Presentation Slides (KRI & Jayati Ghosh)

1. Re-configuring the Care Economy
for Gender Convergence
3 October 2019
The Point, Level 7, Mercu UEM
9.30am – 12.00pm

2. Care, the macroeconomy
and women’s work
Jayati Ghosh
Jawaharlal Nehru University, New
Delhi
Khazanah Research Institute,
Kuala Lumpur, Malaysia
3 October 2019.

3. Why care about care work?
Care work: activities that involve “looking after” someone
else, meeting the physical, psychological and emotional
needs of dependent adults and children.
Social reproduction: cooking, cleaning, provisioning for
the household and other domestic services; looking after
the young, the elderly, the sick, disabled or differently
abled as well as healthy adults.
Key feature of care is that it is fundamentally relational
and involves human interaction, even when mediated by
technology.
Direct care work: services that are essential for human
survival, or to improve the quality of human existence
Indirect care work: enabling such services to be
provided.

4. The public value of care work
Essential for human survival
Contributes significantly to human well-
being and social development.
Unpaid and underpaid care work provides
a very significant subsidy to the formal
economy.
Care work can be a significant source of
good quality employment generation,
especially with fears of technology-related
job losses and has strong multiplier effects
on employment.

5. Social undervaluation of care
Care work is mostly undervalued by
society, markets and governments.
So it is underprovided and provided
in poor conditions with low/no pay
Performed by women, migrants,
those at lower end of social
spectrum
Association with women’s work adds
to inequalities for workers and to
those receiving care.

6. Provider/Recipient
Nature
of care
work
Children Elderly Sick/
Differently
abled
Healthy
adults
Self
Unpaid work
by household members
within household
and by volunteer
workers in community
Direct
Feeding,
bathing,
cleaning,
watching
over
Assistance
in eating,
bathing or
moving
around
Nursing,
assisting
mobility
and daily
functions
Counselling Seeking
medical
help,
exercising
Indirect
Growing food for own consumption, cooking, cleaning, laundry,
providing other essential services like shopping for necessities,
fetching and carrying fuelwood and water for household
consumption
Informal
market work by paid
workers
Direct
Feeding,
bathing,
cleaning,
watching
over,
teaching
Assistance
in daily
functions
and
mobility,
nursing
Nursing,
therapy
and other
assistance
in daily
functions
Providing
personal
services
Indirect
Informal paid work for cooking, cleaning, laundry, providing
other essential household services, procuring water or fuel,
shopping for necessities
Paid formal
employment
Direct
Child care
providers,
Day care,
Pediatric
workers,
Early
education
workers
Geriatric
services,
Family
day care,
Old age
home
workers
Nurses,
Doctors,
Physio-
therapists,
other
clinical
and
medical
services
Therapists,
Counsellors,
Nutritionists
Indirect
Managers, administrators and other service providers (like
clerical or sanitary services) in child care, elderly care and day
care facilities, clinics, hospitals, nurseries and kindergartens,
schools

7. Care is a relational activity
Even in its most “unskilled” form, care work is
never “routine” and requires cognitive input and
responses.
So technology can never replace human
engagement completely, even if it can assist in
reducing drudgery of some care activities and
make others easier to perform more efficiently.
Demand for care is hard to adjust and in some
cases cannot be adjusted at all – non-delivery of
such care will result in actual detriment to the
potential receiver rather than simply deferment or
reduction of perceived wants.
Care work will expand at a faster rate than many
other economic activities, with income elasticity of

8. Productivity in care work
Better quality care (paid or unpaid) typically
requires more intensive human input.
So standard concepts of labour productivity are
irrelevant, misleading and counterproductive.
Productivity cannot be raised significantly through
mass production, and productivity measured in
terms of number of people served is a misleading
indicator.
Increasing “productivity” in numerical terms (like
patients per nurse) can make things worse:
Overwork of caregivers reduces the quality of care
and can cause impatience or irritation or neglect on
the part of the caregiver, thereby leading to harm

9. Technology and care work
Some aspects of care delivery can be made
more productive by reducing drudgery, difficulty
and repetitiveness by substituting machine
labour for human labour.
Artificial Intelligence and new digital
technologies can make care work more efficient
and streamlined, with faster and more flexible
responses.
This will require skilling workers to be able to
utilise these processes.
But new technologies would supplement rather
than replace most care workers

10. Skills in care work - 1
Different care activities require different
degrees of skill and prior knowledge.
Some (like doctors) are known to be highly
skilled requiring advanced qualifications.
But skills and training required for some
crucial care work are not adequately
recognized,
For example, early childhood education,
geriatric care, dealing with differently abled
persons.

