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Caregiving as a shared public-private responsibility in Costa Rica

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In Costa Rica, 80% of households with children under four assume 100% of the caregiving. This usually means that women take on this task.

An infographic from the National Institute of Statistics and Census (INEC) depicted this reality as part of the celebration of Children’s Day in September 2022. The data presented also show that only 19.5% of children from 0-4 years old attend some type of child care center. When children reach 5-6 years and children enter school settings, this number rises to 97.8%, and 99.6% of those between 7-12.

According to the July 2022 National Household Survey, the descriptor “Out of the workforce due to family obligations” affects 23.2% of households in poverty as defined by the Multidimensional Poverty Index.

“In most cases, this refers to households where there is at least one woman who, wanting to work, cannot do so because she must dedicate herself tofamily obligations such as caring for people,” says the report.

“Care is the cornerstone of economic reactivation,” says Pamela Castillo, who heads the Technical Secretariat of the Costa Rica Gender Parity Initiative (IPG). She made this comment in an interview with El Colectivo 506 in 2021. A new conversation with Pamela in 2022 brought to light three programs that, for the IPG, continue to serve this need: care options for dependents under four that allow women and families to work or study, thus improving their socioeconomic status.

National Child Care and Development

Costa Rica’s Child Care and Development Network (REDCUDI) has become a regional reference. Structured and strengthened in a 2014 law promoted by the presidential administration of Laura Chinchilla, the network seeks to ensure not only access to early childhood care services, but also the quality of those services.

“Generally it was thought: a care network is about poverty,” explains Itzel Granados from the National Child Care and Development Network Technical Secretariat. “But the law is broader than that. What it tells us is that any entity—public, private or mixed—that provides child care and development services in this country is part of the network. For all public institutions, our job is to support them so that they can provide a quality service to kids.”

In 2021, state care services were provided to more than 67,000 children through public institutions such as the IMAS, PANI and CEN-CINAI. This year, as of September, more than 58,000 boys and girls. However, these children are all from families below the poverty line, which is the population that can be subsidized by the state—unless an entity such as PANI carries out a study that shows that a family needs state support for different reasons. For example, one of these reasons may be a family has only public care options nearby.

Since 2015, the coverage of public caregiving options for vulnerable populations has increased by 50%. Itzel explains that the IMAS, PANI and CEN-CINAI, which are the program’s implementing units, have achieved this increase despite not increasing their available resources since 2014.

“We have been able to stretch the blanket and cover the largest number of girls and children,” says Itzel.

According to data provided by the REDCUDI Technical Secretariat, as of October 2022 there are 1,327 child care and development centers that receive this subsidized population. These centers work in various ways: from the Casas de la Alegría that serve migrant coffee workers’ families in the Southern Zone and Los Santos, to Cecudi Municipal, CEN CINAI, community homes, and private care centers that receive populations subsidized by the IMAS.

Now, Law 9941—”Reactivation and Strengthening of the National Child Care and Development Network,” March 2021—has established new financing options for the network that could allow this coverage to increase still further. These new resources are drawn from various institutions’ budget surpluses. However, the government is still studying whether these surpluses can be used for this purpose, and the fiscal implications of this practice.

“Hard work is being done on this at the highest level,” adds Itzel. “We are very busy as a network right now. I hope that when the internal and hierarchical evaluations have been carried out, we can announce to the country how these resources could be invested.”

Regarding supply and coverage in the private sector, the information is less precise.

“We are missing the large universe of people and families who pay for their services privately, and who also receive quality services with all the state guarantees,” explains Itzel.

One of the current projects carried out by the REDCUDI Technical Secretariat in partnership with UNICEF is the creation of a single system for collecting information on childcare recipients in Costa RIca, whether the care they receive is public or private.

This system is expected to be able to register not only the number of children served, but also their condition, through screening processes. Itzel explains that these screening processes are already carried out at childcare centers, but by hand within each individual facility.

