Women, Caregiving and the Economics of Unpaid Care in Nigeria

In many Nigerian households, the person who keeps an older relative safe is not described as part of the care workforce. She may be a daughter who leaves work early to prepare meals, a daughter-in-law managing medicines and appointments, a granddaughter sleeping nearby in case help is needed at night, or an older woman caring simultaneously for a spouse, grandchildren and another dependent relative.

The work may never appear on a payroll, in employment statistics or in the price of long-term care. Yet without it, the household would need to purchase support, another relative would have to withdraw from paid work, or the older person might go without essential assistance. Across the Nigeria Ageing, Long-Term Care & Community Support Knowledge Hub, this unpaid layer of care is one of the most important parts of the emerging long-term care system because it connects family responsibility, gender inequality, labour-market participation, poverty and future demand for formal services.

Nigeria is also beginning to measure this hidden economy more explicitly. The National Bureau of Statistics’ Time Use Survey provides detailed evidence from Borno, Cross River, Kaduna and Lagos showing a pronounced gender divide in unpaid domestic and care work. Across those four states, women spent around five times as much time on unpaid domestic and care activity as men, with rural women facing particularly high time demands.

That evidence should change how long-term care is discussed. Family care is not cost-free merely because no invoice is issued. Its costs are transferred into women’s time, earnings, career progression, health and future financial security. The central policy challenge is therefore not whether families should continue caring. It is whether Nigeria can recognise, reduce and redistribute excessive unpaid care while building enough formal support to make family caregiving more sustainable.

Unpaid care is part of the economy even when no money changes hands

Economic activity is often understood through paid employment and market transactions. Care exposes the weakness of that definition.

If a household employs a caregiver to help an older person bathe, eat and move safely, that activity has a market price and is visible as employment. If a daughter performs exactly the same tasks without pay, the economic value does not disappear. It simply becomes unpriced.

The same principle applies to coordination. Families organise transport, purchase medicines, accompany relatives to hospitals, monitor symptoms, communicate with siblings and manage household finances around care. These activities consume time that could otherwise be spent in paid employment, education, business, farming, rest or other productive activity.

Unpaid care therefore has at least three economic dimensions:

• the direct value of the work being performed;
• the opportunity cost of time that cannot be used elsewhere; and
• the longer-term effect on earnings, savings, pensions and economic security.

Recognising these dimensions does not require every family caring relationship to become a commercial transaction. It requires policymakers to stop treating unpaid care as economically neutral.

Nigeria now has better evidence about the gendered distribution of time

The Nigeria Time Use Survey marked an important improvement in the evidence base because it examined how people actually spend their days rather than relying only on employment categories.

The survey covered 3,600 households across Borno, Cross River, Kaduna and Lagos and was designed to provide representative estimates for those selected states across seasonal rounds. It found substantial differences between women and men in unpaid domestic and care work.

Among surveyed participants aged 15 and above, women devoted around 21% of their day to unpaid domestic and care activities, equivalent to about five hours, while men spent around 4.1%, approximately one hour. Rural women recorded particularly high unpaid workloads.

This is wider than older-person care. It includes household and caring activity involving children, illness, disability and other responsibilities. Nevertheless, it provides critical context for ageing policy because older-person care is layered onto an already unequal allocation of unpaid work.

A woman caring for an increasingly frail parent may not begin from a position of spare capacity. She may already be cooking, cleaning, collecting water, caring for children and participating in paid or informal work.

The addition of long-term care can therefore create time poverty rather than simply another household task.

The gender gap is produced by social organisation, not biology

Women often provide excellent care, but their concentration in unpaid caregiving should not be mistaken for evidence that care is naturally women’s work.

Gender expectations influence who is considered responsible when somebody in the family needs help. Daughters may be contacted before sons. A woman living near an older parent may be expected to reduce work because her brother is perceived as the household income earner, even where she also has employment or business responsibilities.

These patterns are reinforced when formal alternatives are scarce or unaffordable.

The family then makes what appears to be a private practical decision: somebody has to provide care, and the person whose income is lower or work is considered more flexible withdraws time from employment.

But previous gender inequality may already have contributed to that lower income. Care responsibilities can then deepen the same inequality.

