The Needs of Carers in Low- and Middle-Income Countries

Unpaid carers are an integral part of wider healthcare systems in just about every country in the world. In the UK, unpaid carers have access to a range of support services, and the quality of care is increasing as a result. However, carers in low- and middle-income countries often face a multitude of challenges due to factors such as limited access to resources, inadequate healthcare infrastructure, socio-economic disparities, and cultural norms. How does this affect their needs, and what can be done to help?

What Are the Main Needs of Carers in Low- and Middle-Income Countries?

By understanding the differences in needs, charities such as Carers Worldwide are able to target where communities can benefit the most from donations and projects. The main needs usually consist of the following:

• Access to healthcare services
• Financial support
• Education and training
• Mental and social support
• Respite care
• Recognition and advocacy

Access to Healthcare Services

Unpaid carers require access to affordable and reliable healthcare services, including preventive care, treatment for chronic conditions, and mental health support. In many low- and middle-income countries, healthcare services may be limited or inaccessible, making it difficult for carers to ensure the well-being of their loved ones, and themselves. Examples of healthcare services which could be inaccessible for carers include hospitals and GPs for both emergency and routine treatments, pharmacies for important medication requirements and occupational therapists (OTs) for more specific home needs, such as equipment for those who have disabilities. The geographical location of unpaid carers could also affect the accessibility of healthcare services, with rural families living significantly further away from hospitals and pharmacies, for example. Those living in cities may find healthcare services are more accessible, but also more overcrowded or have longer waiting times. 

Financial Support

Carers in these countries often shoulder the financial burden of caring for their family members, which can include expenses related to medical treatment, medications and daily living needs. Many carers face financial hardship due to low incomes, lack of employment opportunities and limited social safety nets, so it is no surprise that 92% of family carers worry about money. In the UK and other high-income countries, there are a number of grants and funds available to unpaid carers, but those in parts of the world simply do not have access to such funds. This is particularly important when coupled with the fact that many unpaid carers give up paid work in order to provide care to family members, adding more of a financial strain on the family. This has a knock-on effect on the economy too, as there is a reduction in economically active individuals since they are providing unpaid care. 

Education and Training

Carers in low- and middle-income countries may lack the necessary knowledge and skills to provide effective care for their loved ones, particularly if they are dealing with complex medical conditions or disabilities. This is down to the lack of education received, particularly for women/girls, who make up the vast majority of unpaid carers in such countries; there is still a disparity in education between males and females, with poorer families often favouring boys for education. According to UNICEF, 129 million girls are out of school, worldwide, with only 49% of countries having achieved gender parity in primary education, 42% in lower secondary and 24% in upper secondary education. This lack of education affects the quality of caregiving, and unpaid carers will often lack any access to further education on the needs of those who need to be cared for. More investments into education for girls may see a significant shift in the quality of care provided later in life, and could potentially boost the healthcare economy as a whole in low- and middle-income countries. 

Mental and Social Support

Caregiving can take a toll on the mental and emotional well-being of individuals, especially in the absence of adequate support systems, which is predominantly the case in low- and middle-income countries, currently. Carers may experience stress, anxiety, depression, and feelings of isolation across the world, but this is exacerbated in countries, such as India, Bangladesh and Nepal, where a balance between providing care and life outside of caring is unsustainable. Providing this care often creates social disparity leading to poorer mental health. However, the mental health of unpaid carers is becoming a more frequent talking point worldwide, with celebrations such as Mental Health Awareness Week often tailoring more towards the mental well-being of unpaid carers worldwide, but there is still a long way to go in terms of providing adequate mental and social support for carers.

Respite Care

Caregiving is often a round-the-clock responsibility, leaving carers with little time for rest and self-care. As mentioned above, this can contribute to poor mental health, with increasing levels of loneliness and stress being experienced by unpaid carers. Respite care services, which provide temporary relief for carers by allowing them to take breaks from their caregiving duties, are essential to prevent burnout and ensure the long-term sustainability of caregiving arrangements. However, respite care services are seen much more commonly in some countries such as the UK in comparison to low- and middle-income countries such as India. This lack of access to respite care means that unpaid carers in low- and middle-income countries experience burnout on a more regular basis, having little opportunity to have a break from daily care duties. 

Recognition and Advocacy

Carers in low- and middle-income countries may lack recognition for their contributions to society and face stigma or discrimination due to their caregiving roles. The negative attitudes towards unpaid carers in these countries may occur from those who are economically active, seeing unpaid carers as “less important” to the overall economy. The lack of appreciation towards unpaid carers may also stem from education standards or cultural norms of attitudes towards women (who make up the majority of unpaid carers in such countries). Advocacy efforts are needed to raise awareness about the importance of caregiving and to advocate for policies and programs that support carers' rights and well-being.

Carers Day

What Can We Do to Help?

Having looked into the needs of unpaid carers in low- and middle-income countries, there are a number of key ways in which further investments could benefit carers across nations such as India, Nepal, Bangladesh and beyond. A focus on education, healthcare services and mental health services could be pivotal in the development of unpaid care, addressing the needs of the carers and the quality of care they are able to provide. Levelling educational opportunities for girls is a challenge which many charities are looking to address, as well as further investment into hospitals, pharmacies and mental support groups.

At Carers Worldwide, our projects are based around our Carers Worldwide Model, which meets these needs and transforms the holistic well-being of unpaid carers. Some of the projects include:

• In Odisha, India, we’ve promoted income-generating activities for unpaid carers and established a revolving fund which will support many more carers in the future.
• In Tamil Nadu, India, we are working with 500 people with mental illnesses and 500 unpaid carers, looking to reduce feelings of isolation in carers, improve their mental well-being and increase their confidence in advocacy skills.
• Across 18 districts in Nepal, we have created a project which provides information, advice and psychosocial support for family carers and their disabled children via a telephone helpline and printed resources.
• In Kaski and Syangja, Nepal, we helped to improve the physical and mental health of 200 family carers who were caring for individuals with mental illnesses or disabilities, promoting social inclusion and increasing household income. 
• Across Bangladesh, we have implemented the full Carers Worldwide Model, giving 1,008 carers access to medical advice and counselling, forming 50 carers groups and training 425 carers, engaging in livelihood activities.
• Also in Bangladesh, we provided nutritious food and vital emergency medical and therapeutic support to 108 children with disabilities alongside 431 adult carers during Ramadan 2023.

Get Involved to Help Carers in Low- and Middle-Income Countries

Since we started in 2012, we have transformed the lives of more than 180,000 carers and family members. We have only been able to do that with the generosity of supporters like you! If you’d like to get involved in helping the lives of unpaid carers, explore our fundraising opportunities or donate to make a difference.