Women’s health in the care economy: Empowering domestic workers in Peru

When Mexico welcomed its first female president, Claudia Sheinbaum, in October 2024, she quickly moved to introduce historic constitutional reforms to protect and enhance women’s rights. As part of this package, Sheinbaum’s government announced a new pension program for older women, combined with health services and training to empower women economically and combat inequality. 

These reforms recognize the critical role of women who spend substantial hours to provide unpaid labour caring for children and family members, cleaning, and cooking meals at home. This was particularly evident during the COVID-19 pandemic. 

Like other regions of the world, women across Latin America are contributing to the care economy, often without social protections, contracts, access to health services or other support. Many provide domestic services, work in the informal sector, or make a living as waste pickers and recyclers. Within the context of the COVID-19 pandemic, researchers in the region are examining the health and work conditions of women in the care economy, offering evidence to inform policymaking and recommending solutions for a more equitable future.  

Empowering domestic workers in Peru 

In Peru, women hired to provide domestic services do so largely without a contract in place, resulting in a lack of labour protection. There are no occupational standards to ensure their safety and security on the job. Between 2019 and 2021, the number of domestic worker women without a contract in Peru increased from 89% to 93% nationally.  

A project called Addressing the challenges and constraints of social protection policies for Peruvian women domestic workers, or ANITA, examined women domestic workers’ working conditions and access to health care in three areas of Peru: Lima, La Libertad and Piura. The researchers surveyed 456 women domestic workers, interviewed 55 stakeholders and held two deliberative dialogues with domestic workers, government officials and domestic worker associations. The results offered important insights, yielded recommendations and built effective pathways to improve social protection policies for women domestic workers. 

The project was funded under the Women RISE initiative with support from IDRC, the Canadian Institutes of Health Research and the Social Sciences and Humanities Research Council. 

Findings revealed precarious working conditions for women 

The project team, led by the Cronicas Center of Excellence in Chronic Diseases and its partners, characterized and compared the health and working conditions of women domestic workers before and during the COVID-19 pandemic. The findings revealed that during and after the pandemic, domestic work became more precarious, with scarce social protection policies such as employment contracts, employer-paid health insurance and retirement pensions.  

The research showed that the COVID-19 pandemic disproportionately affected domestic workers compared to other women working in the service sector. In addition, groups such as older women and Afro-Peruvians within the domestic worker sector were more severely impacted by the pandemic and its restrictions. 

One domestic work leader who took part in the dialogues reported that many female colleagues accept being poorly treated or paid below the minimum wage because they have little choice. They need to make a living.  

“The workers accept this treatment out of necessity […] Work is not only difficult here and one must accept what there is. There is a salary, and with that, they are satisfied,” she said.  

Barriers limit domestic workers’ access to social protection safeguards 

The project identified barriers that affect women domestic workers’ knowledge of and access to social protection policies. The barriers include:  

• undervaluation of domestic work, which is seen as help rather than work
• absence of written contracts, with mostly verbal agreements that put employers in control of working conditions  
• lack of monitoring or enforcement procedures for the few contracts that do exist, with long working hours and unsafe working conditions being the norm.
• lack of labour benefits such as employer-paid insurance, retirement pensions and paid holidays 

As one Peruvian domestic worker reported in the dialogues, many deal with poor working conditions and treatment, as well as emotional coercion by their employers.  

“When they say that we are part of the family, we have lost rights. They don’t understand. Who in the family lives cooped up all week and doesn’t see the street on Sundays? That’s not family. Or did I eat what they ate at their table? Is that part of the family? Or did I go for walks with them or watch TV? That's not family,” she said.  

Moving from evidence to improved conditions for women workers 

This research project examined the systemic challenges faced by informally employed women in a COVID-19 and post-pandemic context, yielding important outcomes to support women workers. 

The ANITA team demonstrated the value of working in collaboration with domestic workers, whose participation added richness and better contextualization to the research design, methodology, results and, ultimately, the success of the project. The participatory approaches via deliberative dialogues benefitted research participants by increasing their awareness of their health and labour conditions and associated rights in the short term.  

Over the long term, through continued engagement with decision-makers and domestic worker organizations, the research results aim to serve as the impetus toward institutionalizing and formalizing women’s domestic labour in Peru — empowering women informal workers and leading the way for greater equality and rights.   

Contributors: Adrijana Corluka, senior program specialist, IDRC; Janeth Tenorio Mucha, principal investigator, ANITA research team, Universidad Peruana Cayetano Heredia.