This creates a cycle in which women earn less partly because they provide more unpaid care, and are then selected to provide further care because they earn less.

The wider equality and inclusion implications are therefore significant. Care systems are not gender-neutral simply because eligibility rules do not explicitly distinguish between men and women.

An older parent’s stroke can become a daughter’s labour-market decision

Consider a woman running a small retail business in Enugu while raising two children. Her widowed mother experiences a stroke and returns home needing help with bathing, transfers, meals and hospital appointments.

The family does not initially consider purchasing a formal care service. Her brothers contribute towards medicines and household expenses but live elsewhere. Because she lives nearby and has no fixed employer requiring her attendance, she becomes the default caregiver.

Her business appears flexible enough to accommodate care, but that flexibility has a cost. She opens later, closes unexpectedly for appointments and loses customers. She cannot travel to purchase stock as frequently. Revenue falls gradually rather than through one obvious financial shock.

The family may still perceive the arrangement as relatively inexpensive because the brothers continue financing some direct medical costs. Yet the largest hidden contribution may be the daughter’s lost income.

If her mother’s needs continue for several years, the consequences extend beyond current earnings. Reduced profits mean lower savings, less capacity to invest in the business and greater vulnerability to future emergencies.

This is why family partnership and carer support should include the economic sustainability of the caregiver, not merely whether somebody is technically available to provide care.

Informal employment can make caregiving both easier and more damaging

Nigeria’s large informal economy shapes unpaid care in distinctive ways.

Informal work may offer flexibility that salaried employment cannot. Traders, farmers, self-employed workers and people operating small enterprises can sometimes reorganise their working day when a relative requires support.

That can be valuable.

But flexibility should not be confused with protection.

A salaried employee who takes authorised leave may retain some income. A market trader who spends the day accompanying an older relative to a clinic may simply lose that day’s earnings. A farmer unable to complete work at the right point in the agricultural cycle may experience consequences well beyond the hours actually spent caregiving.

Informality also means weaker access to occupational benefits, paid family leave, employer-supported care arrangements and contributory retirement protection.

The economic cost of care can therefore be less visible while simultaneously being more severe.

Care costs are distributed between money and time

Families do not choose only between paid care and unpaid care. Most combine them.

A household may pay somebody to stay with an older person during working hours while relatives provide evenings and weekends. Family members may purchase meals, transport and medicines but still perform personal care themselves. A domestic worker may gradually take on more assistance as an older person becomes frailer.

The financing question is therefore inseparable from time.

A family that cannot afford formal support pays more through unpaid labour. A household able to purchase reliable care may protect relatives’ employment and time. Wealthier households may also be able to share care across more people or finance adaptations that reduce the intensity of physical support.

This creates a strong inequality dimension. The health inequalities and prevention lens is relevant because the capacity to sustain care safely depends not only on health need but on household resources, geography and the availability of support.

Caregiving affects women across the life course

The economic effect of care changes with age.

A younger woman may interrupt education or delay entering employment. A woman in mid-life may reduce working hours at the point when she would otherwise be advancing professionally or expanding a business. An older woman may continue providing intensive care when she is herself developing chronic illness or mobility limitations.

Nigeria’s National Policy on Ageing explicitly recognises the intersection between gender, employment and family-care obligations. It also highlights the economic vulnerability of older women and the importance of integrating gender considerations into ageing policy.

This matters because women can move through several caregiving roles without a clear boundary between them.

A woman may spend years raising children, then care for ageing parents, later support a spouse and simultaneously provide childcare for grandchildren.

Care is therefore not necessarily a temporary interruption. For some women it becomes a recurrent structure shaping much of adult economic life.

Older women are carers as well as care recipients

Ageing policy can inadvertently portray older women only as people who receive support.

In reality, many older Nigerian women continue providing substantial practical and emotional care within families and communities.

They may support spouses, grandchildren, adult children with disabilities or other relatives. They may also provide counselling, household organisation and financial support from pensions, trading or farming income.

The National Policy on Ageing recognises older women’s continuing supportive roles as caregivers, mentors, counsellors and community participants.

That contribution is important, but it should not be romanticised.

