Gender and policies on paid family care: Overview of debate and theoretical reflections




theoretical debate, care policy, family care, gender


Objective: This article discusses the implications of systematically including policies on paid family care in the concept of care policy for older people for theorizing the relationship between such policies and gender inequality.

Background: In theoretical debates about the relationship between gender and care policy, most welfare state researchers agree that policies that support extra-familial care promote women’s participation in formal, paid work and can thus reduce gender inequality. By contrast, the role of policies that offer pay and elements of social security for family care in promoting gender equality is up for debate.

Method: This article addresses the aforementioned debates’ key arguments by discussing the relationship between gender equality and care policies that actively support family caregivers. The argument is contextualized with examples of empirical findings from the literature.

Results: We argue that, to some degree and under specific conditions, new policies on paid family care have the potential to reduce gender inequality.

Conclusion: The article contributes to theoretical debates about gender and care policy by evaluating the implications of systematically including policies on paid family care in the study of care policy. This inclusion could clarify the circumstances under which policy support for family caregivers can contribute to fostering gender equality.


Akgunduz, Y. E., & Plantenga, J. (2013). Labour market effects of parental leave in Europe. Cambridge Journal of Economics, 37(4), 845–862. DOI:

Anttonen, A., & Zechner, M. (2011). Theorizing care and care work: In B. Pfau-Effinger & T. Rostgaard (Eds.), Care between work and welfare (pp. 15–34). Palgrave Macmillan. DOI:

Aulenbacher, B., Lutz, H., & Schwitter, K. (2021). Gute Sorge ohne gute Arbeit? Beltz Juventa.

Bettio, F., & Plattenga, J. (2004). Comparing care regimes in Europe. Feminist Economics, 10(1), 85–113. DOI:

Bettio, F., & Verashchagina, A. (2012). Long-term care for the elderly: Provision and providers in 33 European countries. Publications Office of the European Union.

Bouget, D., Spasova, S., & Vanhercke, B. (2016). Work-life balance measures for persons of working age with dependent relatives in Europe. European Social Policy Network.

Brimblecombe, N., Fernández, J.‑L., Knapp, M., Rehill, A., & Wittenberg, R. (2018). Review of the international evidence on support for unpaid carers. Journal of Long-Term Care, 25–40. DOI:

Ciccia, R., & Bleijenbergh, I. (2014). After the male breadwinner model? Childcare services and the division of labor in European countries. Social Politics: International Studies in Gender, State & Society, 21(1), 50–79. DOI:

Ciccia, R., & Sainsbury, D. (2018). Gendering welfare state analysis: Tensions between care and paid work. European Journal of Politics and Gender, 1(1), 93–109. DOI:

Courtin, E., Jemiai, N., & Mossialos, E. (2014). Mapping support policies for informal carers across the European Union. Health Policy, 118(1), 84–94. DOI:

Crompton, R. (Ed.). (1999). Restructuring gender relations and employment: The decline of the male breadwinner. Oxford University Press. DOI:

Dalla Costa, M., & James, S. (1972). The power of women and the subversion of the community. Falling Wall Press.

Daly, M. (2011). What adult worker model? A critical look at recent social policy reform in Europe from a gender and family perspective. Social Politics: International Studies in Gender, State & Society, 18(1), 1–23. DOI:

Daly, M. (2020). Gender inequality and welfare states in Europe. Edward Elgar. DOI:

Daly, M., & Lewis, J. (2000). The concept of social care and the analysis of contemporary welfare states. British Journal of Sociology, 51(2), 281–298. DOI:

Da Roit, B., & Le Bihan, B. (2010). Similar and yet so different: Cash-for-care schemes in six European countries’ long-term care policies. The Milbank Quarterly, 88(3), 286–309. DOI:

Da Roit, B., & Le Bihan, B. (2019). Cash for long‐term care: Policy debates, visions, and designs on the move. Social Policy & Administration, 53(4), 519–536. DOI:

Deusdad, B. A., Comas-d’Argemir, D., & Dziegielewski, S. F. (2016). Restructuring long-term care in Spain. Journal of Social Service Research, 42(2), 246–262. DOI:

