Figure corresponds to 25% of the employed population and was released as the country draws up its first national policy on the topic
Mariana Waechter
From domestic workers, nurses, and elderly caregivers to physicians, cooks, cleaners, drivers, teachers, and hairdressers, a contingent of 24 million caregiving professionals accounted for 25.2% of Brazil’s employed population in 2019. As the nation prepares to introduce its first national policy for this sector, the size of the workforce has only recently been comprehensively estimated, in a collaborative study conducted between 2022 and 2023 by researchers from the Department of Sociology at the School of Philosophy, Languages and Literature, and Humanities of the University of São Paulo (FFLCH-USP), the Brazilian Center for Analysis and Planning (CEBRAP), and the Institute of Applied Economic Research (IPEA).
Nadya Guimarães, a sociologist affiliated with FFLCH-USP and CEBRAP, notes that academic research about the caregiving sector in Brazil has steadily expanded since 2000, in line with international trends. She is among the authors of the recent study, jointly funded by FAPESP and the Transatlantic Platform — a collaboration between humanities and social science research funders from South America, North America, and Europe. Preceding this study, she explains, there is a substantial body of academic literature on the issue of unpaid domestic work performed by women, typically explored within the framework of feminist theory.
For example, this was the topic of the cover article in the January 2021 issue of Pesquisa FAPESP (see Pesquisa FAPESP issue nº 299), and the subject of the essay for the National High School Examination (ENEM) in 2023. “In Brazil, there have also been a wide range of studies on domestic employment, given its significant role in the economic integration of impoverished women,” notes Guimarães. These studies not only shed light on the needs of care recipients — such as young children, dependent elderly, and individuals with special needs — but also on the caregivers themselves, whose rights and needs have often been neglected.
In Brazil, a major research gap in this field stems from the lack of official statistics. A recent article by Guimarães and Luana Simões Pinheiro, a sociologist at IPEA, noted that it was only in 2002, with the introduction of the new Brazilian Classification of Occupations (CBO), that a substantial portion of the paid caregiving workforce —comprising caregivers for the elderly, people with disabilities, and bedridden individuals — could be quantified. “We took on the challenge of comprehensively quantifying the large contingent of caregiving professionals in Brazil. We classified the various services commonly provided in this market to scope out the boundaries of paid caregiving work in the country,” says Guimarães. Their article was published in CEBRAP’s Working Papers series and is also featured in the collection Cuidar, verbo transitivo (Caring: a transitive verb), published by IPEA in 2023. Establishing these boundaries is important, particularly in identifying professionals in sectors like healthcare and education who are engaged in caregiving.
Mariana Waechter
Previous studies, such as a 2018 report by the International Labour Organization (ILO), have attempted to measure the size of the care workforce. However, these reports have often included individuals not directly involved in caregiving, such as hospital directors and school administrative staff. “We dissected the official statistics to improve the accuracy of our estimates,” Guimarães remarks. The study drew upon data from the Continuous National Household Sample Survey (PNAD-C) by the Brazilian Institute of Geography and Statistics (IBGE), supplemented by definitions from the CBO.
The authors used three dimensions to assess diversity within the caregiving sector. The first was the setting in which the work is carried out, whether within households as part of domestic employment or outside of the household setting. The second was the nature of the relationship with the care recipient—whether direct, as in the case of babysitters and caregivers, or indirect, as in the case of cleaners or cooks. The third dimension refers to the recurrence of the care relationship, which increases with the level of dependency of care recipients. “In situations of very low autonomy, recurrence becomes imperative since any discontinuation may not only compromise the quality of care and wellbeing of the beneficiaries, but their own lives,” Guimarães writes.
The caregiving sector primarily consists of household-based occupations, which can be categorized into two groups. The first group consists of professionals who have a direct and recurring relationship with the care recipient, such as elderly caregivers and babysitters. In 2019, this group totaled 1.1 million people (see chart). The second group consists of professionals who perform recurring tasks but have an indirect relationship with the care recipient. This includes cleaners, domestic workers, and cooks. In 2019, this group numbered 4.8 million people.
Alexandre Affonso / Revista Pesquisa FAPESP
“Professionals working in domestic settings were hardest hit during the pandemic,” says Simone Wajnman, a demographer at the Federal University of Minas Gerais (UFMG). In a study completed in 2023 with doctoral student Mariana Almeida, they found that these jobs saw a decline of 20% to 30% in the first half of 2020. However, by the end of 2021, the market had rebounded to pre-COVID-19 levels. “Although the recovery in employment opportunities is good news, these workers are now facing increased workload and responsibilities,” Wajnman adds.
In addition to domestic workers, Guimarães and Pinheiro also identified occupations outside the household setting. This category comprises three major groups. The first group includes professionals who have a direct and recurring relationship with care recipients, such as early childhood and special education teachers, nurses, and caregivers in institutional settings. This category employed 2.9 million individuals at the time of the study.
The second group comprises professionals like beauticians and hairdressers, who interact directly with care recipients but with less frequency and dependence. This group also includes healthcare professionals with a higher education, such as physicians, physiotherapists, dentists, and nutritionists. According to 2019 PNAD data and Guimarães and Pinheiro’s study, this group numbered 7.3 million professionals. The study found that in these two categories, which primarily consist of education and healthcare occupations, the public sector accounts for 40% and 50% of employment, respectively. Interestingly, this is the only group where Black individuals are not the majority (see chart below). “This is precisely the segment that represents the highest-income occupations,” Pinheiro notes.
Alexandre Affonso / Revista Pesquisa FAPESP
The third group, which involves less recurrent and indirect service provision, includes professionals like restaurant cooks and cleaning workers. This group is the largest within the caregiving sector, totaling 7.6 million people, with the majority working in the private sector.