An older woman caring for a dependent spouse may have arthritis, hypertension or her own mobility limitations. Assuming that she can continue indefinitely because she has always managed the household can conceal significant risk.

Carer assessment therefore needs to consider the caregiver’s health as well as the needs of the person receiving care.

Caregiver health is an economic issue too

Unpaid caregiving can affect physical and mental health through interrupted sleep, lifting and transferring, emotional stress, financial pressure and the cumulative effect of being continuously responsible for another person.

These consequences have direct human importance, but they also create wider economic costs.

A caregiver whose own health deteriorates may need treatment, lose further working time or eventually become unable to continue providing support. Another relative then has to step in, or formal care becomes necessary at a later and potentially more complex point.

The household can therefore appear to save money in the short term while accumulating risk.

This is one reason a sustainable care system cannot regard family capacity as infinitely renewable.

Carer wellbeing needs to become part of service planning, particularly where an older person has high levels of dependence.

Formal services can function as economic infrastructure

A home-care visit is often evaluated only by what happens to the person receiving care. That is essential, but it captures only part of the effect.

Reliable support can also release family time.

If a trained caregiver assists an older person for four hours while a daughter attends work, the service supports both people. The older person receives care and the daughter retains employment.

This broader understanding is increasingly visible in Nigeria’s policy discussion. In 2026 the Federal Government explicitly placed the care economy within national social-development and economic debate, arguing that childcare, elderly care, disability support and related services should be viewed as infrastructure capable of increasing women’s economic participation as well as supporting vulnerable people.

This framing is important.

Care spending can look like consumption when considered narrowly. In reality, well-designed care infrastructure can also support labour-force participation, employment creation and household resilience.

The economic social value and local-spend perspective is therefore useful. Investment in care may circulate through local employment while releasing other household members to remain economically active.

Professional care does not replace family relationships

Policy discussions about reducing unpaid care can provoke concern that families will be displaced by institutions or paid workers.

That is a false choice.

Formal support can change what families have to do without changing the relationship itself.

A daughter may still visit, prepare favourite meals, accompany her mother to important appointments and provide emotional support while a trained worker assists with bathing and transfers. A spouse may remain closely involved while somebody else provides respite for several hours each week.

Indeed, separating family relationship from relentless physical caregiving can sometimes strengthen both.

The aim is not to monetise every act of kindness. It is to avoid building an entire care system on the assumption that unpaid relatives can absorb unlimited levels of dependency indefinitely.

Paid care can redistribute unpaid care, but only if it is affordable and trustworthy

A professional home-care market can reduce pressure on families, but only where households can access services with confidence.

Price matters. So do quality, reliability and cultural acceptability.

A family may be financially capable of purchasing support but unwilling to leave an older relative with an unknown worker. Another household may want help but find formal care unaffordable. Rural communities may simply have few organised providers available.

The development of occupational standards and quality frameworks for geriatric social care is therefore relevant to gender equality as well as service regulation.

Trustworthy formal care gives families a realistic alternative to total reliance on unpaid labour.

Organisations developing services can use the Governance Maturity Assessment to examine whether accountability, workforce oversight and service assurance are sufficiently robust. The tool is not a Nigerian regulatory instrument, but the underlying governance questions matter wherever families are being asked to entrust intimate care to an organisation.

A Lagos household can afford care but still struggle to share responsibility

An older woman in Lagos develops moderate dementia. Her three adult children contribute financially, and the family employs a caregiver during the day.

On paper, the unpaid burden appears to have been solved.

In practice, the eldest daughter still coordinates almost everything. She recruits and supervises the caregiver, arranges medical appointments, replaces staff when somebody is absent, purchases supplies and handles repeated telephone calls from siblings.

She also provides overnight support when her mother becomes distressed.

Her brothers contribute money and reasonably believe they are sharing responsibility. Yet the cognitive and organisational work remains highly unequal.

This scenario demonstrates that care cannot be measured only through hours of hands-on personal assistance.

There is also a management burden: remembering, organising, anticipating and responding.

Formal services reduce that burden most effectively when they provide reliable coordination rather than merely another pair of hands.

