Unpaid Care Work Among Women in South Asia: A Systematic Review

Background/Purpose

In South Asia, women disproportionately bear the burden of unpaid care work (UCW) as women are 6.5 times more likely to engage in UCW compared to men and 4.5 times more likely to engage in UCW compared to women in other countries. As a consequence women face barriers in distributing their time between paid and unpaid labor. The disparities in performing UCW has a detrimental effect not only on women’s physical and mental health, but also on their career and employment trajectories. While there is a growing body of research that focuses on UCW among women in other countries, little is known about UCW in the South Asian context. This systematic review is the first attempt to synthesize literature pertaining to UCW responsibilities of women in South Asia. The key contributions of this systematic review is to understand the prevalence of UCW in South Asia and factors influencing UCW. Furthermore, it also examines the disparities in time allocation for UCW that influence women’s lives.

Methods

The Cochrane Handbook’s Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) steps were followed to identify relevant studies. Pre-identified search terms were used to identify studies that met inclusion criteria in 21 academic databases. Google Scholar and reference lists of key manuscripts were also used to identify additional studies. The search produced 180 studies published between 1990 and 2020 on UCW in South Asia. Three independent readers reviewed the articles against the eligibility criteria, and inter-rater reliability was ensured as consensus was reached on all coding decisions. A final sample of 13 peer-reviewed articles was selected, including three mixed method studies, three qualitative studies and seven quantitative studies.

Results

Findings underscore the high prevalence of UCW among women in South Asia. We found four main recurring themes in the selected studies: (1) women in South Asia disproportionately shared the burden of UCW responsibilities, (2) structural factors and socio-cultural norms influenced the toll of UCW, (3) devaluation of UCW and those who perform it, primarily women, (4) idea to promote flexible working arrangements for women. Our review identified an additional gap in that none of the included studies highlighted the causal relationship of UCW with women’s socioeconomic, health or mental health status.

Conclusions and implications

Despite several limitations, this review is a novel contribution to understanding how to improve provision of care services and employment options for women allocating a greater time on UCW activities. We conclude that there is a need for a universal care work policy in South Asian countries. The idea of the five Rs of labor (recognize, reduce, redistribute, reward, and representation) as proposed by the International Labor Organization (ILO) and examples of flexible work arrangements and family-friendly polices from Nordic regions can serve as a guide for amending or introducing new care policies in South Asia. However, we should be cognizant of the sociocultural fabric, demographics, and overall market system that can influence the distinct policy outcomes in South Asian countries.