“This system will allow the state to generate general statistical data on how many children access the service privately,” says Itzel. “This is expected to be a win win. It will speed up the work and allow us, finally, as a country, to generate data on how many people access services privately. That will allow us to quantify unsatisfied demand. That kind of data is key for decision making—for example, being able to identify whether we need to generate more centers, or more subsidies.”

Another part of REDCUDI’s processes—both in public, private and mixed settings—is training to standardize the quality of care.

Part of this work was a national quality assessment carried out at 312 different childcare centers in 2021 throughout all of Costa Rica’s seven provinces. The assessment included centers whose 814 professionals were serving 15,283 kids. It resulted in conclusions in five caregiving areas—health and nutrition, pedagogy, infrastructure and security—and recommendations for additional training for all childcare centers. The report also recommended creating a model to standardize types of childcare services as a tool for families when they choose a facility.

“It would allow us as a state to tell them, ‘Well done!’” explains Itzel. “We hope that this is an incentive that we can give from the State to the centers, like a Blue Flag program for child care and development.”

For Itzel, the strength of REDCUDI is its philosophy that improving access to quality early childhood caregiving services, whether public or private, is a joint effort.

“The state alone cannot do it,” she says. “We seek to come together to make sure our kids are ok, and to lighten the burden of domestic tasks on our shoulders. We want [families] to have real support from the state, civil society, and private companies, so we can develop personally and professionally.

In Tibás, paying it forward

The “Win-Win-Win” Program

Another of the most significant efforts to improve access to care is called “Gane Gane Gane (Win-Win-Win): Public-private co-responsibility to improve the quality of Early Childhood Development services and female employment.”

This project seeks to evaluate the effects of a private financing scheme, according to Marcela Rivera, Advocacy Coordinator of the Business Alliance for Development (AED): a company-employee co-payment system for the care of children under four,

This project, also known as Gane tr3s, has been developed by the Inter-American Development Bank (IDB), the AED, and the DEHVI Foundation. It was launched in June 2020 and will end in June 2023. Eight companies have established specific co-payment systems for early childhood caregiving.

In 2021, through these co-payment schemes, the companies invested more than $95,000 and benefited 46 kids. By 2022 the program has doubled, benefiting 100 children and some 90 families.

Marcela explains that the objective of this pilot project is to achieve “case studies that allow us to build documented arguments, with indicators such as the decrease in turnover, productivity, absences, late arrivals and others, to position the companies’ role… co-responsibility for early childhood care.”

Once the experiences of these eight companies generate conclusions about their impact on each business, the organizations that lead Gane tr3s seek to share these cases with other companies to promote similar programs.

“Companies are beginning to understand that care is also their responsibility, and that it goes beyond corporate social responsibility,” says Marcela. “They are beginning to see it as a business issue—a strategy to attract talent and retain it, especially when it comes to women. They’re the ones who leave jobs the most for care issues.”

The companies that are part of Gane tr3s are BAC Credomatic, Boston Scientific, Alimentos Prosalud, Grupo Empresarial de Este (GEESA), Empresas Berthier EBI de Costa Rica SA, Pozuelo, Abbot, and Edwards Lifesciences.

The co-payment systems that these companies have implemented are varied. They range from 100% coverage of the cost of care by the company, to a distribution of 54% by the company, 24% by the employee, and 22% by the employee solidarity association. All of the participating childcare centers are privately owned.

Marcela adds that the analysis of their staff members’ economic situations has led the companies to go one step further, including financial education, tutoring to complete high school, and short videos on early childhood development. In addition, they have carried out fundraising campaigns within the companies to support staff members, or to extend childcare benefits to their communities, especially for single moms.

These processes, especially the socioeconomic assessment of families, are carried out hand in hand with the DEHVI Foundation.

“Economic data shows that for every dollar invested in early childhood, there is a return between $7 and $17,” says Marcela. “Companies must be made aware that investing now in early childhood is investing in the future. These are our future collaborators and company leaders. Investing in quality care is important for everyone.”

So far, the impact measurements of the project are positive.

“There is one [company] in particular that tells us that they realized that women who had left their jobs did so because of caregiving issues. They have begun to reduce turnover of female personnel,” says Marcela. “[Another company] told us that it is something that they are going to start including as part of their company benefits… For women, it is a benefit and a plus.”

