Women in global care chains: The need to tackle intersecting inequalities in G20 countries


Global care chains connect people across the world through care work: households transfer care needs to one another, reinforcing unfair gender dynamics and the undervaluation of care work. Migrant care workers face several struggles: they often work in the informal economy, receive low wages, and lack access to social protection. The Group of Twenty must address intersecting inequalities and guarantee rights for migrants by committing to provide documentation and social protection, to enact comprehensive care policies, to provide migration support, to foster policy coherence, and to support data collection, research, and peer learning. The COVID-19 crisis underscores the importance of rethinking care policies worldwide.



Care work is essential for sustaining life. It encompasses diverse activities like cooking, cleaning, shopping, teaching, and caring for children, the sick, the elderly, and people with disabilities. The value of care work varies. When performed in the market economy, it is a paid job; yet in private settings, its economic worth remains hidden (Fraser 1994; Folbre 1994; Federici 2012).

Globally, care and domestic work falls disproportionately on women: they perform 76% of unpaid care work (ILO 2018a), which limits their availability for paid work, education, and leisure. Among women, the poorest bear the heaviest burden, an inequality that exists within and between countries. In an integrated world, these gaps fuel a global care chain with poorer women migrating to provide care.

Global care chains link people across the world based on care work (Hochschild 2000). As richer women recruit other women—occasionally, and increasingly, migrants—to provide care, the latter face greater obstacles to fulfilling their own care needs and are forced to depend on others, usually even poorer women or relatives (Yeates 2005). Therefore, households transfer care needs to one another, reinforcing unfair gender dynamics and the undervaluation of care.

Migrant care workers face multiple struggles that affect their rights. They often work in the informal economy, earn low wages, and lack access to social protection. As care is feminized, this has clear implications for gender equality (Blofield 2012).

Care work migration depicts diverse contexts, dynamics, and intersections (Yeates 2012). It involves unskilled labor, often occurring in households, and skilled activities, such as healthcare provision. Additionally, migrant care workers are not always women who leave their families to care for someone else’s family; they may have different roles in varied family conformations. Moreover, care chains occur both within and between countries. The policy challenge is to consider this diversity without reinforcing gender stereotypes (Yeates 2012).

Thus, in the context of globalized production systems, the socio-spatial dimensions of care become crucial. A comprehensive approach to global care chains is paramount to widening the efforts to achieve gender equality and social cohesion. The intersection of migration, care, class, ethnicity, and gender create a node of compounding inequalities that must be addressed to foster inclusive and sustainable development.

The Group of Twenty (G20) countries host 65% of the world’s international migrants (OECD 2018), and they are among the top destinations for migrant women (UN DESA 2019). In some countries, 10% of migrant workers are occupied in healthcare, social, or domestic work (OECD,2020). Therefore, G20 members are key stakeholders in delivering on the rights of women and migrant care workers, by designing policy responses to the challenges of global care chains. This becomes crucial during Saudi Arabia’s presidency, as the country is a major migrant destination and most female migrants work in the care economy (ILO 2018a).

The COVID-19 crisis underscores that care work is essential, while revealing policy flaws worldwide. Today, women are at the forefront of containing the pandemic. This emergency is a call to action for the G20 to coordinate and implement initiatives that address global care chains and guarantee rights for all.



The challenges in terms of global care chains, gender dynamics, and intersecting inequalities highlight the need to analyze the socio-spatial dimensions of care. This need is heightened by ageing populations that struggle to receive support and the flux of migrants, to which the COVID-19 pandemic has added further stress. To guarantee rights for all, the G20 must address five key aspects of migrant care work: (i) providing documentation and social protection, (ii) enacting comprehensive care policies, (iii) providing support through the migration cycle, (iv) fostering policy coherence, and (v) supporting data collection, research and peer learning. Some of these policies may also benefit migrant workers more generally.

Proposal I
Documentation and social protection
G20 countries vary in their approach to migration, including with regard to residence permits, contracts, and family unification. Yet, they all reveal deficiencies in guaranteeing the rights of migrant care workers. As there is no one-size-fits-all response, G20 states must consider the context-specific interactions between care, migration, and employment regimes in policy design, implementation, and evaluation.

As migration law usually prevails over labor law, schemes to promote care workers’ rights do not necessarily ensure migrant protection (King-Dejardin 2019). Therefore, G20 countries must promote legal frameworks that allow all migrants to claim their rights as workers, regardless of their situation, and implement enforcement mechanisms.