11. Skills in care work - 2
Many of these services are performed in
informal settings by unpaid or low paid
workers, so the care provided can be
inadequate quality because of lack of
training.
Societies then undervalue both the skills
and the workers
When mostly women do such work, it
compounds the gender discrimination
and hierarchy.

12. The affective element in care
Human emotions and empathy play
important roles.
Much care work, especially unpaid care, is
delivered in context of socio-cultural norms
about familial duties, responsibilities and
commitment.
These interact with patriarchal structures
and values to create gendered divisions of
care work.
So across all societies, women are seen as
dominantly responsible for paid and unpaid

13. Feminisation of care
Globally, around 75 per cent of total unpaid
care work (in work hours) is performed by
women .
Most women across all societies typically
work longer hours than men, whether or not
they are recognised as doing so.
This adversely affects labour force
participation of women.
It creates “wage penalty”, lower wages and
worse working conditions for all care work,
even when performed by men.

14. Gender distribution of care work is universal

15. Paid-unpaid care work continuum
Care work is often performed by those with lower
educational attainments (even when levels of skill
required are quite high) and by disadvantaged
workers like migrants.
Because so much care work is unpaid within
families, it is not valued even when it is paid for.
The nature of such work – more amenable to part-
time employment and informal contracts – also
contributes to its devaluation both in market terms
and in social perception.

16. Time poverty
Time poverty is the shortage of time
available to devote to purely personal
requirements, including leisure and
relational activities.
Most people who are time-poor are also
income poor and suffer from other (often
multiple) deprivations.
Presence of time poverty adds to overall
deprivation in a significant way that is
rarely captured, even in newer
multidimensional measures of poverty.

17. Care work and time poverty
Poorer people cannot afford to buy various
goods and services (especially care) from the
market, and if these are not provided by public
policy, then they can only consume them if
they produce these goods and services
themselves.
So in addition to having to work often long
hours for relatively low wages, or paltry
remuneration for self-employment, they must
also engage in unpaid labour to meet the
essential consumption needs of themselves
and their family members.
This lowers the quantity and quality of such

18. The double burden of time and income
poverty
In all societies, unpaid labour increases sharply as
the income of a household falls – and this is mostly
performed by women.
Time poverty also reduces volume and quality of
goods and services provided in unpaid form and so
adds to the material deprivation of that family.
So more than loss of leisure – it actually affects
material conditions.
So time poverty is not a disease of the rich – it is
actually much worse for the poor and adds to their
material deprivation.

19. Globalisation of care work
Global value chains emerging in care economy,
driven especially by migration of women for care
work.
Nurse migration one significant example: out-
migration from the Philippines (the world's largest
supplier of temporary migrant nurses) to the
United States (the world's largest demander of
internationally trained nurses) affected by political
economy, wages and working conditions in both.
Migration of domestic workers: 80 per cent of all
female cross-border migrant workers are domestic
workers.

20. Domestic workers around the world,
2010

21. Global Value Chain of care work
Major form of subsidisation of
accumulation in the North.
Remittances from such migrants to home
countries tend to be more stable than from
male migrants in construction and
manufacturing work.
Internal migrant within developing countries
add to value chains.
Bottom of global care value chain is unpaid
worker in developing societies

22. Can care work be an
opportunity?
Concerns about new technologies taking away
jobs, especially in routine manufacturing and
services tasks
But care work is relational and requires flexible
responses, so it cannot be entirely replaced by
machines.
With changing demography and social changes,
more skilled care services will be required.
These MUST be provided through public
intervention, as private markets will
underprovide them.

