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A Comparative Exploration: Unpaid Care in the UK vs. Low- and Middle-Income Countries

Published: 14 May 2024
Updated: 14 May 2024
Woman distributing medication to individuals at a table.

In the UK, around 5.7million people are providing unpaid care. That’s around 9% of the UK population. This kind of data doesn’t exist in many countries around the world, but if we were to use this figure as a guide, then we could expect there to be 126 million carers in India, 15.25 million in Bangladesh and 2.7 million in Nepal (Our Work in Nepal | Carers Worldwide). With more people living longer, the number of unpaid carers is only going to increase.

Unpaid care, often undertaken by family members or friends, is a vital yet often overlooked component of healthcare systems worldwide. In this blog post, we delve into the nuances of providing unpaid care in two contrasting contexts: the United Kingdom and low- and middle-income countries (LMICs) such as India, Nepal, and Bangladesh, where Carers Worldwide operate. By examining factors such as healthcare structure, cultural perspectives, access to medication and technology, public health initiatives, and mental health differences, we aim to shed light on the diverse challenges and realities faced by unpaid carers in these settings.

A woman sitting at a table with another woman wearing a hijab, measuring blood preasure.

Healthcare Structure

In the UK, a comprehensive national healthcare system, the National Health Service (NHS), provides free or subsidised healthcare to all residents. This structure alleviates some financial burdens on carers, as medical consultations, treatments, and medications are largely covered. In LMICs like India, Nepal, and Bangladesh, healthcare systems vary widely in their accessibility and quality. Many rely heavily on out-of-pocket expenses, placing significant financial strain on families. Consequently, unpaid carers in LMICs often shoulder not only the responsibilities of caregiving but also the financial burdens of accessing essential healthcare services.

Two women in traditional saris having a conversation

Cultural Perspectives

Cultural attitudes towards caring play a significant role in shaping the experiences of unpaid carers. In the UK, there is growing recognition and support for carers, with initiatives aimed at providing respite care, counselling, and financial assistance. In April 2024, the Carer’s Leave Act came into force, meaning that working unpaid carers are now entitled to one week of unpaid leave a year to give or arrange care. However, cultural expectations may still place pressure on individuals to prioritise caring over personal pursuits or career aspirations.

In LMICs like India, Nepal, and Bangladesh, familial caregiving is deeply ingrained in cultural norms, with little formal support from government or societal institutions. While this may foster strong familial bonds, it can also perpetuate gender inequalities and hinder economic opportunities for carers, particularly women. At Carers Worldwide, we were very proud of our achievement in influencing the Government of Karnataka, India, to announce a Carers Allowance in their 2024-25 budget. This allowance will be Rs1,000/month for carers of people with Cerebral Palsy, Muscular Dystrophy, Parkinson's & Multiple sclerosis. This is truly advocacy in action and is the result of a lot of long-term work behind the scenes advocating for unpaid carers and highlighting the importance of financial support for carers. This shows the power of our advocacy work and is just the beginning.

Access to Medication and Technology

Access to medication and technology significantly impacts the quality of care provided by unpaid carers. In the UK, the availability of advanced medical treatments and assistive technologies can enhance the independence and well-being of care recipients. However, disparities in access may still exist, particularly for marginalised communities. In LMICs like India, Nepal, and Bangladesh, limited access to essential medications and medical equipment presents formidable challenges for carers, who often resort to improvised solutions or alternative therapies. Addressing these disparities requires concerted efforts to improve healthcare infrastructure and strengthen supply chains in resource-constrained settings.

Public Health Initiatives

Public health initiatives aimed at supporting carers vary widely between the UK and LMICs. In the UK, government-funded programmes offer practical assistance, education, and emotional support to carers, recognising their crucial role in the healthcare system. In contrast, LMICs may face resource constraints and competing health priorities, resulting in limited support for carers at the policy level. Efforts to integrate carer support into broader public health agendas can help bridge this gap and promote the well-being of both carers and care recipients.

A man and a woman are positioned in front of a store smiling.

Mental Health Differences

The mental health impact of caring differs between the UK and LMICs due to varying levels of support and stigma. In the UK, carers have access to mental health services and peer support networks, which can help alleviate stress and prevent burnout. However, stigma surrounding mental health issues persists, potentially deterring carers from seeking help. In LMICs like India, Nepal, and Bangladesh, cultural norms may dictate that caring is an expected duty, minimising recognition of carers' emotional needs. Addressing mental health disparities requires destigmatisation efforts and the integration of psychosocial support into healthcare services across diverse cultural contexts.

In conclusion, while unpaid caring is a universal phenomenon, the experiences of carers vary significantly between the UK and LMICs such as the countries Carers Worldwide work in: India, Nepal, and Bangladesh. By understanding the distinct challenges and resources available in each context, policymakers, healthcare professionals, and communities can work towards fostering more supportive environments for carers worldwide.

What Can We Do to Make a Difference?

At Carers Worldwide we work with our local charity partners to implement our Carers Worldwide Model, promoting the emotional, physical and financial well-being of unpaid carers and equipping carers to advocate for their rights.

carers worldwide model diagram

Learn more about the Carers Worldwide Model

Could You Help Support Unpaid Carers in Low- and Middle-Income Countries?

Could you spare some time to make a real difference to the lives of unpaid carers and their families in India, Nepal and Bangladesh? If yes, then please volunteer with us!

We know that everyone has different skills and interests. That is why we offer a variety of volunteering opportunities to suit you, your time and your skills. Please have a look at the current volunteering opportunities available.

A woman standing beside a clothes-covered tent in a picturesque setting.