Domestic workers are usually excluded from general labor regimes. Therefore, G20 countries must ratify and implement ILO Convention No. 189 and Recommendation No. 201 (ILO 2011), which extend fundamental rights to the 67 million domestic workers around the world. As of 2020, around 70 countries have taken action and only 30 have ratified the convention, mostly in Latin America. In Asia and the Pacific countries and in the Middle East, 61% and 99% of domestic workers, respectively, lack legal protection (King-Dejardin 2019).

Addressing intersecting inequalities to promote the rights of migrant domestic workers

The relationship between domestic workers and employers is one of gender, race, and class. In Argentina, this bond was part of the construction of social hierarchies: the middle class—generally, white, urban groups of European descent—built its identity based on an ethnic opposition to the working class, usually migrants (Pérez 2018). Employers frequently describe domestic workers as the “girl who helps” (Gorbán and Tizziani 2014). In Brazil, they are considered “part of the family,” which paves the way for vulnerability and exploitation (Corossacz 2018) and resembles the former treatment of slaves.

In Arab countries, negative perceptions of foreign domestic workers also abound (Sabban 2002). Workers commonly lack basic rights, suffer discrimination, and face employer abuse (Kagan 2017).

This underscores a process of racialization of socioeconomic status, to which the migrant condition is added in negative terms (Gorbán and Tizziani 2014). Legal frameworks for domestic worker rights must consider prevailing social norms. These cultural representations are context-specific and require G20 countries to combine regulations with communication strategies to debunk stereotypes.

Proposal II
5R approach to care
In recent years, a new approach to care work has emerged: the 5R Framework, which is a combination of the Recognize-Reduce-Redistribute recommendations and the Decent Work Agenda (ILO 2018a). As a rights-based and gender-sensitive approach, its goal is to inform transformative care policies that alleviate inequalities, promote gender equality, and provide quality care (ILO 2018a).

This framework identifies five policy areas—care, macroeconomics, social protection, labor, and migration—and divides actions into groups, namely recognizing care work’s value, reducing women’s burden of unpaid work, redistributing care work, rewarding care work fairly, and guaranteeing representation for care workers. Investing in the care economy guarantees rights, promotes gender equality, and provides economic returns in terms of GDP growth and job creation (Díaz Langou et al. 2019; De Henau, Himmelweit, and Perrons 2017). Evidence also reveals that these policies can contribute to a more even distribution of care work, better working conditions for caregivers, and positive development outcomes for children (ILO 2018a). While some G20 members have achieved progress, emerging economies still lag behind. Therefore, the G20 must commit to enacting national policies and conducting collective action to guarantee rights in global care chains, through the following measures:

Recognizing, reducing, and redistributing care work:

  • Developing a sound methodology to measure care work and consider the contribution of unpaid work to GDP. This methodology should be standard among all G20 countries to allow comparability.
  • Investing in quality care infrastructure to ensure that services are available to all, in line with W20 recommendations.
  • Implementing active labor market policies to encourage the inclusion of women in the workforce.
  • Enacting family-friendly policies and initiatives that promote shared responsibility within households and better work-life balance, such as publicly-funded, mandatory parental leaves.
  • Guaranteeing social protection floors that are gender sensitive.
  • Providing gender-responsive education and information.

Rewarding care workers:

  • Implementing decent terms and conditions of employment.
  • Guaranteeing equal pay for equal work.
  • Providing safe and stimulating working environments.
  • Ensuring legal protection for migrant care workers.

Representing care workers:

  • Guaranteeing freedom of association.
  • Encouraging social dialogue between care workers, unpaid caregivers, and care recipients.
  • Promoting collective bargaining in care sectors.
  • Supporting collaboration between trade unions in origin and destination countries within the G20.
  • Fostering women’s participation in decision-making positions.

G20 countries should also ratify and implement conventions and recommendations about care policies, such as the ILO’s instruments on maternity protection (C. 183), social protection floors (R. 202), and work-family balance (C. 156).

Care policies require cooperation among different stakeholders to change longstanding social norms, including governments, legislators, educational institutions, civil society, private firms, trade unions, and the media. Therefore, G20 countries should implement participatory processes to foster discussions and achieve consensus on gender-sensitive care policies. Through peer-learning mechanisms, the G20 forum should also provide support and guidance to countries with constraints on participation due to low trade unionization, restricted civil society engagement, or low levels of social cohesion.

