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Publié sur octobre 29, 2024

Building a Foundation for Care:  The Journey to a National Care System in the Dominican Republic


“Care policies are essential if we want more people to receive quality care, but above all, to create decent and quality jobs in the Dominican Republic. This is crucial for advancing toward much stronger, more ambitious and life-friendly welfare states”. 

Ángel Serafín, Sectoral Coordinator of the Ministry of Economy.  

Imagine a society where caregiving is not solely shouldered by women but embraced as a collective responsibility. As of the end of 2019, 6.0% of the employed population in the Dominican Republic was engaged in paid domestic and care work, a sector predominantly composed of women, who make up 92.9% of this workforce. This gender disparity is even more pronounced in the informal sector with women constituting an overwhelming 94.1% of the workforce and men only 5.9%. (1)

Recognizing the need for transformation, the Dominican Republic launched the "Communities of Care" (2) pilot in 2021. In 2022, with the Joint SDG Fund's support, the pilot expanded to the programme “Care Communities: Design and Implementation of the National Care Policy Pilot in Prioritized Territories of the Dominican Republic,” (3) to develop comprehensive solutions initially focusing on the municipalities of Azua and Santo Domingo Este and addressing the diverse needs of the population. This project was implemented by UN Women, ILO, UNFPA, and UNDP. With active leadership from government institutions such as the Ministry of Economy, Planning, and Development, the Ministry of Women, SUPÉRATE, National Council for the Elderly (CONAPE) National Institute for Comprehensive Early Childhood Care (INAIPI), National Institute for Technical and Professional Training (INFOTEP), and more than 10 institutions, this program has laid crucial groundwork to address care needs while promoting gender equality and economic empowerment. 

The pilot’s achievements stem from the combined efforts to strengthen institutional frameworks, foster inclusive social dialogue, modernize training programs, and improve information systems. Through these initiatives, significant progress has been made in redefining care as a fundamental right, not a luxury.

 

Before and After: Unlocking Wins and Takeaways 

“For the first time in the country, we are seeing this issue as a high priority for investment and for promoting the development of people who need care and those who dedicate themselves to caregiving.”  

Nisaly Brito, Former Director of Comprehensive Women's Rights, Ministry of Women.

The journey toward building a comprehensive and inclusive care system in the Dominican Republic has seen remarkable progress. These actions have transformed the landscape of care management, strengthening institutions, modernizing training, and promoting cultural change. These efforts have established a more coordinated and sustainable approach, setting the foundation for a care system that truly meets the needs of all.  

Also, the initiative has advanced several SDGs by promoting inclusion and gender equality in the workforce, strengthening the State's role in protecting vulnerable populations. By professionalizing care work and improving working conditions, it enhances equal employment opportunities. Additionally, it boosts data collection capacity, supporting evidence-based policies for sustainable development.  

Some key achievements and lessons learned across four areas—institutional strengthening, strategic communication, training programs, and information systems—that contribute to a fairer and more effective care framework, have been: 

  • Institutional Strengthening and Care Management: Key achievements in institutional strengthening and care management include establishing the Intersectoral Care Committee, which has improved coordination among ten key institutions. The adoption of a Methodological Guide for Local Plans has promoted a sustainable approach to care management, enhancing institutional capacity. Additionally, the draft document for the preliminary bill is crucial for creating a legal framework that ensures quality and equitable care rights, facilitating governance through inter-institutional collaboration and serving as foundational input for discussions within the committee and Congress. 
  • Strategic Communication and Awareness: The program's communication strategy shifted cultural attitudes towards valuing care work and encouraged equitable responsibility distribution. The unified visual identity and spokesperson workshops helped foster dialogue with civil society and private sector actors, raising awareness of the importance of care. 
  • Modernized Training Programs: The professionalization of care training aligned with the National Qualifications Framework, incorporating human and gender rights. New programs, such as "Personal Assistance for People with Disabilities,"4 prepared caregivers for various roles while ensuring quality care. 
  • Enhanced Information Systems: Improved statistical and information systems enabled better management of care services' supply and demand. Through georeferenced mapping and quality assessments, the interconnected registry facilitated institutional coordination for a more equitable care system. 

 

Scalation and Expansion: Recommendations for Sustaining the Momentum 

“States must promote all possibilities, technical assistance, and reasonable accommodations to foster personal autonomy and independent living for all individuals, including people with disabilities” 

Damaris Solano,  Inclusion and Human Rights expert and instructor of the first training program for personal assistance to people with disabilities requiring support in the Dominican Republic

 

 

As we look to the future, we must strengthen our commitment to developing a robust care system. The next steps involve: 

  • Securing Financial Resources: To enhance funding for local care plans in Azua and Santo Domingo Este, as well as nationwide, it’s essential to engage financial authorities in meaningful dialogues. Advocating for resource allocation within the National Budget will support care services at all levels. Additionally, diversifying funding sources, including social bonds, can unlock new resources for care initiatives. By projecting future needs, we can establish a sustainable financial framework that adapts to the evolving landscape of care demands across the Dominican Republic. 
  • Expanding Representation: Enrich the Intersectoral Care Committee by expanding its representation to ensure diverse perspectives contribute to our mission. To enrich the Intersectoral Care Committee, it is essential to broaden its representation by including diverse stakeholders. This expansion should involve civil society organizations, the private sector, academia, and community leaders to ensure various perspectives contribute to our mission.  
  • Fostering Inclusive Dialogue: Promote social dialogue with civil society and the private sector to shape a unified proposal for our Care System. Engaging voices from marginalized communities will help us better understand their unique challenges and needs. By fostering this inclusivity, we can enhance our decision-making processes and develop comprehensive solutions that effectively address the complexities of caregiving and promote a robust care system in the Dominican Republic. 
  • Professionalizing Care Work: Prioritizing the professionalization of care work is essential for improving caregivers' status and working conditions. Implementing training and certification programs will ensure caregivers receive recognition and develop essential skills for high-quality care. This initiative will enhance job security, promote equitable wages, and attract more individuals to the profession. Furthermore, establishing clear career pathways will empower caregivers, fostering their growth and ultimately improving the overall quality of care within the system. 
  • Developing Comprehensive Mapping: Creating a national mapping of care services is essential for identifying gaps and ensuring effective resource allocation. By conducting studies on critical issues like elder abuse, we can gather vital data that informs evidence-based policy design. This comprehensive mapping will facilitate collaboration among stakeholders, enabling targeted interventions to address the specific needs of vulnerable populations. Ultimately, this initiative aims to promote transparency and accountability within the care system, ensuring that all individuals receive the support they need. 