“In total, the Brazilian labor market has around 70 caregiving occupations. These range from commonly recognized roles like nurses to others that are not traditionally viewed as caregiving professions,” says Guimarães. One less conventional group added to the CBO classification in 2015 is sex workers, based on the rationale that they “address sexual needs and provide support.” Individuals employed by religious institutions are another notable group identified in their research.
Besides differences in the nature of services provided, the study also highlighted racial and gender disparities within each occupational category. The researchers found that women represent 75.3% of the 24 million jobs in the care sector. Within the core group of occupations in domestic settings, characterized by closer and more recurrent interaction, women make up an overwhelming 98% of the workforce. Further analysis showed that 45% of these 24 million caregiving positions were held by Black women.
In 2019, out of every 100 employed women in Brazil, 14 were engaged in domestic work, serving as cooks, cleaners, or caregivers. Within this category, 63% of the positions were filled by Black individuals. “These statistics underscore that domestic work remains a primary pathway for women, particularly for Black women with lower incomes and educational levels, to enter the labor market,” notes Guimarães. A 2018 study by the International Labor Organization (ILO) revealed that Brazil has the highest proportion of domestic workers in its workforce among the 187 member countries.
Mariana Waechter
Luiza Nassif Pires, an economist at the University of Campinas (UNICAMP) and director of the Center for Research on Macroeconomics of Inequalities (MADE) at USP’s School of Economics, Business, and Accounting, observes that 92% of domestic workers in Brazil are women, and 63% of these women are Black. Even with the enactment of Law no. 150 in 2015, regulating the rights of domestic workers, Pires notes that their working conditions have remained substandard, with limited government protection, high levels of informality, and low wages.
He estimates that over 70% of domestic workers in Brazil are employed informally, and more than half earn less than one minimum wage (R$1,412.00) per month. “Not only is their income insufficient to meet basic needs today, it also means their social security contributions are proportionately small, potentially compromising their retirement security in the future,” Pires comments on the findings from the 2022 study, conducted in collaboration with other MADE members and the Center for Racial Justice and Law at the Getulio Vargas Foundation (FGV). The research results were published in an article early last year.
Also on the topic of racial disparities, Pinheiro from IPEA notes that his research with Guimarães revealed both gender and racial divisions in caregiving work. Taking nurses and nursing technicians as an example, despite women being the majority in both categories, the researchers identified racial disparities in education and pay: in high-paying nursing positions requiring higher education, white women were predominant, whereas in associate-level nursing technician roles, which involve lower salaries and intense interpersonal relationships, Black women were the majority.
According to Pinheiro, the data show that investments in programs aimed at creating or improving public caregiving services tend to benefit women most, and Black women in particular. In 2023, Pinheiro was seconded to the Ministry of Development and Social Assistance, Family, and Hunger Alleviation to serve as the Director of Care Economics at the National Bureau of Caregiving and Family Policies. Currently, she is one of the coordinators heading the development of the National Caregiving Policy and the National Caregiving Plan, both due to be announced by the federal government in the first half of this year. The policy proposals that will be included in the plan are being developed by a cross-ministry group established in March of last year, involving 23 federal government organizations as well as representatives from state and municipal governments, international organizations, and civil society.
Pinheiro explains that the new policies will target four priority groups: children and adolescents, with special attention to early childhood; the elderly and people with disabilities who require support for daily life activities; and caregivers, whether paid or unpaid. “With our aging population, demand for care among the elderly is increasing, placing a growing burden on women who provide this care within families,” she comments. The goal in the new policy is for the State to play a larger role in elderly care and reduce the workload for family caregivers.
Piecemeal legislation In Brazil, rules on caregiving rights and responsibilities are fragmented across a patchwork of laws and regulations
Brazilian law has largely addressed caregiving rights and duties in a piecemeal fashion. This is seen in both private law, governing caregiving duties within families, and in the social rights of caregiving professionals and recipients. “Each legal domain dealing with caregiving, even if not explicitly, does so through its own lens. Brazilian legislation lacks a cohesive framework on caregiving,” explains Regina Stela Vieira, a legal scholar at the Federal University of São Paulo (UNIFESP). Alongside fellow legal expert Pedro Augusto Gravatá Nicoli from the Federal University of Minas Gerais (UFMG), Vieira conducted a study between 2022 and 2023 to chart out the introduction and progress of caregiving regulation in Brazil.
The laws pertaining to caregiving rights and duties in the country include the Civil Code, Penal Code, Consolidated Labor Laws (CLT), the Child and Adolescent Statute (ECA), the Elderly Statute, and the Domestic Workers Law (Law no. 150/2015). “Each legal domain sees individuals involved in caregiving from a single-role perspective, as if one could only be a care worker, provider, or recipient. This highlights the system’s inability to deal with such a multidimensional issue,” Vieira notes.
This fragmented approach results in inconsistencies and conflicts. For instance, in full-time employment under the CLT regulations, parents are required to work eight-hour days with a one-hour break for meals. “This often conflicts with family caregiving responsibilities,” notes Vieira. While the National Education Guidelines Law mandates children to attend school from the age of four, public school hours often do not align with parents’ full-time work schedules. “Disjointed regulation prevents a more holistic approach to the rights and duties associated with caregiving in daily life under Brazilian law,” says Vieira. She hopes that the National Caregiving Policy currently being developed by the federal government will pave the way for integrating these disparate legal domains into a more coherent and unified framework.
Project Rebuilding care in a post-pandemic world (nº 21/07888-3); Grant Mechanism Regular Research Grant; Principal Investigator Nadya Araujo Guimarães (USP); Investment R$ 326,927.23.
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Mariana Waechter