Proposal III
Support through the migration cycle
Care work mostly involves women from vulnerable contexts who migrate to attain better life prospects. To guarantee their rights, sending and receiving countries should implement coherent and equity-based support strategies through the migration cycle and beyond.

G20 countries must grant legal protection for migrants by implementing the UN’s Global Compact for Safe, Orderly and Regular Migration and ratifying ILO Convention 143, which promotes the rights of migrant workers and equality of opportunity and treatment. To date, only 25 countries have ratified it, and almost none belong to the G20.

Data show that most G20 countries are receiving countries. Migrant care workers are usually recruited through temporary schemes that offer few prospects for long-term residence, naturalization, or family reunification in the host country. Therefore, G20 countries should embrace rights-based migration schemes to keep families together and promote decent livelihoods. Additionally, they must address cultural and linguistic barriers to make information accessible to migrants.

The G20 must also promote decent work opportunities for migrants, providing fair pay, social protection, job stability, training, and skills certification. To this end, there must be policy coherence between migration, employment, and sectoral regimes as well as strengthened law enforcement and inspections. In the Gulf region, it is a priority to end the kafala system, a sponsorship scheme that leads to rights deprivation and promotes labor exploitation of migrant domestic workers.

Some G20 countries, including India and Indonesia, are mostly sending countries. In normal times, these countries should protect their citizens’ rights regarding freedom of movement and equality of treatment. To promote safe migration procedures, countries should implement official migration mechanisms that guarantee access to justice and legal support (ILO 2016).

Both sending and receiving G20 countries should support collective agreements and the representation of migrant care workers. Their unequal bargaining position often prevents them from claiming rights and undervalues their work (ILO 2018a). Therefore, G20 countries must foster collective organization and promote cooperation among trade unions.

Codes of practice and legal instruments for ethical recruitment of migrant healthcare workers

In 2010, the World Health Organization (WHO) adopted the WHO Global Code of Practice on the International Recruitment of Health Personnel. The goal was to alleviate the negative impact of care worker migration, both on the workers themselves and on their countries of origin, by addressing the healthcare workforce shortages in low-income countries.

The Code should serve as a framework for global dialogue and cooperation. Countries agreed to discourage the active recruitment of health workers from developing countries facing critical health workforce shortages. However, the complex patterns of healthcare migration and deficiencies in documentation obstruct the implementation of the Code. The obstacles are myriad. First, it is difficult to guarantee its enforcement, to monitor the implementation, and to evaluate its impact. Second, the Code’s principles can hardly be transformed into concrete measures without strong coordination. Third, people might have persistent desires and incentives to migrate (King-Dejardin 2019). Therefore, G20 countries must deepen international cooperation to maximize its impact.

Proposal IV
Policy coherence
Global care chains, at the crossroads of migration, labor, gender, social, and care policy, and spanning multiple countries, are a clear example of global systemic concerns (Ahmed and Khan Toru 2020). They require coherent transnational approaches. Otherwise, certain seemingly “domestic” decisions—such as upholding restrictive migration policies or deregulating labor markets—taken in specific countries can have negative spillover effects on care workers in other countries (Díaz Langou et al. 2020; Knoll 2014). Tackling these challenges requires coherent policies both between and within countries, both vertically and horizontally.

The multiple Sustainable Development Goals (SDGs) that global care chains tap into make it particularly challenging to guarantee a coherent response, but they also represent a major opportunity for progressing on the 2030 Agenda. This is because care policy can be an “accelerator” for “cross-cutting transformation” (UNPD 2017; Sachs et al. 2019); it can act as a catalytic intervention, triggering positive synergistic multiplier effects that advance several goals at once (Díaz Langou et al. 2020).

The G20 could facilitate exchanges among states through the Development Working Group to ensure an overall coherent strategy on care chains and alert any potential transboundary or intertemporal impacts of domestic measures. The analysis should consider how global care chains function in the broader context of interlinkages among SDGs. These exchanges should consider synergies and trade-offs among goals from a systemic perspective to design evidence-based actions, following previous efforts such as the G20 Action Plan on the 2030 Agenda for Sustainable Development (Lay et al. 2017).

The G20 has made progress in promoting “whole-of-government” approaches that can break policy silos, but its architecture—with separate tracks working independently— still presents challenges for institutional coherence. This calls for reforms within the G20 that create spaces for joint work across tracks and working groups (Lay et al. 2017). These changes would also make it easier for G20 countries to promote similar initiatives at the national level, in line with the Policy Coherence for Sustainable Development approach (OECD 2018).

