By Afaf I. Meleis
Imagine a world where society values every woman’s informal and unpaid contributions and compensates her fairly for them. What would your status and income be? Wouldn’t you be better positioned to pursue your dreams and realize your full potential?
For many women, in developed as well as developing countries, caregiving is the contribution that is largely informal and unpaid. As a result, on one end of the spectrum, you have women who are dropping out of their careers or going part-time in order to look after children or parents; on the other end, you have women who have no income, status or access to health care for themselves.
What’s more, this caregiving work is on the rise due to longer life expectancies, which, on one hand is a sign of great scientific progress, but on the other hand, is placing more demands on caregivers with elderly family members. Though men have become more involved in family and household responsibilities, it is still primarily women who carry the majority of the health monitoring and care burdens for their families as well as their extended families and communities.
These are among the reasons a commission that I co-chaired with Harvard’s Dr. Ana Langer analyzed data and identified women-centered solutions to deal with the unique obstacles that girls and women face as both consumers and providers of health care. We based our analyses and recommendations, which were published in The Lancet, on the premise of universal and equitable health care for women as formal and informal providers of care and as recipients of care.
Our recommendations to governments and organizations are to:
- Value women by insuring development and implementation of policies that support women and enable them to integrate social, biological and occupational contributions. Gender-responsive social, economic, environmental and health policies should help women integrate their varied roles and provide them with opportunities to advance their careers and leadership.
- Compensate women equally for formal and informal work. In one study, it is documented that 45–57% of women’s work is unpaid (as compared to 24–44% of men’s), and on average, women spend 2.3 hours per week on unpaid contributions. Since women have many informal roles, and 60% of all health care providers are informal workers (family members), we recommend making their work visible and developing strategies to insure pay balance/equity in pay, including benefits.
- Count women for better planning and for identifying discriminations and inequities. Sex desegregated data is essential for constructing comprehensive plans for women’s health, work and leadership across the life course.
- And establish mechanisms for insuring accountability to women that will protect the continuity and sustainability of the other three recommendations.
In the end, perhaps women’s work should not be defined as employment, formal or informal, but in terms of the time and energy they expend in all activities, the relationships they foster, the personal and environmental resources they mobilize and the social and societal affirmation and valuation they do and do not receive. Adding these factors together are a more accurate depiction of women’s work, which profoundly influences their health, and in turn, the health of their families and communities. We envision that these recommendations will empower women to reach their full potential in all aspects of their lives and in all of the roles they constantly integrate.
Afaf I. Meleis, Ph.D., Dr.P.S.(hon), F.A.A.N., is the former dean and professor of nursing and sociology at the University of Pennsylvania School of Nursing. She will be leading the panel “Optimize Your Stress and Improve Your Overall Well-being” at the 2015 Pennsylvania Conference for Women.