23. Factors affecting demand for care
- 1
Demographic patterns and ageing
Level of per capita income
Income distribution and extent of economic
inequality
Social attitudes to care and to those who are
dependent: children, elderly, those with specific
care needs
Social patterns like increase in single member
and two member households
Increase in psychological care needs
Gender construction of society and the status of
women, their own unpaid care responsibilities and

24. Factors affecting demand for care - 2
Availability of basic infrastructure and
amenities such as electricity, piped fuel and
piped water, that reduce the need for some
indirect unpaid care activities;
Attitudes to role of the state and the extent of
public responsibility for the delivery of care
services (and therefore willingness to allow the
state to tax for more provision)
Available technologies that reduce more
manual or tedious jobs that have to be
performed by caregivers

25. How can we estimate desirable
levels of paid care work?
A thought experiment: Take Sweden as
country in which care services are
currently adequately provided
Sweden 2014 employment levels as
benchmark to estimate likely/desirable
number of care workers for all societies.
Apply these numbers to 2030 population
projections for all countries. (SDG goals)
(This may still be an underestimate.)

26. Care worker ratios in Sweden in
2014
“Health workers”: health care managers,
doctors, nurses, physiotherapists, psychologist
and psychotherapists, other health care
therapists and complementary medicine
therapists, dentists and dental nurses and other
health care assistants: 1 worker per 12.82
persons.
Child care workers: pre-school managers,
primary and pre-school teachers, and childcare
workers and teachers’ aides: 1 worker per 3.6
children (0-14 years).
Elderly care workers: elderly care managers

27. Projections for 2030
For world as a whole
Health care
workers: 663 million
Child care workers:
340 million
Elderly care
workers: 86 million
130.99
384.00
57.25
56.25
30.91
27.75
Likely requirement of health
workers in 2030
(millions)
Africa
Asia
Europe
Latin America &
Caribbean
Northern America
Oceania

28. Projections for 2030
105.96
175.37
18.89
25.75
12.02
1.77
Likely requirement of dedicated
child care workers in 2030, millions
Africa
Asia
Europe
Latin America & Caribbean
Northern America
Oceania
6.49
52.00
13.38
7.45
6.45
0.59
Likely requirement of dedicated
elderly care workers in 2030,
millions
Africa
Asia
Europe
Latin America &
Caribbean
Northern America
Oceania

29. Direct employment effects
If reasonably adequate care services are to be
provided to people across the world in 2030, this
will require a massive increase in care employment,
even in these limited occupations.
This would be a significant proportion of the
working age population – and therefore an even
larger proportion of the actual employed population.
Many more workers beyond these will be required
in the total care economy, as part of the support
and administrative systems to deliver these
services.

30. Aggregate employment
effects
These projections are actually significant
underestimates, since they refer to only three
very specific types of relational care.
In addition, care work has very strong
multiplier effects.
Studies have found employment multipliers for
care investment to be as much as three times
higher than those for construction
So there is huge potential for care economy
as employment generator in the future.

31. Inequalities among paid care workers
Care workers very heterogenous, from highly skilled and
well-paid professionals such as specialized doctors to
poorly paid domestic workers.
Even within the same industry, various forms of care work
are neither equal nor equally valued
The gender dimension is very important, also because
women provide so much of the unpaid care work
High status care work often receives a substantial
earnings bonus, while low-status care work incurs a wage
penalty amplified in less regulated labour markets.
Low-status care workforce tends to be more feminized,
often older, typically less educated and more likely to be
engaged in informal employment.

32. Importance of public
intervention
This will NOT be delivered by the market on its
own.
So public intervention essential
Direct public investment and expenditure on
care services and on related infrastructure
Fiscal transfers (child support, old age and
disability payments) to enable private care
services
Employment multipliers of such spending can
generate more growth and more tax revenues
over time.

33. Public intervention has to get it right
Combination of direct provision, transfers and
regulation essential to provide more and better
conditions of care work
But this should not aggravate inequalities.
Fiscal austerity drives tend to see public
provision of care as a soft target for expenditure
reduction, reducing the availability of care adding
to social problems.
Should not seek to provide care work on the
cheap
Avoid the Indian example of underpaid health
and early childhood workers.

34. What has to be done?
5Rs: Recognise, reward, reduce and
redistribute and represent care
work.
Reduction can use technological advances to
avoid drudgery and repetitive tasks
Redistribute care work between public, private,
family and community; AND between men and
women
Mobilisation of care workers (paid and unpaid) and
representation of care workers in decision-making
on policies that affect them and their work.