Finally, the G20 must commit to mainstream gender in the official tracks, discussions, commitments, and engagement groups, and to develop orderly handover strategies (Díaz Langou, Caro Sachetti, and Biondi 2019). This can create an environment that fosters coherence in tackling global care chains and ensures that commitments are gender-sensitive throughout the subsequent G20 presidencies.

Proposal V
Data production, peer learning, and research
One of the main obstacles to effective policy implementation is the lack of data about the international migration of care workers. G20 countries must honor their international commitments on data production, such as the WHO Global Code of Practice on the International Recruitment of Health Personnel (WHO 2010). Additionally, in partnership with international organizations, the G20 should monitor the factors affecting migration flows, conduct standardized data collection on care migration, and support the Global South in data production. Collecting genderdisaggregated data that accounts for the socio-demographic characteristics of migrant care workers is crucial to designing adequate policies, measuring impact, and evaluating progress.

G20 countries should also support and fund research on global care chains, which can be achieved by deepening cooperation with G20 engagement groups (T20, L20, C20, and W20). This is critical to addressing knowledge gaps, challenging the prevailing sexism regarding care issues, and designing evidence-based policies to guarantee the rights of migrant care workers.

Robust evidence could allow G20 countries to exchange good practices and lessons learned. In this way, the G20 should commit to evaluating domestic policies and their spillovers and to implementing peer-learning mechanisms. These processes could be channeled through the G20 Development Working Group. In the same vein, the G20 should follow recommendations to conduct collective reporting on the progress on the 2030 Agenda (Görlich et al. 2020; Ordóñez et al. 2018), including a view on global care chains in the related SDGs.

Finally, the G20 must work together to re-engineer GDP methodology and consider unpaid work; valuing these chores as we should will contribute to empowering women. A fresh GDP theory should consider the changes that have occurred in labor markets during the last century and women’s unpaid contribution to the economy. While some progress has been achieved, most of it remains in the academic realm, and there is no agreement on a common methodology (ILO 2018b). Official statistics institutions and those working on national accounts in G20 countries must coordinate the efforts to effectively advance the valuing of care work.

Closing remarks: the way forward
Global care chains represent several challenges to guaranteeing migrants’ and women’s rights. Care is vital for life, and it requires recognition as such. As populations age around the world, demand for care will increase, and current tensions will escalate if left unaddressed.

G20 countries are migrant recipients. To guarantee rights, they must implement adequate policies and pursue international cooperation to address gender dynamics and intersecting inequalities. Their key role in the global economy makes them crucial stakeholders in fostering the adoption of comprehensive and coherent approaches to global care chains worldwide.

The topic gains heightened relevance during Saudi Arabia’s G20 presidency. The country is one of the main migrant destinations in the world. While women represent a small share of the total migration (around 33% in the Arab region), almost all end up employed in the care economy as domestic workers, healthcare providers, or caregivers (ILO 2018a). The female care workforce represents 90% of all employed women (ILO 2018a), and the labor participation of migrant women is substantially higher than that of the native-born (30% vs. 20%; OECD, IOM, and UNHCR 2018). Therefore, it would be in Saudi Arabia’s best interest to advance migrant domestic workers’ rights.

Additionally, the current global COVID-19 emergency has exposed many deficiencies in healthcare provision, quality care, labor regimes, and migration policies. As care workers are more frequently women, and women seem to be more affected by the crisis, the pandemic poses challenges to gender equality. Furthermore, the poor and ethnic minorities have proven to be more vulnerable to COVID-19, raising the relevance of addressing the intersectionalities in policy solutions. This underscores the need for larger public investment in care worldwide to increase resilience and wellbeing by recognizing our interdependencies and placing people first. This requires not only domestic action but also multilateral coordination to achieve an effective global response.

Once the emergency has passed, the five policy areas outlined in this brief will be crucial to addressing the socio-spatial dimensions of care. G20 countries must deliver on these aspects, as gender equality, decent work, and quality care are prerequisites to achieving inclusive and sustainable development.


The authors would like to thank Valeria Esquivel (ILO) and Eleonore Kofman (Middlesex University) for their comments and literature suggestions. The authors also appreciate the suggestions of the Task Force co-chairs Suzan Alqurashi, Gianluca Grimalda, Marc Fleurbaey, and Abla Abdel Latif.

This policy brief was developed and written by the authors and has undergone a peer review process. The views and opinions expressed in this policy brief are those of the authors and do not necessarily reflect the official policy or position of the authors’ organizations or the T20 Secretariat.

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