India needs a national framework to build a sustainable care economy

The NITI Aayog’s proposal for a national policy on caregiving is timely. The number of Indians aged 60 and above is projected to rise from 149 million in 2022 to 347 million, or 20.8 per cent of the population, by 2050. At the same time, rising female labour force participation, urbanisation, the migration of younger family members for employment, and the shift from joint to nuclear households are weakening traditional family-based care systems, creating greater demand for professional caregivers. India’s caregiving system remains predominantly informal and heavily dependent on women. Formal services, mainly available in cities, are fragmented and often unaffordable. The challenge, therefore, is not simply to increase the number of caregivers but to build a care system that is accessible to households while providing dignified employment to workers. 

The government is focusing on this area. The Union Budget for 2026-27 announced measures to strengthen the care ecosystem, including the expansion of geriatric and allied services, and programmes to train 150,000 multiskilled caregivers. The training is intended to combine core caregiving with skills such as wellness, yoga and the operation of medical and assistive devices. But training alone will not create a sustainable care workforce. What is needed is an institutional framework that provides recognised qualifications, quality standards and decent working conditions. The NITI Aayog’s proposal for a National Caregiving Council is, therefore, important. The council would coordinate across institutions and help bring greater consistency to caregiver education, training, accreditation and certification through a national caregiving qualification framework. A national caregiver registry and digital platform could further improve workforce planning, verification, and match caregivers with those in need. 

Professionalisation must also translate into decent work. Fair wages, written contracts, insurance, sick leave, and occupational safety are essential to attracting and retaining workers. Technology-enabled care, innovation, and the exchange of best practices across states could further improve service delivery. Persistent shortages of care workers in several countries also create an opportunity for India to develop structured overseas placement mechanisms. India can draw lessons from how other countries have financed and organised care. Japan’s long-term care-insurance system has helped develop community-based care around certified care managers, while Germany provides support to both formal and informal caregivers. South Korea has integrated home-based, community and institutional care within a long-term-care framework, while Australia has emphasised nationally recognised training and regulatory standards. These experiences suggest that a sustainable care system requires financing, quality assurance, and institutional coordination, alongside workforce protection and training. 

It will be important to recognise caregiving as essential social infrastructure. This will require sustained public investment, greater participation by the private sector and civil society, and stronger community-based delivery, particularly in rural and underserved areas. A well-designed national policy can reduce the burden on households, support women’s participation in paid work, and create dignified employment.