What Is a "National Care System"?
Latin America's Redesign of Care

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Across Latin America, there's a growing push to build "national care systems" (Sistema Nacional de Cuidados) — to make care a job of the state. The work of looking after children, older people, and people with disabilities has long fallen on families — above all on women, unpaid. The move now is to turn that into "care systems" the state takes responsibility for. CEPAL, the UN's economic commission for the region, sets these within a larger idea it champions: the "caring society" (sociedad del cuidado).

Unpaid care is over a fifth of GDP

Start with the numbers. CEPAL estimates that the economic value of unpaid domestic and care work runs to 21.3% of GDP on average in the region — between 15.9% and 27.6% depending on the country, in every case a load-bearing share of the economy. Women do 74.5% of it, spending roughly three times as long on unpaid care as men. In households with children under 15, about 60% of women say they're out of the labor market to tend to family. Care isn't a "private family matter" — it underpins the economy itself. Making that visible is where the whole debate starts.

"Recognize, reduce, redistribute" — the blueprint

The core rests on three verbs: recognize (make its economic value visible), reduce (ease the burden itself with nurseries, day services, assistive devices), and redistribute (shift the load off women onto men, the state, business, and the community). It's the "three Rs" that feminist economics developed, reframing housework and caregiving from "free work" into productive labor that keeps society running.

Making care a right — a fourth pillar

The other pillar is writing care into law as a right. Chile's and Mexico's recent laws set out, side by side, the right to receive care, to give care, and to care for oneself. CEPAL places this as a "fourth pillar" of social protection — after pensions, health, and income security — and at the regional women's conferences (the Buenos Aires Commitment in 2022, the Tlatelolco Commitment in 2024) governments pledged to move toward a "care society."

"Care" or "autonomy"? The view from disability

Here disability policy enters an important caveat. Most care systems grew out of feminism's "care economy" agenda. But Article 19 of the Convention on the Rights of Persons with Disabilities (CRPD) sets out the right to live independently in the community and to choose where, how, and with whom to live. The "support" it means is not standardized "looking after" but personal assistance the person chooses and directs — support that enables autonomy and participation.

The trouble is that the word "care" (cuidado) can slide into paternalism — "tending to a dependent person." The Independent Living Movement has argued since the 1960s for user-directed personal assistance as a right and for an end to institutionalization; feminism, meanwhile, asks who protects the labor and dignity of the person doing the assisting. The two can collide. Mexico's care-system proposal was criticized by advocacy groups in 2025 for being weak on the rights of disabled and older people. A good care system hinges on whether the design can hold both at once: share the carer's burden across society, without letting go of the cared-for person's autonomy.

Latin America is out front — but implementation is the test

It may be surprising, but here Latin America leads. By CEPAL's count, eight countries — Brazil, Colombia, Costa Rica, Cuba, Ecuador, Panama, Uruguay, and Venezuela — already have laws on care systems or policies. Yet law and reality are far apart. Funding, reach into provinces and the countryside, the pay of care workers, and the guarantee of autonomy for the cared-for — all of it is still homework.

What this movement is asking

That unpaid care exceeds a fifth of GDP means the invisible outlay of those who carry it — mostly women — is exactly that large. Sharing care across society is a question of fairness. At the same time, how you protect the autonomy of the cared-for — above all people with disabilities — is a question of rights. Latin America's experiment is trying to hold both in one system. For a Japan facing the same ageing and the same weight of care, it's anything but someone else's problem.

Unpaid care is over a fifth of GDP. Who shares it, and how you protect the autonomy of the cared-for — a care system asks both.

This article is the author’s commentary and opinion based on public information. Please confirm the latest details and procedures with governments and primary sources. Quotation is kept minimal and sources are cited.