The hidden management of care deserves greater attention

Family caregiving includes significant administrative labour.

Somebody keeps track of appointments, communicates with doctors, monitors prescriptions, arranges transport, pays bills and resolves disagreements among relatives.

Where formal systems are fragmented, families become the integration mechanism.

This work can be especially demanding when an older person has several conditions requiring contact with multiple health services.

Care coordination therefore has economic value in its own right.

Reducing fragmentation between healthcare, community support and formal home care can reduce unpaid family workload even where the quantity of direct personal care remains unchanged.

Social protection can reduce the financial consequences of caregiving

Not all carer support needs to take the form of a dedicated caregiver payment.

Social protection can reduce unpaid-care pressure through several routes.

Income security for the older person reduces reliance on relatives for all household expenditure. Health coverage can limit some medical costs. Disability-related support can reduce financial pressure where functional limitations are substantial. Publicly supported community services can reduce the number of hours relatives need to provide personally.

The key principle is that long-term dependency generates costs somewhere.

If public or pooled systems do not carry those costs, they are shifted towards households. Within households, they may then be shifted disproportionately towards women.

Nigeria’s current social-protection architecture does not amount to a comprehensive long-term care entitlement. That distinction is important. Existing programmes may improve household resilience without paying for the full range of ongoing personal support that frailty or disability can require.

Future policy therefore needs to examine not only who receives cash or health benefits but whether those arrangements materially reduce care-related financial and time poverty.

Cash support alone cannot solve the care gap

A family receiving additional income may be better able to manage care, but money does not automatically create a care service.

If there are no trained workers available locally, the family may still have to provide care itself. If formal services are unreliable, additional cash may not translate into reduced caregiver time.

This distinction matters for policy design.

Income support, workforce development and service infrastructure need to develop together.

The strongest care-economy strategy is therefore mixed rather than dependent on one intervention.

It may include social protection, professional home care, community support, workforce training, health integration and measures that help families share responsibilities more equitably.

Employment policy can reduce the penalty attached to care

Formal-sector employers also influence the economics of unpaid care.

Workers caring for older relatives may need short-notice flexibility for appointments, emergencies or temporary deterioration.

Where employment systems offer no flexibility, workers may use annual leave, lose pay or eventually leave employment.

Reasonable flexibility can therefore preserve both workforce participation and family care.

This does not mean employers can absorb unlimited absence without operational consequences. The issue is designing proportionate responses rather than forcing workers to choose immediately between employment and caregiving.

Flexible scheduling, temporary changes in working arrangements and supportive leave policies can make a material difference.

The principle of fair and responsible employment is therefore relevant not only to paid caregivers but to workers throughout the economy who also hold family-care responsibilities.

The formal care workforce itself is highly gendered

Reducing unpaid care through professional services can create new employment, but this does not automatically remove gender inequality.

If women move from unpaid caregiving into poorly paid, insecure paid caregiving, some economic recognition has been achieved but structural inequality may remain.

Care-economy development therefore needs to consider employment quality.

Professionalisation should include training, clear roles, supervision, safe working conditions, credible progression and remuneration capable of supporting workforce stability.

The local employment and skills opportunity is substantial. As demand for organised care grows, Nigeria could create jobs close to communities while expanding support for families.

But a care economy built on a second layer of underpaid female labour would reproduce rather than resolve the underlying problem.

Care infrastructure can have a multiplier effect

Investment in care creates value beyond the individual service transaction.

A formal service employs workers. Workers spend income locally. Families gain time for employment or enterprise. Older people may remain at home safely for longer. Hospital use may be avoided where community support identifies problems early and maintains continuity.

These effects are difficult to reduce to one simple monetary return, but they matter in public policy.

Organisations examining the wider impact of care investment can use the Adult Social Care Social Value Report Builder to structure thinking about employment, inclusion and community benefit. It is a general analytical framework rather than a Nigerian government reporting requirement.

The broader lesson is that care expenditure should not be judged only as a cost line. It can also be productive social infrastructure.

Rural women face a distinctive combination of care and infrastructure burdens

The gender gap identified in the Time Use Survey was particularly pronounced among rural women in the four states studied.

