India must build a holistic care system

1. At a Glance

• Care economy: paid and unpaid work that looks after children, older people, the sick and people with disabilities. The article argues India should treat it as infrastructure needing public investment and planning, in the same way it treats highways, metro lines, electrification and digital public platforms [1].
• Core problem: care is split across several ministries, from Women and Child Development to Housing and Urban Affairs. Each runs useful programmes, but there is no common framework tying them together [1].
• Why it matters: when care services are missing, families, and women most of all, pay for it through unpaid work, lost earnings and fewer opportunities. This links directly to female labour force participation (FLFP) and to the Viksit Bharat 2047 goal [1].
• Demographic pressure: as India's population ages, demand for accessible care services will keep growing [1].

2. Why in the News

• An op-ed titled "India must build a holistic care system" appeared in The Hindu on 29 October 2026 (p. 15, Chennai edition). It was written by Shoko Ishikawa (Country Representative, UN Women India) and Angela Lusigi (Resident Representative, UNDP India) [1].
• The op-ed draws on two recent official surveys:
• PLFS 2025: 44.4% of women outside the labour force gave childcare and homemaking as the main reason [1].
• Time Use Survey 2024: 41% of women aged 15–59 provided unpaid care, spending an average of 140 minutes a day on it [1][2].

3. Background & Evolution

• Time Use Survey (TUS) 2019: India's first nationwide TUS. Participation in unpaid caregiving was 32.8% for women and 16.2% for men (ages 15–59). Women who did care work spent ~137 minutes a day on it, men ~73 minutes [2].
• TUS 2024: conducted January–December 2024 by MoSPI, with results released in February 2025 [2].
• TUS 2024 results: participation rose to 41% for women and 21.4% for men. Time spent by participants was ~140 minutes a day for women and ~74 minutes for men [2].
• PLFS 2025: identified childcare and homemaking as the leading reason women stay out of the labour force (44.4%) [1].
• Policy framing: the article says India's development story over the past decade has been one of physical and digital infrastructure, while care "rarely features in India's growth strategy" [1].

4. Core Static Facts

Item	Fact
Unpaid care work	Non-market care for household or family members, recorded in the TUS under "unpaid caregiving services for household members" [2]
Survey agency (TUS, PLFS)	Ministry of Statistics and Programme Implementation (MoSPI) [2]
TUS 2024 reference period	January–December 2024; results released February 2025 [2]
Women's participation in unpaid care (15–59)	41% (2024), up from 32.8% (2019) [2]
Men's participation in unpaid care (15–59)	21.4% (2024), up from 16.2% (2019) [2]
Daily time, care participants	Women ~140 min, men ~74 min (2024). In 2019: ~137 and ~73 [2]
PLFS 2025	44.4% of women outside the labour force cite childcare/homemaking [1]
Global benchmark (ILO)	Women spend about 4 h 25 min a day on unpaid care work, men 1 h 23 min. This is an older global estimate, so it is not directly comparable with TUS figures [3]
Ministries involved	Fragmented: MWCD, MoHUA and others [1]
Authors' institutions	UN Women India and UNDP India [1]

5. Multi-Dimensional Analysis

Economic

• Lack of care services shrinks the labour supply. Childcare and homemaking are the single largest reason women stay outside the labour force (44.4%, PLFS 2025) [1].
• The article argues care is a foundation every economy depends on and should get public investment like physical infrastructure [1].
• Unpaid care has a real economic value that does not appear in GDP. Making it visible is an ILO policy theme [3].

Social / Gender

• The burden falls heavily on women. Women's participation in unpaid care (41%) is nearly twice men's (21.4%), and women spend about 1.9× as much time on it [2].
• Men's participation rose from 16.2% to 21.4% between 2019 and 2024. This is slow movement towards redistribution, but the gap remains large [2].
• Affordable, good-quality care gives women more freedom to take up employment, leisure and public life [1].

Demographic

• Population ageing will push up demand for elder care. A care system planned only around childcare will not be enough [1].

Governance / Administrative

• Programmes are fragmented across ministries (MWCD, MoHUA and others) with no common framework. The result is duplication, gaps and no single point of accountability [1].
• The article implies a whole-of-government approach: a common framework, convergence across ministries, and care built into growth strategy [1].

Ethical

• Care is a universal need: "everyone needs care at some point in life." That makes it a public good and a question of dignity and social justice, not just a private family duty [1].

