesses.

Gender inequality: unequal distribution of paid and unpaid work between women and men within the household, which is reflected in inequalities in the public sphere of life: work, study, social and political participation, socialization, among others. This also results in the reduced autonomy of women in terms of current or future income generation, and dependency on the income of the spouse or other family member.

Average daily hours of unpaid work by gender, age and household per capita income quintile (Country total, September 2007)

Source: Salvador (2010) based on Time Use Module

Labor force participation rate of parents by age of youngest child in the household - Urban households country total with children aged 0-12 years and stay home mother, 2009.


 

Source: Araya et al (2011), based on Household Survey (ECH) 2009

Care crisis: "This crisis occurs when the number of people whose condition require care increases and the proportion of people (traditionally female) who are in a position to exercise that function decreases at the same time. In other words, we are witnessing a situation of increased demand (demographic transition) and decreased supply "(ECLAC, 2009:173).


Evolution of the population of 0-4 years old and 65 and over (1996-2050)


 
Source: Population Projections, National Institute of Statistics (INE) 

Activity rate by gender, Urban Country Total (1986-2010)


 
Source: ECH, INE

Quality care: Kimmel (1998) also notes that one of the potential impacts of these interventions is the increase in the likelihood of reducing poverty in the long term, as a subsidized care system ensures improvements in the development and wellbeing of boys and girls, especially those living in poverty.

Economic development: care policies generate incentives to work and study as they reduce the costs associated with those activities. At the same time, they entail increases in productivity as they reduce the chances of disruption and absences from work or study sessions.

 

The process of building a care system in Uruguay 

Since 2010 the relevance and design of a care system for Uruguay is being discussed. This issue was introduced in the agenda by social organizations that defend the rights of women (see video 1) and quickly became part of advocacy efforts by children, disabled and elderly rights organizations. 

The acknowledgement that in Uruguay the right to care is not being fulfilled and the process of building a new social policy on this regard stemmed from a rights-based approach, which entailed participation from different social actors.

For the national elections in 2009, the issue of caring for dependents was included in the ruling party platform, and once reelected; the party created an interagency working group on the subject, and three phases can be clearly identified since then:

  1. In 2010, work within and between public institutions aimed at defining a unified perspective in relation to a set of principles and conceptual guidelines. These agreements are contained in a document approved by the National Council for Social Policies(see video 2 and video 3)
  2. In 2011, a national debate on the subject was opened for participation of more than 3,000 actors ranging from politicians, scholars, businessmen, trade unions and representatives from social organizations, among others. In addition, a website was launched with the objective of sharing concept notes and receiving feedback on the creation of the new system: http://www.sistemadecuidados.gub.uy/
  3. In 2012, the development of a proposal and the drafting of a National Care System bill which contains the fundamental guidelines regarding institutions, financing, regulation, training and services. (Document available only in Spanish)

To conclude, it is important to mention one of the biggest difficulties that we have faced in the process. Building a care system entails a first challenge: identifying the problems associated with caring for dependent care and its consequences. This means, among other things, defining care as a concept and acknowledging that these duties require special knowledge, training and skills, and are not necessarily inherent to women.

In this sense, this pillar of social protection involves different policy actions. Everyone knows what policies we refer to when we talk about health, education, social security, etc. However, care policies have been incorporated in the social protection matrix only recently. This makes it necessary to not only implement policies but also to raise awareness about care and its implications.

 

 

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