Part of the explanation lies beyond direct personal care.

Where households spend more time collecting water, preparing fuel, travelling to health services or completing other domestic work manually, every additional care responsibility is layered onto an already intensive workload.

An older person with mobility limitations may also require transport over long distances to reach health services.

Formal home-care providers are generally less concentrated in remote areas, reducing the possibility of purchasing substitute support.

Rural care policy therefore cannot focus solely on increasing the number of caregivers.

Transport, primary healthcare access, water, digital connectivity and community infrastructure can all reduce the amount of unpaid time required to sustain an older person at home.

This is one reason the care economy should be treated as a system rather than a single service market.

Technology can reduce coordination burdens but may also transfer work back to families

Digital technology has real potential to support caregivers.

Telehealth can reduce travel for some appointments. Shared digital records may reduce repeated explanations. Medication reminders, communication tools and remote monitoring can support independence where appropriately used.

But technology does not automatically reduce unpaid work.

A monitoring system that sends every alert to a daughter’s phone may increase vigilance rather than reduce it. A digital health service that assumes a relative will arrange equipment, upload readings and troubleshoot connectivity may shift administrative work from professionals to households.

Technology therefore needs to be assessed partly through its effect on caregiver time.

The person-centred technology principle is relevant because digital systems should work for both the older person and the support network around them.

Organisations considering digitally enabled care can use the Digital Transformation Readiness Assessment to test issues such as capability, governance and inclusion before assuming that a digital intervention will reduce workload.

Data can make invisible care visible to decision-makers

The significance of time-use evidence extends well beyond gender statistics.

It creates a measurable basis for decisions about transport, employment, social protection and service infrastructure.

If policymakers know where unpaid care burdens are highest, interventions can be better targeted. Repeated surveys can also show whether care responsibilities are becoming more or less equally distributed over time.

Long-term care data should eventually connect with this wider evidence.

Useful indicators could include not only the number of older people receiving services but also:

• hours of unpaid care provided by household members;
• caregiver labour-market participation;
• financial strain associated with care;
• caregiver health and wellbeing;
• access to formal respite or home support;
• rural and urban differences; and
• the gender distribution of care responsibilities.

This would create a more complete picture of system capacity.

A caregiver crisis can expose hidden dependency in the whole service model

An older man in Kaduna lives with his wife and adult daughter. He has significant mobility limitations and requires help throughout the day.

His wife prepares meals and remains with him while the daughter works. The daughter handles bathing, heavier transfers, appointments and household purchasing outside work hours.

The arrangement appears stable for several years.

Then the daughter becomes ill and cannot provide support for three weeks.

The household suddenly discovers that almost every part of the care arrangement depended on her availability. Her mother cannot safely perform transfers. There is no established home-care agency already involved, and finding a trusted worker at short notice is difficult.

The immediate crisis is the daughter’s illness. The underlying system risk is concentration of responsibility in one unpaid caregiver.

A more resilient plan would have identified that dependency earlier. Even limited formal support, a second trained family member or a known community-care option could have reduced the risk.

This is the care equivalent of business continuity: arrangements that work only while one person remains permanently available are inherently fragile.

Men need to become more visible participants in care

Redistribution cannot be achieved through formal services alone.

Within families, men can undertake more direct personal care, household work and coordination.

This may require shifts in social expectations as much as policy.

Public messaging that recognises men as legitimate and responsible caregivers can help. Employers also need to avoid assuming that family-care flexibility is primarily a women’s issue.

Men may already provide significant financial support for older relatives. The next step is recognising that financial contribution and hands-on care are different forms of responsibility, both of which can be shared.

Redistribution does not require every family member to provide identical hours. It requires moving away from automatic gender assignment.

Care policy should use the recognise, reduce, redistribute principle

A useful framework for Nigeria is to think about unpaid care through three linked objectives.

Recognise means making unpaid work visible in data, policy and economic analysis.

Reduce means lowering excessive or avoidable workload through services, infrastructure, technology, health support and prevention.

Redistribute means sharing necessary care more fairly between women and men, families and public systems, and unpaid and paid workers.

None of these objectives implies removing family care.

They create conditions in which family support is more sustainable and less likely to produce poverty or exclusion.