6. Recent Developments (last 12–18 months)

• Feb 2025: MoSPI released the TUS 2024 results, showing women's unpaid care participation at 41% [2].
• 2025: PLFS 2025 reported that 44.4% of women outside the labour force cite childcare and homemaking [1].
• 29 Oct 2026: the UN Women–UNDP op-ed in The Hindu called for a holistic, cross-ministerial care system tied to Viksit Bharat 2047 [1].

7. Prelims Hooks

• India's Time Use Survey is conducted by MoSPI (not MWCD or NITI Aayog) [2].
• TUS 2024 covered January–December 2024; results were released in February 2025 [2].
• TUS 2019 was the first all-India TUS; TUS 2024 is the second [2].
• 41% of women aged 15–59 did unpaid caregiving in 2024, up from 32.8% in 2019 [2].
• 21.4% of men aged 15–59 did unpaid caregiving in 2024, up from 16.2% in 2019 [2].
• Women who provide care spend about 140 minutes a day on it, men about 74 minutes (TUS 2024) [2].
• In 2019, the figures were about 137 minutes (women) and 73 minutes (men) [2].
• PLFS 2025: 44.4% of women outside the labour force cite childcare and homemaking as the main reason [1].
• ILO global estimate: women spend 4 h 25 min a day on unpaid care work, men 1 h 23 min [3].
• UN Women and UNDP India have both called for treating care as infrastructure [1].

8. India Already Has a Crèche Scheme, and It Is Running Far Behind

• The main childcare scheme has reached only about a quarter of its target
• Palna is the Centre's crèche scheme. It sits under the Samarthya part of Mission Shakti, run by the Ministry of Women and Child Development (MWCD) [5].
• It adds a crèche to an existing anganwadi centre. These are called Anganwadi-cum-Crèches (AWCCs). This part started on 1 April 2022 [5].
• MWCD set a target of 17,000 new AWCCs [6]. By August 2026, only 4,172 were running across the country [4].

• So the article's demand for a 'care system' is not a call to start from zero. The first question is why the scheme India already has is so slow.

• The cost is shared, so each state controls how fast it moves

• Palna is a Centrally Sponsored Scheme (the Centre pays part of the cost and states run it and pay the rest). The split is 60:40, or 90:10 for North-East and special category states [5].

• A state that does not put in its 40% holds back the whole crèche, including the Centre's 60%.

• The care workers are paid an honorarium, not a wage

• An honorarium is a fixed token payment. The worker is not a regular employee and gets no salary scale.
• Palna fixes ₹5,500 a month for a crèche worker and ₹3,000 for a helper. States may add more from their own funds [5].

• So a scheme meant to help women take up jobs depends on women doing low-paid work. This is the 'reward' problem in the ILO's 5R framework, explained below [9].

• The crèche hours suit some jobs but not others

• AWCCs open 26 days a month, for 7.5 hours a day, for children aged 6 months to 6 years. Each crèche takes about 25 children [5].

• A woman on a long commute, or working shifts, still has hours with no cover. One centre for 25 children cannot meet demand in a crowded urban area.

• One child, two ministries: this is what 'fragmentation' looks like

• Palna is run by MWCD [5]. The legal duty on employers to provide crèches is a labour law. It is now part of the Code on Social Security, 2020, which comes under the Ministry of Labour.
• Neither one counts or plans for the other, so no one knows how many working mothers have no crèche at all. That is the gap the article means when it says there is 'no common framework' [1].

9. What the Survey Numbers Hide

• More men now do care work, but the gap between men and women has grown
• In 2019, 32.8% of women did unpaid care work, against 16.2% of men. That is a gap of 16.6 percentage points [2].
• In 2024, the figures were 41% and 21.4%. The gap grew to 19.6 points [2].
• Women still take part at about twice the rate of men: 2.0 times in 2019, 1.9 times in 2024 [2].

• So 'redistribution' (men taking a fairer share) has barely started. Care work is growing for everyone, and women are taking on more of the increase.

• The time spent by each carer has not changed

• Women who give care spent about 137 minutes a day on it in 2019 and about 140 in 2024. For men it was about 73, then 74 [2].

• The ratio stays at about 1.9 in both rounds. When a man does care work, he still does about half as much as a woman.

• The 44.4% figure mixes two different things

• PLFS (the Periodic Labour Force Survey) puts 'childcare and homemaking' together as one reason why women are not in the labour force [1].
• A crèche can take over childcare. It does not cook, clean or look after an elderly in-law.
• The survey also records only what the woman says. Some of these answers reflect what her family expects of her. Free crèches do not change that.
• So do not write in Mains that crèches will bring 44.4% of these women into work. Crèches deal with only one part of the reason.

