In Nepal, the recent surge in urbanization and foreign employment has brought about changes in family structure.

 Due to competitive life, high cost, single family, busy schedule, some people have difficulty finding time to take care of their children, disabled, sick or elderly family members, give them medicine and clean them. In such a situation, professional care centers or care houses have now become a necessity of urban life. 

Women in particular are still bound by the dual responsibility of household work and family care, which is not included in the economic calculation in large numbers. Due to the lack of adequate care houses, many women have to give up their careers and jobs to take care of their families full-time. Studies have shown that this has also hindered their financial independence.

According to a report by UN Women, discriminatory social norms regarding care and the lack of professional care centers mean that most of women's time is spent on unpaid care and housework. As a result, they are lagging behind in the labor market and education.

The experience of Krishna Kumari Shrestha, Deputy Director General of the Revenue Investigation Department, confirms how difficult it is for even high-ranking female employees to balance family and work. She said that she was able to fulfill her responsibilities while raising her two children because of the availability of a day care center within Singha Durbar. Since there was no other guardian to leave the child at home and her husband was also in a government job, she was forced to carry the child to the office. 

‘Since there was a day care center within Singha Durbar, I used to leave the child there all day and go to the office,’ says Shrestha. ‘When I reached the position of officer to deputy secretary, both children grew up like that until they were 2 and a half years old. It is impossible to say how difficult it is to raise a child. Despite the day care facilities within Singha Durbar, raising a child and working at the same time was very difficult.

There is a Civil Servants' Wives' Association under the Ministry of Women, Children and Senior Citizens within Singha Durbar. The same association manages the ‘day care’. Employees within Singha Durbar can keep their children there from 9 am to 5 pm. Meanwhile, Kopila Adhikari, who works as a nurse in a private hospital, went to the hospital to work until a few days before the birth of her child. However, she did not work anywhere for about 20 months after the birth of her child. The reason was that there was no one to look after the child at home. 

‘My husband was busy with business and business work,’ says Kopila, ‘I did not get a job for almost 2 years because there was no one to look after the child. After that, I sent the child to Montessori and started working.’ She has experienced that most female employees working in hospitals have faced the same problem as hers. According to UN Women’s latest study report (2025) on the state of the care system in Nepal, the employment ratio of women among couples with children under the age of 6 is only 30 percent. For men, it is 72 percent. This means that women are not able to devote time to their careers and employment when the main responsibility of caring for young children falls on women.

According to a UN Women report, 41 percent of women are only able to engage in part-time employment. Social discrimination places the responsibility of household chores on their shoulders, and the number of women who are able to do full-time income-generating work is low. According to the Nepal Labor Force Survey 2074/75, only 27 percent of women in the working age group (above 15 years) are involved in economic activities. Of these, only 10 percent are in the formal sector.

The Constitution includes the rights of senior citizens, children, and persons with disabilities as fundamental rights. It also refers to various types of care or care required in their life cycle. Legally, children have the right to receive care from their families, says advocate and women's rights activist Indu Tuladhar. However, leaving aside the day care center within the Singha Durbar complex, investment in basic care infrastructure by all three levels of government is almost zero.

‘Nepal has very little care infrastructure, even though there is a sufficient amount of care needed, care centers have not been built accordingly,’ says Tuladhar, ‘The public sector has built care centers only here and there. A complete care infrastructure should include care workers, care-seeking groups, care institutions, health centers, child care centers, and senior citizen day care centers.’ According to her, if there is a home-based care system, those who are engaged in care should be paid and such caregivers should be protected. She emphasizes that the private sector should be brought forward to commercialize and institutionalize care work and that the security of their investment should be guaranteed. 

The government has put forward policy incentives to promote the care economy in India, which Nepal considers close in socio-cultural structure. India has a policy framework in place to attract funds to be spent under Corporate Social Responsibility (CSR) towards care infrastructure, and to provide Viability Gap Funding (VGF) to develop limited projects related to care infrastructure, including old age homes/senior citizen care centers.

The government has been providing free training in various types of care through various agencies through the ‘Pradhan Mantri Kaushal Vikas Yojana (PMKVY)’ to produce skilled manpower required for care centers. A new proposal has also been put forward to provide corporate tax exemption to micro, small and medium enterprises, including childcare and day care centers run by women, to promote the care economy.

In Nepal, efforts are also being made to formulate a ‘National Integrated Care Policy’ to recognize the work of women and workers and to contribute to the country’s economy. The National Planning Commission is preparing a draft policy with the support of the International Labour Organization (ILO). The concept of ‘care economy’ has been introduced in the 16th Five-Year Plan, said Prakash Kumar Shrestha, Vice Chairman of the National Planning Commission. ‘Work is underway to formulate a national care policy,’ he says, ‘the demand for care is increasing globally, and if investment is made in care infrastructure, it can also create new jobs.’

Vice Chairman Shrestha analyzes that the ‘care economy’ is likely to develop strongly due to the rapid demographic dynamics in Nepal over the past two decades. ‘There is migration from the mountains to the cities, migration from the cities to foreign countries is happening again, the population growth rate is decreasing, while the number of elderly people is increasing, children are not together,’ he says, ‘Yesterday there was one joint family. Grandparents used to look after the children. In the future, those same grandchildren would look after their grandparents, but now it is changing rapidly.'

Shrestha says that this social scenario has a strong potential for businesses related to the care of people of different ages and conditions and the care economy inspired by it to flourish. Ajayraj Joshi, founder of Suvidha Sewa Pvt. Ltd., a care service provider company, says that the demand for 'care givers' has increased significantly in most urban areas of Nepal due to the lack of people to care for the elderly at home. However, today, the required number of quality care homes do not seem to have been established well even in big cities including the capital. 

Although a few such privately funded centers, ranging from day-care services for children to care for the disabled, sick and elderly, have come into operation, concentrated in the Kathmandu Valley, there is still a great shortage of highly professional care homes with quality infrastructure. In this context, Lumanti (Support Group for Shelters) is working in the care sector in 10 municipalities of Madhesh, Sudurpaschim and Karnali. Lumanti has run a day care center with bhajan kirtan for senior citizens by repairing and maintaining a community building in Belauri Municipality, Kanchanpur. 

Lumanti's attempt to establish a learning center in Birgunj seems to be trying to address the lack of care infrastructure at the local level. 'We are discussing with the local municipality on infrastructure construction,' says Lumanti's project officer Sonu Shrestha, 'Since there is not much budget for this, we are working in coordination with the mayor and deputy mayors.' She understands that the need for care centers is high from the local level.

Although technology and robotics have displaced employment in many sectors, Shrestha, Vice Chairman of the Planning Commission, argues that care work cannot be completely automated because it requires a 'human touch'. According to him, different types of care are required for children, senior citizens, people with disabilities and autism patients. The proposed policy is expected to guide investment and employment in these sectors. He said the proposed policy would also cover issues such as social security and low wages for domestic workers. Shrestha said the commission is formulating a policy with priority for the development of care infrastructure. However, experts have pointed out that it is not clear how the policy will attract private investment. In India, the Companies Act 2013 (Section 135) stipulates that companies with an annual net worth of more than Rs 5 billion or an annual turnover of more than Rs 10 billion or a net profit of more than Rs 5 crore must spend at least 2 percent on CSR. Schedule 7 of the Act also provides for companies' investments in 'care infrastructure', including senior citizen care, elderly welfare, child protection-rehabilitation, childcare, day care centers and services for people with disabilities, to be counted as CSR expenditure.