Dobrotić, I., Blom, S., & Koslowski, A. (Eds.) (2023). Research handbook on leave policy: Parenting and social inequalities in a global perspective. Edward Elgar. DOI:

Eggers, T., & Grages, C. (2023). Social risks of family carers in the context of welfare state policies. Journal of Family Research, 35, 304–325. DOI:

Eggers, T., Grages, C., Pfau-Effinger, B., & Och, R. (2020). Re-conceptualising the relationship between de-familialisation and familialisation and the implications for gender equality – the case of long-term care policies for older people. Ageing and Society, 40(4), 869–895. DOI:

Eggers, T., Grages, C., & Pfau-Effinger, B. (2021). Politiken zur familialen Care-Arbeit und Gleichstellung der Geschlechter–eine theoretische Diskussion. In S. Scherger, R. Abramowski, I. Dingeldey, A. Hokema & A. Schäfer (Eds.) Geschlechter-ungleichheiten in Arbeit, Familie und Wohlfahrtsstaat (pp. 165-190). Campus.

Eggers, T., Grages, C., & Pfau-Effinger, B. (2022). Care-Politiken, soziale Risiken und Geschlechterungleichheit im internationalen Vergleich. In U. Knobloch, H. Theobald, C. Dengler, A.-C. Kleinert, C. Gnadt, & H. Lehner (Eds.), Caring Societies – Sorgende Gesellschaften: Neue Abhängigkeiten oder mehr Gerechtigkeit? (pp. 38–65). Beltz Juventa.

Ehrlich, U., Minkus, L., & Hess, M. (2020). Einkommensrisiko Pflege? Der Zusammenhang von familiärer Pflege und Lohn. Zeitschrift für Gerontologie und Geriatrie, 53(1), 22–28. DOI:

Eichler, M., & Pfau-Effinger, B. (2009). The ‘consumer principle’ in the care of elderly people: Free choice and actual choice in the German welfare state. Social Policy & Administration, 43(6), 617–633. DOI:

EIGE (2023). Gender equality index 2023. Publications Office of the European Union.

England, P. (2005). Emerging theories of care work. Annual Review of Sociology, 31(1), 381–399. DOI:

Esping-Andersen, G. (1999). Social foundations of postindustrial economies. Oxford University Press. DOI:

Eydal, G. B., & Rostgaard, T. (Eds.) (2014). Fatherhood in the Nordic welfare states. Comparing care policies and practice. Policy Press. DOI:

Federici, S. (1975). Wages against housework. Falling Wall Print.

Fink, M., & Valovka, K. (2018). ESPN thematic report on challenges in long-term care. Austria. European Commission.

Folbre, N., & Nelson, J. (2000). For love or money? The Journal of Economic Perspectives, 14(4), 123–140. DOI:

Fraser, N. (1994). After the family wage: Gender equity and the welfare state. Political Theory, 22(4), 591–618. DOI:

Frericks, P., Jensen, P. H., & Pfau-Effinger, B. (2014). Social rights and employment rights related to family care: Family care regimes in Europe. Journal of Aging Studies, 29, 66–77. DOI:

Geissler, B., & Pfau-Effinger, B. (2005). Change in European care arrangements. In B. Pfau-Effinger & B. Geissler (Eds.), Care and social integration in European Societies (pp. 3–19). Policy Press. DOI:

Gerlinger, T. (2018). ESPN thematic report on challenges in long-term care. Germany. European Commission.

