Paid Care Providers in South Africa: Nurses, Domestic Workers, and Home-Based Care Workers

By Francie Lund, Debbie Budlender on January 01, 2009

This paper considers people working in three occupations where the work is centrally about care: nurses, home-based care workers, and domestic workers. These were selected for a number of reasons. Women are concentrated in these types of work, which provide employment or opportunities for voluntary work for hundreds of thousands of South African women. The work is found in both the public sector and the private formal health sector, as well as in the subsidized not-for-profit welfare sector. Domestic workers work in the private homes of their employers. The selection enables the identification of movement horizontally across and within private and public sectors, for example nurses moving between government and private sector employment. It also enables analysis of vertical movement within a sector, for example when nurses’ tasks, formerly restricted to certain professional grades, are shifted downwards towards lowly paid or unpaid women ‘volunteers’ (so-called ‘task shifting’). The three occupations also contain a range of types of employment and work, from very formal and relatively well paid, to thoroughly informal, and low paid and altogether unpaid. They are active on a continuum from the secure, formal  employment of professional and assistant professional nurses, to the informal home-based care workers, some of whom are truly volunteers, while others are in an ambiguous and precarious employment position. Domestic workers occupy a position in-between: domestic work in South Africa was regulated fairly recently and there is access to some social security coverage.

This is the fourth report in the South Africa research for the care project, and it covers three groups of carers: nurses, domestic workers, and paid and unpaid home-based care workers.

View list of all: City/Country Level Reports