Marcela says that the main limitations that this project has encountered so far come from the business side and from the families themselves.

“Companies still perceive childcare as a private matter,” she says. On the other hand, families also continue to believe that “children are better off when cared for at home.”

However, when companies and families participate in these programs, the perception changes.

In addition, onsite childcare programs can actually increase parents’ time with children. Marcela shared with El Colectivo 506 a quote from a beneficiary compiled by the DEHVI Foundation: “I feel very happy to have been chosen. Before the program, I spent very little time with my daughter because I had to leave her with my parents to take care of her while I was at work.”

The documentation of the impact of the project carried out by the DEHVI Foundation also shows the gains made by children. According to comments collected from parents, the children in the program are “more independent, more self-confident.” In addition, they “get along better with children and with other people, say words in English, already know numbers, have learned a lot,” “they have advanced academically, area already learning to write, add and subtract.”

“These are expensive programs but the companies have the availability,” says Marcela. “They are assuming it very conscientiously, where in addition to seeing that there is a need for care they also see a need to approach the program from a female perspective. The business sector increasingly realizes that the issue of child care is their responsibility, too.”

However, for Marcela the project needs a “third source of support.”

“If we received an additional subsidy [from the State], we could expand coverage and provide the benefit to more collaborators,” she indicates.

Bilingual podcast: Las Titas

State subsidies for care: the case of the INA

As mentioned above, the state component of REDCUDI includes the CEN-CINAI, municipalities, PANI care centers, community homes, and projects such as the Casas de la Alegría. All these services are subsidized by the state and delivered to families in poverty or with special situations evaluated by the PANI, which concludes that the service should be offered to them.

Another reality of state subsidy for care is programs such as those offered by the National Learning Institute (INA) for its students. This type of economic support includes not only people who have young children, but also those who care for the elderly, or people with disabilities.

“We’re seeking strategies to keep people in the classroom,” says Rocío Arce Cerdas, Technical Assistant Manager of the INA. She explains that INA’s financial aid regulations already clearly establish this financial support as a necessary component.

“I believe that having this benefit of care for dependents allows [the student] to complete their studies,” she adds. “And it allows them to have at least some income to pay for childcare, or care for a parent or a person with a disability. It is a great benefit for people.”

In 2021, the INA granted this benefit to 55 people, which represented an investment of ₡28 million colones (about $45,000) for the institution. By August 2022, 54 women and three men had been supported with a total investment of ₡33 million (about $55,000). Rocío clarifies that the financial support can be used only to pay for services or certified professionals. This helps ensure not only that the student stays in his or her program, but also the well-being of the dependent.

“The person can be sure that, as a student, they are guaranteed to have support and training, and that the [dependent] can be cared for in better conditions,” says Rocío.

To access the benefit, as with all other support or scholarships offered by the institution, INA students can request a socioeconomic study from the student welfare teams of any of the training centers. Following the scholarship regulations, these teams will decide if the student is eligible for this kind of support. They will also determine how much the beneficiaries will receive, according to the financial support tables established by the INA,

“It is a very important item that the institution has prioritized,” says Rocío. “It allows them to say, ‘I have the opportunity to enter the INA and…not to drop out when I have a [caregiving] situation on my hands.’”

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Mónica Quesada Cordero
Mónica Quesada Corderohttp://www.mqcphoto.com
Mónica (Co-Fundadora, Editora Gráfica) es una galardonada fotoperiodista con 15 años de experiencia en el desarrollo de proyectos fotográficos en el área editorial, retrato, vida silvestre, comida y arquitectura. Además, cuenta con experiencia en escritura y redacción y una maestría en Producción Audiovisual y Multimedia. Mónica (Co-Founder, Graphic Editor) is an award-winning photojournalist with 15 years of experience developing photographic projects in the editorial, portrait, wildlife, food and architecture areas. In addition, she has experience in writing and a master's degree in Audiovisual and Multimedia Production.

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