Gornick, J. C., & Meyers, M. K. (2008). Creating gender egalitarian societies: An agenda for reform. Politics & Society, 36(3), 313–349. DOI:

Hess, M., de Tavernier, W., & Naegele, L. (2020). Culture matters: Normen, Erwerbstätigkeit und informelle Pflege von älteren Frauen in Europa. [Culture matters: Norms, employment and informal care by older women in Europe]. Sozialer Fortschritt, 69(10), 667–685. DOI:

Hess, M., Schmitz, W., Naegele, L., & Stiemke, P. (2023). You will take care of me when I am old: Norms on children’s caregiver obligations. Journal of Family Research, 35, 196–211. DOI:

Himmelweit, S. (2007). The Prospects for caring: Economic theory and policy analysis, Cambridge Journal of Economics, 31(4), 581–599. DOI:

International Labor Organization. (2018). Care work and care jobs: For the future of decent work. [retrieved: October 11, 2023]

Jensen, P. H., Møberg, R. J., Och, R., & Pfau-Effinger, B. (2017). Explaining differences in women’s working time in European cities. European Societies, 19(2), 138–156. DOI:

Jenson, J. (2015). The fading goal of gender equality: Three policy directions that underpin the resilience of gendered socio-economic inequalities. Social Politics: International Studies in Gender, State & Society, 22(4), 539–560. DOI:

Jessoula, M., Pavolini, E., Raitano, M., & Natili, M. (2018). ESPN thematic report on challenges in long-term care. Italy. European Commission.

Kadi, S., Rodrigues, R., Kahlert, R., Hofmann, S., & Bauer, G. (2022). Does the family care best? Journal of Social Policy, 1–18.

Knijn, T., & Kremer, M. (1997). Gender and the caring dimension of welfare states: Toward inclusive citizenship. Social Politics: International Studies in Gender, State & Society, 4(3), 328–362. DOI:

Kodate, N., & Timonen, V. (2017). Bringing the family in through the back door. Journal of Cross-Cultural Gerontology, 32(3), 291–301. DOI:

Kröger, T. (2011). Defamilisation, dedomestication and care policy. International Journal of Sociology and Social Policy, 31(7/8), 424–440. DOI:

Kvist, J. (2018). ESPN thematic report on challenges in long-term care. Denmark. European Commission.

Land, H. (1978). Who cares for the family? Journal of Social Policy, 7(3), 257–284. DOI:

Le Bihan, B., Lamura, G., Marcak, J., Fernandez, J.‑L., Johansson, L., & Sowa-Kofta, A. (2019). Policy measures adopted to support unpaid care across Europe. Eurohealth, 25(4), 10–15.

Leitner, S. (2003). Varieties of familialism: The caring function of the family in comparative perspective. European Societies, 5(4), 353–375. DOI:

Leitner, S., & Lessenich, S. (2007). (In-)dependence as dependent variable: Conceptualising and measuring ‘de-familisation’. In J. Clasen & N.A. Siegel (Eds.), Investigating welfare state change (pp. 244–60). Edward Elgar. DOI:

León, M., Ranci, C., & Rostgaard, T. (2014). Pressures towards and within universalism. In M. León (Ed.), The Transformation of Care in European Societies (pp. 11–34). Palgrave Macmillan. DOI:

Lewis, J. (1992). Gender and the development of welfare regimes. Journal of European Social Policy, 2(3), 159–173. DOI:

Lewis, J., & Giullari, S. (2005). The adult worker model family, gender equality and care. Economy and Society, 34(1), 76–104. DOI:

Lister, R. (1994). ‘She has other duties’: Women, citizenship and social security. In S. Baldwin & J. Falkingham (Eds.), Social security and social change. New challenges to the Beveridge model (pp. 31–44). Harvester Wheatsheaf.

Liversage, A. (2023). A challenging responsibility: Care for older parents in Turkish immigrant families. Journal of Family Research, 35, 286–303. DOI:

Lohmann, H., & Zagel, H. (2016). Family policy in comparative perspective: The concepts and measurement of familization and defamilization. Journal of European Social Policy, 26(1), 48–65. DOI:

McLaughlin, E., & Glendinning, C. (1994). Paying for care in Europe: Is there a feminist approach? In L. Hantrais & S. Mangen (Eds.), Family policy and the welfare of women, concepts and contexts in international comparisons (pp. 52–69). European Research Centre.

Naldini, M., Pavolini, E., & Solera, C. (2016). Female employment and elderly care: The role of care policies and culture in 21 European countries. Work, Employment and Society, 30(4), 607–630. DOI:

OECD (2023). Health at a Glance 2023. OECD Publishing.