Nigeria’s care-economy agenda creates a policy opportunity

The Federal Government’s recent positioning of the care economy as part of social protection, employment and national development creates an important opportunity to connect areas that have historically been treated separately.

Women’s economic empowerment, older-person policy, disability support, professional caregiver development and household social protection are all connected through care.

The challenge now is implementation across Nigeria’s federal structure.

National statements need to translate into state-level services, workforce capacity, local infrastructure and measurable outcomes.

Different states will have different starting points. Urban areas may develop commercial home-care markets more rapidly. Rural areas may depend more heavily on community-based solutions. Some households will be able to purchase support while others require targeted public or social-protection mechanisms.

A single national delivery model would therefore be unrealistic.

What can be national is the principle that unpaid care should be visible in planning rather than treated as an inexhaustible private resource.

Governance should test who absorbs the consequences of policy decisions

Care policy can appear successful while silently transferring workload to families.

A hospital may discharge an older person appropriately from a clinical perspective, but if the care plan assumes that a daughter will provide continuous assistance without assessing whether she can do so, the system has simply moved responsibility.

A community programme may reduce formal expenditure while increasing unpaid family labour.

Governance therefore needs to ask who absorbs the consequences of each decision.

Organisations and system partners can use the Quality Dashboard Builder to structure broader indicators around workforce, continuity and outcomes. It is not a Nigerian statutory framework, but the underlying discipline is useful: performance measures should reveal hidden pressures rather than reward cost transfer.

The future care economy should create both support and decent work

Nigeria’s demographic transition will gradually increase the number of families managing age-related frailty, disability and chronic illness.

The country therefore faces two related economic questions.

How much unpaid care can families sustainably provide?

And how much paid care capacity will be needed to complement them?

The answer is unlikely to be a rapid replacement of family caregiving by a universal formal system. Nigeria’s current institutions, fiscal capacity, labour market and cultural expectations make a mixed model more plausible.

That makes the quality of the mix particularly important.

A stronger future system would retain family involvement while expanding reliable professional services, community support and social protection. It would treat paid care as legitimate employment rather than low-status domestic labour. It would make caregiver health and economic security visible. And it would recognise that women’s time is an economic resource, not a free input available whenever public or market provision is absent.

International learning: the transferable lesson is to count what households contribute

Many countries have discovered that formal long-term care systems remain heavily dependent on unpaid families even after substantial public investment.

Nigeria therefore should not assume that developing more professional services will eliminate unpaid care.

The more useful international lesson is that care policy needs to understand the relationship between formal provision and family contribution.

Different countries use different combinations of cash benefits, leave arrangements, home-care services, respite, social insurance, taxation and family responsibility. Their institutions cannot simply be copied into Nigeria.

The transferable principle is more fundamental: unpaid care should be measured and incorporated into system design.

Once household contribution becomes visible, policymakers can ask whether support is sustainable, equitable and resilient rather than merely assuming that families will continue filling every gap.

Conclusion

Unpaid care is one of the foundations of Nigeria’s long-term care system, but it is not free. Its costs appear in women’s time, lost earnings, interrupted careers, reduced business activity, caregiver health and weaker future financial security. The country’s emerging time-use evidence makes that burden more visible, while recent federal attention to the care economy creates an opportunity to move unpaid caregiving from the margins of social policy into mainstream economic planning.

The strongest response is not to replace families. Family relationships, reciprocity and intergenerational support will remain central to Nigerian care. The policy objective should instead be to prevent those relationships from becoming a hidden mechanism through which excessive responsibility is transferred disproportionately to women.

That requires several systems to move together: stronger social protection, accessible formal care, professional workforce development, workplace flexibility, rural infrastructure, better health coordination and continued measurement of unpaid work. Men also need to participate more fully in direct caregiving, while paid care employment should develop with credible standards and decent working conditions.

Nigeria’s care economy will ultimately be judged by more than the number of formal services created. A stronger system will be one in which older people can receive dignified support without another person having to sacrifice economic security invisibly in order to provide it. Making unpaid care visible is therefore not simply a gender-policy issue. It is essential to designing a sustainable long-term care system.