35. Care and public policy
Recognise importance of care work and
investment in good quality care services
Investment in skills and training for care
Instead, recognising and valuing care work,
making sure it is performed by trained people in
good working conditions and with acceptable
wages is the smart way
Public purpose is served at multiple levels: more
and better quality employment; improved
conditions of life; genuine (rather than false)
productivity growth -
And happier, healthier, more

36. Thanks for your attention!

37. Re-configuring the Care Economy
for Gender Convergence
3 October 2019
The Point, Level 7, Mercu UEM
9.30am – 12.00pm

38. Time to Care:
Gender Inequality,
Unpaid Care Work and
Time Use Survey

39. KhazanahResearchInstitute
The Case for Care
Content
KRI’s Pilot Time Use Study
Care Policies
39

40. Section 1:
The Case
for Care
40

41. KhazanahResearchInstitute
+ The Case for Care
Overview of the Care Economy
Market Remuneration
Work
Characteristics
Children Elderly PWD Sick Adults
Formal Paid
Direct Registered care centres; Market provision of domestic
servicesIndirect
Informal Paid
Direct Unregistered family day care; Domestic workers in
householdsIndirect
Non-Market Unpaid
Direct Unpaid care and domestic services for household and family
membersIndirect
Source: KRI’s adaptation of Folbre (2006)
Boundary of the care economy
41
• The nature of care affects affordability and dampens market demand for
formal care, further driving growth in the informal and non-market
spheres.
• However, the size of unpaid care work suggests that there is untapped
economic potential. Investing in the care economy will increase
employment and consequently expand the national economy.

42. KhazanahResearchInstitute
+ The Case for Care
#1 Care burden is rising in Malaysia
Life expectancy at birth and total fertility rate,
1966 – 2017
Care dependency ratio, 2010 – 2018
Source: DOS (2017) Source: DOS (various years) and author’s calculations
42
63.1
72.7
66.0
77.4
5.7
1.9
0
1
2
3
4
5
6
0.0
10.0
20.0
30.0
40.0
50.0
60.0
70.0
80.0
90.0
1966
1969
1972
1975
1978
1981
1984
1987
1990
1993
1996
1999
2002
2005
2008
2011
2014
2017
TotalFertilityRate
LifeExpectancy(Years)
Men's Life Expectancy (LHS) Women's Life Expectancy (LHS)
TFR (RHS)
ye
ar
s
y
e
a
r
y
e
ar
s
y
e
a
y
e
ar
s
ye
ar
ye
7.28
7.57
7.78
8.20
8.24
8.34
8.20 8.20
8.29
6.6
6.8
7.0
7.2
7.4
7.6
7.8
8.0
8.2
8.4
8.6
2010 2011 2012 2013 2014 2015 2016 2017 2018

43. KhazanahResearchInstitute
+ The Case for Care
#2 Unpaid care widens gender gaps
0
10
20
30
40
50
60
70
80
90
100
15–19
20–24
25–29
30–34
35–39
40–44
45–49
50–54
55–59
60–64
%
Men
Women
Labour force participation rate, by sex
and age group, 2018
Source: DOS (2019)
43
-5
-4
-3
-2
-1
0
1
2
3
4
5
15–19
20–24
25–29
30–34
35–39
40–44
45–49
50–54
55–59
60–64
2010 2018
MenworkmoreWomenworkmore
Gender gap in mean hours worked,
2010 and 2018
Women in their childbearing years were participating less in the labour force and
working fewer hours but could potentially return to the labour force in the mid-30s
with a wage penalty.

44. KhazanahResearchInstitute
#3 Unpaid
care work
impacts
poverty and
inequality
+ The Case for Care
44
HH
D
M1
T1
T2
A
Tm
B
C
Time-adjusted income poverty
Income (RM) Food (RM)
Household A 5,000 1,000
Household B 4,000 Cooks at home
Example of household production and income distribution
Poverty and inequality
measures rely exclusively on
market income and excludes
non-market work as
measures of household
living standards.

45. KhazanahResearchInstitute
+ The Case for Care
Why is unpaid care not measured?
General Production Boundary Personal Activities
Market Production Non-Market Production
 Learning
 Socialising and community
participation
 Attending/visiting cultural,
entertainment and sports
events/venues
 Engaging in hobbies, games and
other pastime activities
 Indoor and outdoor sports
participation
 Use of mass media
 Personal care and maintenance
P1 Formal employment or work in ‘formal
enterprises’ to produce goods and
services for pay or profit
P2 Production of goods by households for
income or for own final use
P3 Paid construction activities and
construction for own capital formation
P4 Providing services for income,
including employment in the informal
sector e.g. paid domestic services
P5 Providing unpaid services for own final
use e.g. unpaid care and domestic
services within household
SNA Production Boundary
Locating unpaid care work within production boundaries
Source: KRI’s conceptualisation based on Baigorri (2003) and UNDESA (2005)
45
The System of National Accounts (SNA) production boundary is a subset of the
general production boundary selected to measure a country’s GDP. Unpaid care work
is excluded from a country’s national income accounting.

