Testing innovations to shift and reduce unpaid care work in East Africa

In 2023, some 708 million unemployed women worldwide cited care responsibilities as keeping them out of the job market. Within households and communities, social norms that define caring for children, the sick and the elderly as women’s work reinforce the unequal sharing of unpaid care work. These expectations deprive women of higher-paying jobs and learning opportunities, which in turn limits what they can contribute to economic growth and development.

A wealth of past research has shown that offering families quality affordable childcare is an important part of the solution. Shifting the needle on unpaid care work also demands strong legal frameworks and policies, alongside a change in entrenched norms around how care work is shared. Without widespread social acceptance, even well-designed efforts to redistribute care responsibilities can have limited impact.

Launched in 2020, the Growth and Economic Opportunities for Women – East Africa program supported research to evaluate interventions designed to shift and reduce unpaid care work. Two projects focused on changing norms and perceptions around unpaid care work, while three explored the potential for scaling innovative models of quality affordable childcare for different groups of low-income women. Their findings show how changing care norms and providing quality childcare can advance women’s economic empowerment while demonstrating the pros and cons of various approaches. Backed by evidence, these results are informing decision-making on how to scale up quality care alternatives and change norms and attitudes that hold women back. 

Bundling childcare access with other support

In three urban areas of Ethiopia, Addis Ababa University evaluated a care model implemented by ChildFund that targeted unemployed or poor working mothers. Through 16 community care centres, the model bundled childcare access with efforts to boost women’s economic potential, including through self-help groups, seed capital, training in entrepreneurship and leadership and parenting sessions that engaged women and their partners to promote shared household responsibilities.  

Evaluation of this model showed large economic gains: women’s employment increased by 31% and business ownership by 138%. Household food insecurity declined by 17.8%, while participating women saw a 22.8% reduction in depression scores. Meanwhile, fathers’ involvement in childcare rose by 23%. However, the study detected little change in women’s decision-making power, rates of intimate partner violence and child development and nutrition scores. 

Comparing childcare options for market vendors

In informal markets around Kampala, Uganda, the Ace Policy Research Institute explored how women vendors would benefit from market-based versus community-based childcare centres. Those using market-based care experienced a small increase in profits and life satisfaction, while also spending less time — approximately a half hour per day — working. Given that these vendors were used to minding children while selling their goods, access to childcare likely enabled them to work more efficiently.  

While no significant changes in child development were seen among those in market-based care, development scores for children in community-based care improved by 24%. Their mothers also experienced less depression and anxiety. However, they spent more time on primary care activities, likely because they had to prepare lunches and transport their children to care. 

Surveys found that mothers using either of the two childcare options were more willing to pay for care than before. However, they only pay between USD3 and USD4.6 (CAD4.2 and CAD 6.4), reflecting the limited resources of these small-scale vendors. Neither option appeared to affect women’s agency and decision-making power.   

Empowering “mamapreneurs” to enhance childcare quality 

In informal settlements in Kenya’s Nakuru County, the African Population Health Research Center evaluated the Kidogo “hub and spoke” model. It uses a social franchise approach to support care providers and offer parents quality childcare. The intervention established a centre of excellence to serve as a community hub and resource centre for 52 spokes — care centres run by women known as “mamapreneurs.” These women were given training, coaching, mentoring and a health and safety package to set up their own childcare businesses. This model was compared with existing childcare centres with no upgrades. Kidogo mamapreneurs saw a significant rise in average income and gained vital business management skills. Quality improvements were also seen in their childcare centres. However, the evaluation showed no significant changes in the time mothers spent on unpaid care work or in their economic standing.    

The research has also raised the profile of care as an important policy issue at state and national levels. It prompted the Nakuru County Department of Social Services to take the lead on childcare issues, pushing for the finalization of guidelines for care provision and ensuring collaboration across several government departments. The research team also contributed to the development of a new National Care Policy for Kenya — currently up for cabinet approval — which aims to recognize, reduce and redistribute care work while improving working conditions in the care sector. 

Changing couples’ mindsets around sharing care

In rural areas of Rwanda, the Institute of Policy Analysis and Research evaluated the Réseaux des Femmes behaviour-change model among households with children under the age of 12. The model engaged men and couples on family planning, gender-based violence, positive masculinity and unpaid care work, while women were trained on finances and entrepreneurship and encouraged to engage in paid work. Households were also given access to shared water tanks to reduce time spent collecting water. For women, this combination of interventions resulted in a 92% increase in paid work and a 10% reduction in lived poverty. Couples found they had considerably more time to spend on the family farm, which generated income. Women also experienced less stress and a reduction in intimate partner violence. Interestingly, as their wives’ incomes increased, men reported a 20% increase in lived poverty. Researchers interpret this change as reflecting a shift from men seeing earned income as “their own money” to seeing it as a household resource. 

Interviews and focus groups point to a shift and decline in unpaid care work. As one woman from Rwamagana district reported, “The training changed my husband’s mentality about unpaid home activities. He has learned that doing such work cannot take away his manhood but improves the general wellbeing of the family.” Many women credited the water tank component for saving them time, given their greater responsibility for fetching household water.  

This evidence helped to frame unpaid care work as an economic investment issue — not just a gender issue — and increased government recognition of its contribution to GDP. A separate policy-focused care research project led by Pro-Femmes/Twese Hamwe built on this base. The team coordinated a civil society coalition and engaged two ministries on mainstreaming gender within the National Investment Policy. The revised policy introduces guidelines to reduce gender disparities and encourage women’s participation in the formal investment sector.  

Engaging men and boys

In Uganda, the POWER model engaged men and boys as role models and raised awareness among community leaders and service providers on the issue of unpaid care work, while promoting women’s village savings and loan associations. An evaluation showed that the full intervention, or even group-based awareness activities for men and women alone, reduced women’s time spent on unpaid care but had no impact on their economic activities. Women reported that men were doing more unpaid care, including cooking, looking after children and washing clothes. Analysis suggests that the training, peer influence and awareness-raising had helped men recognize the heavy load women faced from unpaid care work.  

Women spoke of improved family relationships, using words like “peace” and “harmony,” and reductions in intimate partner violence, as tensions over unpaid care work decreased. Testimonials suggest social norms around unpaid care work were also changing at the community level.  

More investment in scaling care innovations

With its support for rigorous, locally led research and advocacy, the Growth and Economic Opportunities for Women – East Africa program has shown how access to affordable quality childcare and multi-pronged efforts to shift norms around care work can improve women’s wellbeing and economic standing. More research is needed to give policymakers a clearer idea of the costs and benefits of various models and how their components can be combined and adapted to specific local contexts. Ongoing policy engagement efforts — tapping evidence-based advocacy, collaboration and coalition building — are also needed to advance government ownership of strong care sectors in East Africa.  

Launched in 2023 by IDRC and Global Affairs Canada, the Scaling Care Innovations in Africa initiative is building on the legacy of this research to deepen our understanding of different methods of scaling care innovations and their associated costs. 

Read more on how research is shifting the burden of care in East Africa: 

• Reducing and redistributing women’s unpaid care work in East Africa: A synthesis of evidence - GrOW East Africa synthesis report
• Reducing and redistributing unpaid care work to economically empower women - GrOW East Africa findings brief
• Balancing the scales in care work to achieve gender equality
• To galvanize progress on gender equality, take action on unpaid care work
• For quality childcare in Kenya