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Long-Term Care is a Human Rights Issue

December 6, 2019 por Gianluca Cafagna Leave a Comment


“Everyone, as a member of society, has the right to social security and is entitled to realization, through national effort and international cooperation and in accordance with the organization and resources of each State, of the economic, social, and cultural rights indispensable for his dignity and the free development of his personality.”

This quote is from Article 22 of the Universal Declaration of Human Rights, adopted one December 10th 71 years ago by the United Nations General Assembly.

On the long path to full recognition of the rights and dignities of all human beings, countries in Latin America and the Caribbean run the risk of overlooking an issue of growing urgency in the region: long-term care. This means care for people who can no longer independently perform the basic activities of daily living, like washing themselves, eating, or getting in and out of bed.

Offering formal long-term care services would be a step towards full recognition of human rights in Latin America and the Caribbean, particularly for:

  • Older people:

    Today, there are more than 8 million care-dependent adults in Latin America and the Caribbean, or 12% of those over age 60 in the region. This figure will rise substantially in the next 30 years. The number of care-dependent older people will more than triple by 2050, reaching 27 million. It is important to recognize that although care dependence is much more prevalent among older people, it affects people of all ages. For example, in Costa Rica in 2018, 54% of care-dependent people were between ages 18 and 59.[1]

  • Women:

    Long-term care is a gender issue for two reasons. First, women live longer than men and have more long-term care needs. Second, long-term care services in Latin America and the Caribbean are in short supply (in Mexico, for example, one out of every four severely care-dependent older people receives no care at all) and are provided mostly by women in families. Therefore, developing a formal market of care services could help increase women’s labor force participation by reducing their workload as family caregivers. It also has the potential to create job opportunities for women in the field of caregiving.

  • Caregivers:

    Family caregivers often live in situations of stress and isolation, have difficulties keeping up with their studies or work, and may even neglect their own health. For that reason, the availability of formal long-term care services also impacts the lives of caregivers. Delia gives an excellent explanation of this dynamic in this video produced by the Sistema de Cuidados de Uruguay [Uruguayan Care System], the first nationwide long-term care system in Latin America and the Caribbean.

To ensure that the dignity and rights of everyone mentioned above are respected, Latin American and Caribbean countries should build long-term care systems, and they should do it now. If they do not act immediately, countries will not have the time and financial resources they need to meet the growing demand for services.

This is the central message of the new flagship publication of the Social Protection and Health division of the Inter-American Development Bank (IDB): “Age with Care: Long-term Care in Latin America and the Caribbean.” The publication offers both an analysis of the current state of long-term care in the region and specific recommendations for countries that wish to design and implement a long-term care system, even if they start on a small scale. The recommendations are:

  1. Choose the system’s beneficiaries based on level of care dependence rather than age;
  2. Deliver transfers that have to be spent on long-term care services;
  3. Start with home care services;
  4. Involve the private sector to create formal jobs;
  5. Train human resources and establish quality standards;
  6. Use a mix of financing mechanisms to set up a single, unified system.

To learn more about each of the six recommendations, be sure to watch this video!

We believe that both the content and form of our work should reflect our commitment to human rights and the effective inclusion of all people. We have therefore worked to make “Age with Care” the first IDB publication that is interactive (it includes other videos and motion graphics) and accessible to as many people with disabilities as possible.

How about you? Do you have an example of how long-term care services have improved your life, or that of a family member? Share your experience in the comments section or mention @BIDgente on Twitter.

[1] Medellín, N., Jara, P., & Matus-López, M. (forthcoming). Envejecimiento y atención a la dependencia en Costa Rica (Technical Note No. IDB-TN-01820). Washington, DC: Inter-American Development Bank


Filed Under: Aging and Dependency Tagged With: ageing, aging, América Latina, América Latina, Banco Interamericano de Desarrollo, Banco Interamericano de Desarrollo, BID, BID, care dependence, human rights, IDB, Inter-American Development Bank, long term care, políticas públicas, políticas públicas

Gianluca Cafagna

Gianluca Cafagna has been an Associate Professional Officer in the IDB's Social Protection and Health Division since November 2016. His work focuses on healthcare systems strengthening, digital health, and long-term care. He contributes to the preparation of loan operations in the health sector, as well as to the research agenda. Before joining the IDB, Gianluca worked for the United Nations Development Programme, in Panama and the Dominican Republic. His work has been published in peer-reviewed journals such as the International Journal of Equity in Health and BMC Health Services Research. An Italian national, Gianluca holds a Ph.D. in Healthcare Management from the Sant’Anna School of Advanced Studies of Pisa and a MSc in Economics from Bocconi University of Milan.

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Latin American and Caribbean countries face multiple challenges to provide quality healthcare for their citizens. In this blog, IDB Specialists and international experts discuss current health issues and hope to build a dynamic dialogue through your comments.

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