46. KhazanahResearchInstitute
+ The Case for Care
Capturing unpaid care with time
46
• “Time-use statistics are quantitative summaries of how individuals “spend” or
allocate their time over a specified period—typically over the 24 hours of a day
or over the 7 days of a week.” UNDESA 2015
• Using “time” as a unit of measurement, improvements have been made over
the years to harmonize TUS methodology and classifications so that there can be
meaningful comparisons across countries.
• At least 65 countries have conducted time use surveys, with the total
number of surveys captured at 102 as at February 2016. This includes countries
from different continents and income levels.
• The Ministry of Women, Family and Community Development, together with the
Department of Statistics conducted a “Kajian Penggunaan Masa dan
Penilaian Kerja Tanpa Bayaran Di Malaysia” in 2003. The research has not
been updated since and the methodology has not been replicated elsewhere in the
country.

47. Section 2:
KRI’s Pilot
Time Use Study
47

48. KhazanahResearchInstitute
KRI’s Pilot TUS
Capital intensive
vs
Labour intensive
Sampling
Design –
Purposive
Sampling
• Where: Kuala Lumpur
• Who: Age 20 – 64 (net care-giver within working-age population)
• Stratification:
Class Gender Male Female
Top 20% households 10% 10%
Middle 40% households 20% 20%
Bottom 40% households 20% 20%
TOTAL 50% 50%
+KRI’s Pilot Time Use Study
48
Respondents 125 63 62
Survey
Framework
• Stand-alone, ad-hoc survey with 24-hour full diaries
• Face-to-face recall interviews
= +

49. KhazanahResearchInstitute
Women suffer from the double
burden
49
Average time spent on activities in one day (hours)
+KRI’s Pilot Time Use Study
6.9
0.7
2.2
0.6
2.5
3.4
3.1
3.2
9.0
0.4
0
4
8
12
16
20
24
Main Activity Secondary Activity
6.6
1.0
3.6
1.3
2.0
3.0
2.4
3.2
9.1
0.4
0
4
8
12
16
20
24
Main Activity Secondary Activity
WomenMen
Paid Work Unpaid Care Work
Socialising and Communication Leisure and Media
Self-care and Maintenance

50. KhazanahResearchInstitute
Women of all income classes do
more unpaid work
50
Average time spent on activities in one day (hours)
+KRI’s Pilot Time Use Study
5.7
7.7 7.7
3.0
1.6 1.9
2.4
2.5 2.9
3.3 3.0
2.9
9.1 9.1 8.7
0
4
8
12
16
20
24
B40 M40 T20
6.4 7.2
6.1
3.8
3.9
2.6
2.3
1.5
2.6
2.6 2.1
2.4
8.8 9.2
9.7
B40 M40 T20
Self-care
Leisure and
Media
Socialising
Unpaid Care
Work
Paid Work
WomenMen

51. KhazanahResearchInstitute
Demarcating by life cycle
intensifies double burden
+KRI’s Pilot Time Use Study
7.4
8.4
5.5 5.1
1.6
4.3
4.0
2.7
2.0
1.6
2.6
3.3
3.2
1.7
2.9
2.7
9.5
7.9
8.9
9.6
0
4
8
12
16
20
24
Life Stage
1
Life Stage
2
Life Stage
3
Life Stage
4
Paid Work
Unpaid
Care Work
Socialising
Self Care
Leisure and
Media
Average time spent on selected activities,
by life stage (hours)
Life Stage Definition
1
Young individuals (<49) with no
children in household
2
Individuals (of any age) with youngest
child <7
3
Individuals (of any age) with youngest
child between 7 and 20
4
Individuals (>49) with no children OR
youngest child > 20
51

