New UN Development Programme research from Moldova, North Macedonia, Türkiye, Ukraine and Uzbekistan reveals that care is becoming more essential than ever as societies age and labor shortages deepen. Yet care systems remain undervalued and underinvested in, while unequal care responsibilities continue to constrain women’s participation in the labor market.

Across Europe and Central Asia, governments face a common challenge: how to build competitive and resilient economies as populations age and labor markets tighten. Investment discussions rightly focus on energy, digital transformation, transport and innovation.

But one equally important form of infrastructure receives far less attention: care.

Care is often viewed primarily as social policy. Increasingly, the evidence shows it is also economic policy. Without affordable childcare, many parents, particularly mothers, cannot participate fully in the labor market. Without quality long-term care, family members may have to reduce their working hours or leave employment to support ageing relatives. And without a well-trained care workforce, essential services become increasingly difficult to deliver.

Like transport networks, energy systems or digital connectivity, care enables economies to function.

UNDP recently analyzed care systems across Moldova, North Macedonia, Türkiye, Ukraine and Uzbekistan. While each country faces distinct circumstances, not least Ukraine, where full-scale war has placed extraordinary pressure on care systems, the analysis reveals similar structural challenges.

Across the five countries, young children and older persons made up 17 to 22 percent of the population in 2020. By 2040, that share is projected to rise to as much as 28 percent, increasing pressure on care systems already struggling to meet demand.

One important finding is that care cannot be addressed through isolated policies. It is a system encompassing paid and unpaid work, childcare, disability support, long-term care, social protection, labor market policies and the social norms that determine who provides care. When one part fails, the consequences ripple across families, labor markets and economies.

It starts with unpaid care.

Millions of hours of unpaid care sustain households across the region every day, yet much of this work remains invisible in economic statistics. Women continue to spend at least twice as much time as men on unpaid care responsibilities, constraining their opportunities in the labor market.

There is growing recognition across the region that this needs to change. Earlier this year, I joined the first Europe and Central Asia Care Forum in Istanbul, convened by UN Women, the UN agency dedicated to gender equality and women’s empowerment. Bringing together governments, international organizations, civil society and the private sector, the Forum helped advance a regional agenda for more integrated and gender-responsive care systems. That momentum matters: transforming care will require governments, international organizations, employers and communities to work together.

The economic consequences of inaction are already visible. In Moldova, employment among women aged 25-49 with at least one child under six is nearly 29 percent lower than among women without young children. Too often, families must bridge gaps in public services themselves, with formal childcare costing close to a minimum wage in some contexts and long-term and disability care becoming prohibitively expensive.

When women reduce their working hours, move into informal employment or leave paid work to provide care, economies lose workers, skills, household income and productivity.

Uzbekistan shows what can happen when that equation begins to change. Following a major expansion of preschool provision, enrolment among children aged three to seven rose from 25 percent in 2018 to 63 percent in 2022. Research found that the expansion was associated with a 12 percent increase in women’s labor force participation. Expanding care did not simply benefit children: it opened economic opportunities for women.

But unpaid care is only half of the equation.

Paid care workers perform work fundamental to our societies, whether supporting young children, older persons or people with disabilities. Yet care professions remain highly feminized, frequently underpaid and, in many settings, informal. Limited career pathways, insufficient training and weak social protection make recruitment and retention increasingly difficult, just as demand accelerates.

Stronger care systems therefore require action on both sides: reducing and redistributing unpaid care while building a professional, well-supported paid care workforce.

The economic case is compelling. Research by the International Labour Organization, UNDP and UN Women in Türkiye found that investment in early childhood care and preschool education could create two and a half times as many jobs as an equivalent investment in construction. Social infrastructure can generate employment and economic returns just as investment in physical infrastructure does.

Governments cannot build stronger care systems alone. Employers, municipalities, private providers, trade unions and civil society all have a role to play. But governments are central to setting the policy direction, financing and coordination needed to ensure care is accessible, affordable and high quality.

Across Europe and Central Asia, we have an opportunity to rethink what we mean by economic infrastructure.

Roads move people. Energy powers industries. Digital technologies connect markets. Care enables people to participate.

As governments search for workers and new sources of productivity and resilience, they should no longer view care primarily as a social cost to be managed. Affordable childcare can enable more parents to work. Reliable long-term care can keep family members from leaving the workforce. Better care jobs can help meet growing demand as populations age.

Investing in care is an investment in human capital, gender equality and economic growth. The future competitiveness and resilience of Europe and Central Asia will depend not only on the infrastructure we build, but also on the care systems that allow people and economies to thrive.

This op-ed was originally published in Eurasianet.