Gaps in India’s Care System

What is a holistic care system?

• A care system includes the services, workers, institutions and public policies that support people who need care and those who provide it.
• Care needs arise at different stages of life:
  
• Childcare: Early childhood care, nutrition, development and crèche facilities.
• Eldercare: Assistance with daily activities, health needs and independent living.
• Disability support: Services that help persons with disabilities meet daily needs and participate in society.
• Caregiver support: Training, fair wages, social protection and suitable working conditions for paid and unpaid caregivers.
• Care is not only a household responsibility. It supports public health, human development, employment and economic productivity.

What are the main gaps in India’s care system?

• Fragmented governance
  
• Care services are spread across several ministries and departments, including those dealing with women and child development, housing and urban affairs. 
• Each runs its own programmes, but the absence of a common framework can leave gaps in service delivery.
• For example, crèches can close before factory shifts end, or eldercare needs can fall outside existing schemes.
• Limited coverage
  
• An estimated 9–10 million women in low-income urban households need childcare, according to UNDP.
• Around 24% of older persons face limitations in daily activities.
• National data on the availability and coverage of care services remain limited.
• These gaps affect access to affordable and reliable care, particularly for low-income households.
• Shortage of adequately supported care workers
  
• Care services depend on frontline workers, including Anganwadi workers, home-based caregivers and domestic workers. 
• Many remain inadequately remunerated or work without formal recognition.
• Clear standards, certification, decent working conditions, social protection and career pathways are needed to recognise care as skilled work.
• Inadequate financing and gendered expectations
  
• Care is often treated as welfare expenditure rather than an investment in human development and economic participation. 
• Workplace policies can also assume that caregiving is primarily a woman’s responsibility.
• The Economic Advisory Council to the Prime Minister (EAC-PM) has recommended statutory paid paternity leave in the private sector.

What can India learn from other countries?

• Different countries have adopted institutional arrangements to coordinate care services.
  
• Brazil: Its 2024 National Care Policy and 2025 National Care Plan brought 34 government entities under a common framework and established inter-ministerial committees for implementation.
• Nepal: Care mapping was used to identify needs and support the funding of care pilots.
• Colombia: Its 2025 care-policy framework provides another example of efforts to develop coordinated care systems.
• These experiences point to the value of coordinated governance, mapping local needs and planning services across different care requirements.

How can India build a coordinated care system?

• National-level coordination
  
• NITI Aayog’s report Reimagining Care: Strategies for Empowering Caregivers in Viksit Bharat@2047 proposes a National Caregiving Council to strengthen coordination.
• The Ministry of Social Justice and Empowerment is consulting States and Union Territories on a National Care Economy Mission. 
• Discussions at the May 2026 national workshop covered inter-ministerial governance, aligned financing and shared data.
• State-level care planning
  
• States can map care needs and available services against demographic trends. 
• This can help identify gaps in childcare, eldercare and disability support, prepare costed plans and assign clear responsibilities.
• Recognising and supporting care workers
  
• career progression. 
• Better recognition can improve both the quality of care and the working conditions of caregivers.
• Supporting women-led care enterprises
  
• UNDP and UN Women are supporting this agenda through government-led initiatives, including efforts to map care services and build care workers’ skills. 
• Partnerships with the Ministry of Housing and Urban Affairs and the Women Entrepreneurship Platform can also support women-led childcare enterprises.

Conclusion:

India’s care needs cannot be addressed through separate schemes operating without coordination. A common framework, adequate financing, local care planning, and better working conditions for caregivers can improve access to care and support women’s employment. Recognising care as an essential part of economic and social infrastructure is important for inclusive growth and Viksit Bharat@2047.