52. KhazanahResearchInstitute
Excluding travel time, women
work more than men
52
Average time spent on formal employment by gender, household
income class and life stage, excluding travel time (hours)
+KRI’s Pilot Time Use Study
Men Women
B40 M40 T20
Men Women Men Women Men Women
Home 0.5 0.8 0.5 1.3 0.7 0.4 0.2 0.4
Workplace 3.8 4.9 2.6 4.1 4.0 5.6 5.7 5.0
Other 1.1 0.2 1.5 0.2 0.9 0.2 0.6 0.0
TOTAL 5.4 5.8 4.6 5.7 5.6 6.2 6.5 5.4
Life Stage 1 Life Stage 2 Life Stage 3 Life Stage 4
Men Women Men Women Men Women Men Women
Home 0.4 0.2 1.1 1.1 0.5 1.4 0.0 0.7
Workplace 3.7 6.8 4.8 5.8 3.9 2.4 2.4 4.0
Other 1.3 0.0 1.5 0.4 0.3 0.3 1.0 0.0
TOTAL 5.4 7.0 7.5 7.2 4.7 4.1 3.4 4.7

53. KhazanahResearchInstitute
Men do more “pleasant” tasks
compared to women
+KRI’s Pilot Time Use Study
Average distribution of time in domestic work by
gender (minutes)
53
Average distribution of time in direct care work
by gender (minutes)
11.9
57.6
11.3
20.4
5.4
22.4
3.6
2.3
10.8
17.1
15.9
14.9
5.8
3.0
0
20
40
60
80
100
120
140
Men Women
Meal preparations
Household
management
Travelling for
domestic services
Other
Shopping for
household/family
Cleaning
10.2
17.3
3.5
10.2
0.1
1.0
1.0
4.4
1.9
4.0
6.6
5.4
3.0
9.3
4.1
1.0
38.3
27.8
0.5
0
10
20
30
40
50
60
70
80
90
100
Men Women
Physical care for
children
Minding children
Care of
textiles/footwear
Meeting with schools/child
care providers
Talking/reading to children
Teaching/helping children
Playing with children
Other childcare activities
Care for adults
Travelling/accompanying
for care
Other care activities

54. KhazanahResearchInstitute
Unpaid care work lowers market
hours and income
54
An additional hour of unpaid care work is associated with less
market hours worked and income, and this effect is symmetric for
both men and women
+KRI’s Pilot Time Use Study

55. KhazanahResearchInstitute
+KRI’s Pilot Time Use Study
Valuing time to calculate
household satellite account
value of labour
(time valued at suitable wage)
Source: UNECE (2017)
55
+consumption of capital
___________________________
value of total output
_________________________
+intermediate consumption

56. KhazanahResearchInstitute
Total household production, by output
56
Overall household production
+KRI’s Pilot Time Use Study
Analysis of household production reveals similar gender, income and life-cycle
themes as time-based analysis
30.7 30.5
33.3 33.8
0
5
10
15
20
25
30
35
0
50
100
150
200
250
300
350
400
450
Generalist
Wage
(Primary)
Specialist
Wage
(Primary)
Generalist
Wage
(Primary +
Secondary)
Specialist
Wage
(Primary +
Secondary)
RM('000)
Housing Nutrition
Clothing Care
Voluntary Work Transport
% of HH Income (RHS)
%
33.7 33.4 31.4 30.4
24.0 22.5 22.6 20.6
3.7 3.3 4.0
3.4
10.2 12.5 15.7 19.8
1.1 1.4 1.1 1.4
27.3 27.0 25.2 24.4
0
10
20
30
40
50
60
70
80
90
100
Generalist
Wage
(Primary)
Specialist
Wage
(Primary)
Generalist
Wage
(Primary +
Secondary)
Specialist
Wage
(Primary +
Secondary)
Housing Nutrition
Clothing Care
Voluntary Work Transport
%

57. Section 3:
Care
Policies
57

58. KhazanahResearchInstitute
Care work is generally distributed
among the state, market or family
+Care Policies: Aspirations & Options
Male breadwinner
model
?
Universal
breadwinner model
Care as family’s
responsibility:
men are active in paid
work, women carry out
unpaid care tasks.
Limited care
responsibility by state
and/or market.
Care largely remain
family’s responsibility;
women still primary
caregivers. State provides
generous compensation
for care work, opportunities
for part-time work, flexible
working hours and sufficient
parental leave.
Defamilialisation and
commodification of care
to allow mothers (and fathers)
to have full time employment.
Provision of care by
extensive public childcare
services and/or private
market care arrangements.
OR
58
Universal care parity
model