Together, these recommendations will guide us toward a more resilient and equitable care system that truly meets the needs of all members of our society. 

 

A Milestone for the future in Care Policy Development 

“This project demonstrates how one of the main barriers to women´s participation in the labor market can be eliminated” 

Melvin Asin, Head of Cooperation to European Union Delegation in Dominican Republic

 

 

This Joint Program has laid a solid foundation for a more equitable and efficient care system while sparking a broader societal shift toward recognizing and valuing care work. Through coordinated efforts and sustainable initiatives, significant strides are being made toward building a more inclusive society, where opportunities are expanded for all. 

Between 2023 and 2024, the pilot reached a pivotal moment, significantly influencing the policy development process and generating momentum for regional funding to scale up care initiatives. The "Communities of Care" program received further recognition when the Dominican Republic earned second place in the Social Category of the 2024 Small Island Developing States (SIDS) Partnerships Awards, acknowledging its vital contributions to a National Care Policy projected to benefit around 850,000 people. Additionally, the presentation to Joint SDG Fund donors, including representatives from the European Union, Switzerland, Germany, Italy, Spain, Portugal, and the Netherlands, marked a significant step in advancing the National Care Policy and mobilizing resources for the LAC region. Notably, the UN System in the Dominican Republic is currently developing a Cooperation Strategy on Care Policy to ensure the sustainability of these initiatives and interactions. 

In closing this blog, is crucial to understand that the National Care Policy is more than just a framework; it's a bold commitment to redefining our social fabric and championing human rights in the Dominican Republic. By elevating care to a shared responsibility, this policy ignites social change, inspires innovation, and empowers individuals to take charge of their own lives. With robust financing, we can turn this vision into reality, ensuring that care services are accessible and effective for all. Together, we are not just building a care system; we are cultivating a culture of support and solidarity that will strengthen our communities for generations to come. 

 

For more information about the results of the project visit this link.

 

(1) Paid Domestic Work in the Dominican Republic: Challenges in the Context of COVID-19. ONE, MEPyD, ECLAC (2021) 

(2) Communities of Care Pilot in the Dominican Republic: https://mepyd.gob.do/comunidades-de-cuidado  

(3) Crafting a National Care System: 5 things you should know about the development of a Communities of Care pilot in the Dominican Republic https://jointsdgfund.org/article/crafting-national-care-system-5-things-you-should-know-about-development-communities-care  

El proyecto “Comunidades de cuidado” de República Dominicana es reconocido por los Premios PEID 2024 https://dominicanrepublic.un.org/es/268830-el-proyecto-%E2%80%9Ccomunidades-de-cuidado%E2%80%9D-de-rep%C3%BAblica-dominicana-es-reconocido-por-los-premios  

The Dominican Government and the UN present results to donors of the Joint SDG Fund https://www.jointsdgfund.org/article/dominican-government-and-un-present-results-donors-joint-sdg-fund  

Methodological Guide For The Elaboration And Structure Of Local Care Plans In The Dominican Republic https://www.jointsdgfund.org/publication/methodological-guide-elaboration-and-structure-local-care-plans-dominican-republic  

Assisting people with disabilities in the Dominican Republic: https://www.jointsdgfund.org/article/assisting-people-disabilities-dominican-republic  

 

Note:

All joint programmes of the Joint SDG Fund are led by UN Resident Coordinators and implemented by the agencies, funds and programmes of the United Nations development system. With sincere appreciation for the contributions from the European Union and Governments of Belgium, Denmark, Germany, Ireland, Italy, Luxembourg, Monaco, The Netherlands, Norway, Poland, Portugal, Republic of Korea, Saudi Arabia, Spain, Sweden, Switzerland and our private sector funding partners, for a transformative movement towards achieving the SDGs by 2030.

 

 

Created by Dominican Republic UN Interagency Team – Joint SDG Fund Communities of Care 

Beatriz García, Technical Specialist on Economic Empowerment at UN Women Regional Office for the Americas and the Caribbean 

Marta San Juan, Women's Economic Empowerment Consultant · UN Women 

Katherine Martínez, National Project Coordinator, ILO Country Office for Central America, Haiti, Panama and Dominican Republic  

Paz Arancibia, ILO Technical Specialist on Gender Equality and Non-discrimination 

Larraitz Lexartza, Gender Officer of the ILO office for Central America, Panama, Dominican Republic and Haiti 

Laura Suazo, Population and Development Officer, UNFPA 

Alberto García, Gender Projects Associate, UNDP 

Noemi Gomez, Coordinator of the Joint Project Communities of Care United Nations System in the Dominican Republic 

Mildred Samboy, Partnerships and Development Finance Officer, UNRCO Gender/Care Policy Focal Point