117.4 million women and men in Pakistan are engaged in unpaid care and domestic work - 66.7 million of them are women. As the world observes the International Day of Care and Support, the International Labour Organization (ILO) calls for stronger recognition of care work and coordinated action to ensure decent work, social protection, and equality for all care workers across the country.
Women are overrepresented in nearly all unpaid domestic and care roles - from cooking and cleaning to livestock tending and childcare. Around 60 per cent of women spend over 15 hours a week on domestic tasks, while less than 7 per cent of men do the same. Women also spend significantly more time on livestock management and caring for children, the elderly, or the ill.
This over representation leads to a time and opportunity poverty for women, creating direct barriers to entering and advancing in the paid domestic and care sectors and segregating them into lower-status roles, and a systemic gender pay gap.
Globally, women represent two-thirds of the health workforce yet earn on average 20 per cent less than men and remain underrepresented in leadership roles.
The ILO's Decent Work Country Programme (2023-27) identifies domestic, home-based, sanitation and nurses and community health workers as priority groups for enhanced rights and social protection, while promoting safe and gender-responsive workplaces across the economy.
Geir Tonstol, Country Director for ILO Pakistan emphasized, "The ILO in Pakistan aims to transform care work into decent work, providing care workers with dignity, fair wages, and comprehensive social protection. As a pathfinder country to the Global Accelerator for Jobs and Social Protection, Pakistan has the opportunity to leverage global partnerships and experience to scale up domestic investments - creating a virtuous cycle where decent jobs and stronger social protection foster more resilient economies and more just societies."
Through the ILO-OECD-WHO Working for Health (W4H) initiative, the ILO supports Pakistan's efforts to integrate occupational safety and health (OSH) into healthcare regulations, improve working conditions, and build workforce capacity.
Investing strategically in the care economy of Pakistan is essential for growth, equity, and gender equality - and it starts with the people who care for us. In the National Health Vision for Pakistan, the government pledges to raise health sector allocation to at least 3% of GDP by the next decade. This investment will help create safer workplaces, strengthen training, and retain quality healthcare professionals. The ILO together with the Ministry of National Health Services, Regulations and Coordination (MoNHSR&C) is committed to developing a national OSH policy for the health sector to enhance worker safety and progress toward Universal Health Coverage.
Building on this momentum, the ILO's Promoting Rights and Social Inclusion (PRS) Project, supported by the Government of Japan, has strengthened voice and representation for domestic workers in Punjab. In 2025, the United Domestic Workers Federation was registered, representing domestic workers across the province.
"The PRS Project has given voice and visibility to domestic workers in Punjab," said Arooma Shahzad, General Secretary, United Domestic Workers Federation. "The registration of the Domestic Workers Employers Association and the development of a Code of Conduct for employers are concrete steps that show the commitment of the employers to sit down and open dialogue on this critical issue," she added.
To sustain progress in the care sector, Pakistan requires coordinated efforts and increased investment to transform the care economy. This means establishing minimum education and training requirements, ensuring access to lifelong learning, improving career pathways for new entrants while retaining experienced workers, guaranteeing fair wages, promoting safe and healthy working conditions, providing adequate rest periods, and extending comprehensive social protection, including maternity benefits and safeguards against excessive or non-standard work arrangements.
The ILO's 5R Framework aims to address unpaid care work by reducing, recognizing, and redistributing it, while also rewarding and representing care workers. Pakistan's adoption of this framework will help protect workers' rights and support sector growth.