59. 59
Aspiration #1
Care sector as a
productive sector in its
own right

60. KhazanahResearchInstitute
Only 2%
of children
≤4 y/o are
in JKM
TASKAs
Most existing JKM-licensed
childcare centres in Malaysia
do not have full enrolment.
Under-utilisation of formal
childcare centres suggest
capacity is not main barrier.
Source: NCDC
Undercapacity in existing active childcare centres
Note: Undercapacity is defined as childcare centres which take in (enrol) fewer
children than the maximum approved by government agencies.
60
State
Active
childcare
centres
Childcare
centres with
undercapacity
%
undercapacity
Johor 305 253 83.0
Kedah 223 181 81.2
Kelantan 191 165 86.4
Melaka 148 108 73.0
Negeri Sembilan 223 140 62.8
Pahang 214 166 77.6
Perak 314 216 68.8
Perlis 48 26 54.2
Pulau Pinang 153 124 81.0
Sabah 309 229 74.1
Sarawak 248 171 69.0
Selangor 1,279 970 75.8
Terengganu 268 213 79.5
WP Kuala Lumpur 281 211 75.1
WP Labuan 23 17 73.9
WP Putrajaya 111 88 79.3
MALAYSIA 4,338 3,278 75.6
+Care Policies: Aspirations & Options

61. KhazanahResearchInstitute
Low uptake of formal childcare
centres may be due to unaffordability
61
Note: Calculations made based on available data as reported to NCDC. For this datapoint, an estimated 9.5% of childcare centres in KL
reported data to NCDC, representing 29 TASKAs in the city, of which 16 are PERMATA TASKAs. Source: NCDRC and authors’
calculations
Average fees charged by TASKAs in Kuala Lumpur, by age group
934
435
225
151
934
847
894
750
151
123
104
0
100
200
300
400
500
600
700
800
900
1,000
1 – 12 months 13 – 24 months 25 – 36 months 37 – 48 months
Without
PERMATA
All
PERMATA only
RM
+Care Policies: Aspirations & Options

62. KhazanahResearchInstitute
Source: NCDRC. Caveat: based on data made available to NCDRC, may not be representative of
all salaries for all states.
Teacher salaries often cited to be the
cause for high childcare fees, but…
There are many
challenges underlying the
affordability of formal
childcare centres:
Parents are stretched
thin,
Teachers are paid low
and
Childcare centres are
struggling to make a
profit.
Average childcare teacher salary by state
62
+Care Policies: Aspirations & Options
1,094
1,219
1,244
1,299
1,306
1,343
1,364
1,374
1,399
1,498
1,506
1,613
1,635
1,672
1,763
1,779
0 200 400 600 800 1,000 1,200 1,400 1,600 1,800 2,000
Kelantan
Pahang
WP Putrajaya
Sabah
Selangor
Johor
Sarawak
WP Labuan
Kedah
Terengganu
Perak
Perlis
Negeri Sembilan
WP Kuala Lumpur
Melaka
Pulau Pinang
RM

63. KhazanahResearchInstitute
Note: Numbers in parenthesis represent the effect without the care allowance
programme
Source: Authors’ calculations, based on several assumptions
Incentivising demand-side of formal
childcare can produce significant
impact
Childcare allowance conditional on
sending children to JKM-licensed
childcare centres.
63
Estimated impact of a monthly RM100 care allowance:
1
Boost growth of formal
childcare sector
by increasing use
Help induce non-working
mothers to work
by alleviating affordability as
a barrier
2
+Care Policies: Aspirations & Options
Impact 1-year forecast 5-year forecast
GDP
growth
to RM1.293t
(RM1.287t)
Growth at 5.1%
(4.7%)
to RM1.587t
(RM1.554t)
Growth at 5.2%
(4.8%)
Women’s
labour force
participation
rate
to 56.0%
(55.4%)
to 62.5%
(59.4%)
Employment
in childcare
centres
to ~21,900
(~18,600)
to ~57,500
(~41,200)
From RM1.230t
From 54.4%
From ~12,900