10. Elder Care Is the Bigger Need, and Almost No One Plans for It

• The number of older people is growing fast
• UNFPA's India Ageing Report 2023 says about 346 million Indians will be over 60 by 2050. That is nearly 21% of the population [8].

• The note calls this 'demographic pressure'. In numbers, it means about one Indian in five will be over 60.

• Many older people will need care every day, not just some money

• About 75% of older people have at least one chronic disease (an illness that lasts a long time, such as diabetes). About 40% have a disability, and about 20% have mental health problems [10].

• Long illness and disability need daily help at home: bathing, medicines, moving around. A pension alone does not provide that.

• Many older people cannot pay for care themselves

• More than 40% of older people are in the poorest wealth quintile (the poorest fifth of the population), and about 18.7% have no income at all [8].

• If paid care is left to the market, these families cannot buy it. The work falls back on a daughter or daughter-in-law, who does it unpaid.

• Old age homes have very little regulation

• UNFPA asked for all old age homes to be brought under regulation (a licence, standards and inspection) [8].

• It also noted that India does not have reliable data on many issues facing older people [8]. Care that is not counted cannot be planned.

• Why this matters for the article's argument

• India's main existing care schemes, like Palna and ICDS, are built around children [5].
• A care system planned only for children would leave out the part of demand that is growing fastest.

11. Is Care Worth Public Money? The Case Against, Answered

• The strongest objection: it costs a great deal, and families already do this work
• The ILO estimates that closing care gaps worldwide needs about US$5.4 trillion a year [7].

• India also has other urgent spending needs, such as roads, health and defence. In many Indian families, caring at home is seen as a duty, not a gap that the state must fill.

• What is right about the objection

• Money alone does not build a system. Palna has funding, but only 4,172 of its 17,000 planned crèches are running [4][6]. Raising spending before delivery improves would waste money.
• The ILO itself warns that most new care jobs would go to women, because care work is already seen as 'women's work' [7].

• If those jobs pay an honorarium like Palna's ₹5,500, the state just moves women from unpaid care to badly paid care [5].

• Why the objection is not enough

• The ILO estimates that investing in care could create up to 299 million jobs worldwide by 2035 [7].
• Part of the cost comes back as tax paid by the new workers and by mothers who return to work [7].
• 'Families already do it' really means women do it unpaid, at a cost to their own careers. That is the 44.4% figure [1].

• Care infrastructure does not replace family care. It gives families a choice they do not have now.

• The honest conclusion

• The argument for public care is strong. But it only works if care jobs are decent jobs and if existing schemes start delivering. Bigger budgets alone will not do it.

12. Who Should Do What Next

• Use the ILO's 5R framework to structure the answer
• The ILO's 2018 report Care Work and Care Jobs for the Future of Decent Work gives 5 Rs [9]:
  • Recognise unpaid care.
  • Reduce it.
  • Redistribute it: between women and men, and between families and the state.
  • Reward care workers fairly.
  • Represent care workers, so they have a voice.

• The article's proposals mostly cover 'reduce' (through services). The analysis above shows India is weakest on 'redistribute' and 'reward'.

• MWCD should turn approved crèches into working ones, and publish the progress

• The gap between the 17,000 target and 4,172 working AWCCs [4][6] should be tracked state by state, in public.

• Funds already flow through SNA-SPARSH (a system that releases central money only when it is needed) on PFMS, the government's online payment system [5]. So the money trail can be traced, and slow states can be named.

• States should raise crèche workers' pay using the room the scheme already gives them

• Palna already allows states to add to the ₹5,500 and ₹3,000 honoraria [5].

• This is the 'reward' R [9]. Badly paid carers leave, and centres then stay understaffed.

• MoSPI should make the Time Use Survey a regular survey and put a value on unpaid work

• There were five years between the first two rounds, 2019 and 2024 [2]. That is too long to track whether policy is working.

• Putting a money value on unpaid care, outside GDP, is a core ILO recommendation [3]. This is the 'recognise' R [9].

• The Centre and the states should regulate elder care, as UNFPA recommends

• Bring all old age homes under regulation. Support in-situ ageing (helping older people stay in their own homes with support), wherever possible [8].

• Build better data on older people, so elder care gets planned and not just left to families [8].