Orloff, A. S. (1993). Gender and the social right of citizenship: The comparative analysis of gender relations and welfare states. American Sociological Review, 58(3), 303–328. DOI:

Orloff, A. S. (2009). Should feminists aim for gender symmetry? Why a dual-earner/dual-caregiver society is not every feminist’s utopia. In J. C. Gornick & M. K. Meyers (Eds.), Gender equality (pp. 129–157). Verso.

Ostner, I. (1978). Beruf und Hausarbeit. Die Arbeit der Frau in unserer Gesellschaft. Campus-Verlag.

Pfau-Effinger, B. (2005). Culture and Welfare State Policies: Reflections on a Complex Interrelation. Journal of Social Policy, 34(1), 3-20. DOI:

Ranci, C., & Pavolini, E. (2015). Not all that glitters is gold: Long-term care reforms in the last two decades in Europe. Journal of European Social Policy, 25(3), 270–285. DOI:

Ranci, C., & Arlotti, M. (2019). Resistance to change: The problem of high non-take up in implementing policy innovations in the Italian long-term care system. Policy and Society, 10(3), 1–17. DOI:

Reimer, T. (2019). Why fathers don’t take more parental leave in Germany. Community, Work & Family, 36(3), 1–20.

Rummery, K. (2009). A comparative discussion of the gendered implications of cash-for-care schemes. Social Policy & Administration, 43(6), 634–648. DOI:

Rummery, K. (2021). Gender equality and the governance of long-term care policy. Journal of International and Comparative Social Policy, 37(1), 16–33. DOI:

Saraceno, C. (2023). The Role of the “Social Investment” Concept for the Development of Family Policy. In M. Daly, B. Pfau-Effinger, N. Gilbert & D. J. Besharov (Eds), The Oxford Handbook of Family Policy Over the Life Course (pp. 308–323). Oxford University Press. DOI:

Saraceno, C. (1997). Family Change, Family Policies and the Restructuring of Welfare. In Office of Economic and Cooperative Development (Eds), Family, Market and Community: Equity and Efficiency in Social Policy (pp. 81–100). OECD Publishing.

Saraceno, C., & Keck, W. (2011). Towards an integrated approach for the analysis of gender equity in policies supporting paid work and care responsibilities. Demographic Research, 25(11), 371–406. DOI:

Saxonberg, S. (2013). From defamilialization to degenderization. Social Policy & Administration, 47(1), 26–49. DOI:

Schäfer, A., & Gottschall, K. (2015). From wage regulation to wage gap. Cambridge Journal of Economics, 39(2), 467–496. DOI:

Shaver, S. (Ed.). (2018). Handbook on gender and social policy. Edward Elgar. DOI:

Spasova, S., Baeten, R., Coster, S., Ghailani, D., Pena-Casas, R., & Vanhercke, B. (2018). Challenges in long-term care in Europe. European Commission.

Theobald, H., & Luppi, M. (2018). Elderly care in changing societies: Concurrences in divergent care regimes. Current Sociology, 66(4), 629–642. DOI:

Tronto, J.C. (1993). Moral boundaries: A political argument for an ethic of care. Routledge.

Ungerson, C. (2004). Whose empowerment and independence? A cross-national perspective on cash for care schemes. Ageing and Society, 24(2), 189–212. DOI:

Verloo, M., & Lombardo, E. (2007). Contested gender equality and policy variety in Europe. In M. Verloo (Ed.), Multiple meanings of gender equality: A critical frame analysis of gender policies in Europe (pp. 21–51). CEU Press. DOI:

Wærness, K. (2000). Fürsorgerationalität. Feministische Studien, extra, 18(1), 54–57. DOI:

Yamane, S. (2021). Gender equality, paid and unpaid care and domestic work. The Japanese Political Economy, 47(1), 44–63. DOI:




How to Cite

Eggers, T., Grages, C., & Pfau-Effinger, B. (2024). Gender and policies on paid family care: Overview of debate and theoretical reflections. Journal of Family Research, 36, 43–57.