64. 64
Aspiration #2
Equal participation in
domestic work, not just
market work

65. KhazanahResearchInstitute
We ask women to take up paid work,
but do not ask men to take up care
work
65
Noted importance of
women’s role in
family development
Promoted new centres
to provide care and
vocational training
facilities for PWDs, and
old persons’ homes
1980 1990 2000 2010 2018
4th MP
(1981 – 1985)
55% women in
labour force by
2015
• 59% women’s participation
by 2020
• FlexWorkLife (work from
home programme) and
Career Comeback
10th MP
(2011 – 2015)
11th MP
(2016 – 2020)
Broad policy goals of gender equality as a central
objective, in line with the principle of non-discrimination
enshrined in the Federal Constitution.
National Women’s Policy (1989)
5th MP
(1986 – 1990)
• Flexible working arrangements via
amendments to Employment Act
1955 .
• Tax exemptions for healthcare
spending for children taking care of
their aged parents.
7th MP (1996 – 2000)
• 30% women in decision-making positions
• Care options explicitly considered as a strategy: to
increase provision of childcare facilities and promote
flexible working arrangements to facilitate greater
women participation
• RM20m for PERMATA, providing heavily subsidised
childcare centres for low-income working parents
9th MP (2006 – 2010)
• Promoted state and market care options to
facilitate women entering the workforce.
• Acknowledged that “the dual and often,
competing responsibilities of family and
career restrict the mobility and increased
participation of women in the labour market.”
• Introduced measures e.g. tax exemptions for
workplaces which establish childcare centres at
the premises or nearby, with main objective of
increasing women’s labour force participation
6th MP (1991 – 1995) National Policy for
Older Persons (2011)
+Care Policies: Aspirations & Options

66. KhazanahResearchInstitute
Extending paid parental leave can be a
step towards reducing women’s
double burden
66
“Some call women’s segregation into low-paid work a choice.
But it’s a funny kind of choice when there is no realistic option other than the children
not being cared for and the housework not getting done.”
-Caroline Criado-Perez
Author of Invisible Women
Women are entering the
labour market at a faster
rate than men are
participating in the
domestic realm
To a more gender-inclusive society:
• A more equal distribution of care work in
families via extended paid maternity and
paternity leave.
• Could be funded by transitioning parental
leave from employer’s liability to using
social insurance e.g. including it to the
Employment Insurance System benefit
package.
+Care Policies: Aspirations & Options

67. 67
Aspiration #3
Ensuring quality care
provision without overly
burdening providers

68. KhazanahResearchInstitute
Most households use informal
forms of childcare services
68
Childcare arrangements Percentage
Grandparents 26.8%
Babysitter 24.0
Mother 16.9
Childcare centre 14.4
Relatives living elsewhere 5.6
Relatives living in the same household 3.9
Father 3.7
Older siblings 2.3
Domestic helper 1.5
Other arrangements 0.9
Childcare arrangements for children aged
below 6 years old among working women, 2014
Source: LPPKN (2016)
+Care Policies: Aspirations & Options
456 cases of child abuse in 2018 (MoHA).
Unregistered childcare centres can be
cheaper alternatives for parents.
ARCPM attributes rise in child abuse
cases to unlicensed childcare centres
and inexperienced childminders.
Informal providers can charge lower
fees as they save on financial costs of
complying with Child Care Centre Act.

69. KhazanahResearchInstitute
Introducing minimum care standards
in exchange for incentives for
informal providers
69
+Care Policies: Aspirations & Options
Developing and gradually introducing
minimum childcare standards for informal
care sector
Informal care providers given access to
financial incentives, legal and advisory
services, etc.
Strengthen informal childcare sector
accessible,
quality
childcare
profitability
for
providers

70. KhazanahResearchInstitute
Summary: Towards a coherent family
benefit structure for Malaysia
70
Possible family benefit structure for Malaysia
0 90d2w 4w 4y
Maternity Leave
Optional
Paternity
Leave
(Social
Employment
Insurance)
Fully-paid
Paternity
Leave
(Employer
Liability)
Conditional Childcare Allowance (Formal Care) + Care Incentives (Childminders)
+Care Policies: Aspirations & Options
Conditional childcare allowance would promote
growth of formal childcare sector.
Expansion of parental leave would encourage men
to take up care work and reduce women’s burden.
Incentives for childminders would ensure
minimum standards are met without overburdening
providers.
2.
1.
3.

71. The End
71