• One body should own the whole care framework

• The article's main point is that no one holds the full picture [1].
• Whether this is a NITI Aayog task force or an inter-ministerial group, it needs to bring together MWCD (crèches), Labour (employer crèche duty), the health system (elder care) and MoSPI (data).

13. Anchors for Answers

• Data: TUS 2024: 41% of women vs 21.4% of men (15–59) did unpaid care work. The gap grew from 16.6 to 19.6 percentage points since 2019 [2]
• Data: PLFS 2025: 44.4% of women outside the labour force cite childcare/homemaking as the main reason [1]
• Data: Palna: 4,172 Anganwadi-cum-Crèches running (Aug 2026) against a target of 17,000 [4][6]
• Data: About 346 million Indians (nearly 21%) will be over 60 by 2050 (UNFPA India Ageing Report 2023) [8]
• Report/Committee: ILO, Care Work and Care Jobs for the Future of Decent Work (2018): the 5R framework (recognise, reduce, redistribute, reward, represent) [9]
• Report/Committee: ILO estimate: up to 299 million care jobs worldwide by 2035, with about US$5.4 trillion a year of investment, partly recovered through tax [7]
• Law/Case: Maternity Benefit (Amendment) Act, 2017: employers with 50 or more employees must provide a crèche. This duty is now part of the Code on Social Security, 2020
• Scheme: Palna (Mission Shakti, Samarthya): crèches for children aged 6 months to 6 years, 60:40 Centre–state funding, honorary crèche workers on ₹5,500 a month [5]

14. Mains Relevance

• GS-I: Role of women; population and associated issues (ageing); social empowerment.
• GS-II: Welfare schemes for vulnerable sections; mechanisms and institutions for protecting vulnerable groups; issues relating to development and management of the social sector.
• GS-III: Inclusive growth; employment; mobilisation of resources.
• GS-IV: Ethics of care; justice and dignity in public policy.
• Possible question stems: 1. "Unpaid care work is the invisible foundation of the Indian economy." Discuss in light of recent Time Use Survey findings, and suggest measures to recognise, reduce and redistribute it. (250 words) 2. India's low female labour force participation is as much a care-infrastructure problem as a labour-market problem. Critically examine. (250 words) 3. Care services in India are fragmented across ministries. Make the case for a holistic national care framework in the context of Viksit Bharat 2047 and demographic ageing. (250 words)

15. Related Topics to Study Next

• Female Labour Force Participation and PLFS methodology: the care deficit is a key supply-side constraint on FLFP [1].
• Time Use Survey methodology: explains how unpaid work is measured (participation rate versus time per participant) [2].
• ILO decent work and the care economy agenda: the global framework for care policy [3].
• Population ageing and elder care: the growing other half of care demand [1].
• Gender budgeting: a fiscal tool for funding care infrastructure.
• Anganwadi/ICDS and crèche provisions in labour laws: existing childcare delivery channels that sit under different ministries.
• Viksit Bharat 2047: the overarching growth vision the article ties care to [1].

16. NCERT Concepts to Revise

• Unpaid care work (Economy): Central subject: unremunerated care done mostly by women, left out of GDP, and measured by the surveys cited.
• Care economy (Economy): The article's main idea: paid and unpaid care for children, elderly and the sick should be planned as infrastructure.
• Time use survey (Polity): Source of the 41% and 140-minute figures; MoSPI runs it, and exam questions test its rounds and years.
• Periodic Labour Force Survey (Economy): Source of the 44.4% figure on women outside the workforce citing childcare; often confused with the Time Use Survey.
• Infrastructure (Economy): The article asks that care get public investment and planning like roads, metros and power.
• Population ageing (Geography): Rising numbers of older people will increase demand for elder care, which makes the case for a care system.

17. Common Errors / Trap Areas

• Agency confusion: the TUS and PLFS are run by MoSPI, not MWCD, the Ministry of Labour, or NITI Aayog [2].
• Metric confusion: "140 minutes" is the average time per participant (people who actually did care work), not per person across the whole population. Per-person averages are lower [2].
• Year confusion: TUS 2024 (fieldwork Jan–Dec 2024) was released in 2025. The earlier round was 2019, not 2020 [2].
• Mixing data sources: the 44.4% figure comes from PLFS 2025. The 41% figure comes from TUS 2024. Do not swap them [1][2].
• Wrong comparison: the ILO's 4 h 25 min is a global estimate built on earlier surveys and is not directly comparable with India's TUS figures [3].