Innovating Through Care: Women, Territories, and Structural Justice

A reflection on social transformation, gender justice, and innovation for systemic change, written by Fabiola Aguilar, founder and executive director of Nexus for Social Advancement.

I grew up in a household of women, and from a very young age, my greatest admiration was—and still is—for my mother. For me, it was normal to see her perform multiple roles at once, as if the day had more than 24 hours. She was a distinguished professional, a tireless caregiver, a present, firm, and loving mother, a just disciplinarian, an intuitive psychologist, an impeccable household manager… and also a wife who—through silent courage—knew how to question and break molds that didn’t serve her.

Watching this juggling woman carry out each of these roles with love, commitment, and dedication inspired me in the tenderness of childhood. But later, through the critical lens of adulthood, I came to understand the burden it all entailed—and I asked myself: who cared for her during that stage of life devoted to caregiving? To care without limits, without support, without recognition, is a profound form of self-abandonment. And it takes a toll: physically, emotionally, mentally, and spiritually.

My mother taught me—not with speeches, but by example—that women are capable of holding everything together, but that doesn’t mean we should do it alone. She taught me that we, too, have the right to care for ourselves, to choose, to rest, and not to prove all the time that we can. I learned from her that feminine strength is not a duty—it is a choice; it is not sacrifice—it is dignity. And when that choice is restricted by a system that doesn’t protect us, it is not virtue—it is structural injustice.

At that time, it was enough for a man to "fulfill" his role as provider to be applauded, as if he were doing a favor. No one questioned that his "obligation" came with structural privileges. The idea of shared responsibility was unthinkable. Meanwhile, women gave their bodies, time, and energy to hold up the world—without pay, without rest, without applause.

That personal experience transformed how I see the world. It revealed to me that the personal is always political. And that if we want a more just society, we need to start by honestly asking: who provides care, how is care given, and who pays the cost for care to remain invisible?

📊 When Data Disrupts

That’s why, today, when I see Bolivian women step out each morning to support their families—many from informal economies, many without safety nets, many with postponed dreams—I feel a deep connection. That everyday scene is not an individual act: it’s a collective expression of resistance, of sustaining life, of feminism in action. Because caregiving is also a political act. And only by transforming the care system can we truly speak of equality, justice, and democracy.

This call is not exclusive to Bolivia. It echoes across Latin America, where unpaid care work represents, on average, between 15% and 25% of national GDP—if it were assigned economic value. Latin American women dedicate, on average, three times more time than men to unpaid care, which severely limits their economic autonomy, leisure time, and participation in public life.

While some countries have made significant progress, the historical debt remains deep. Uruguay is a pioneer with its National Integrated Care System (2015), which includes public services for children, the elderly, and people with disabilities. Costa Rica implemented its National Childcare and Development Network (0–12 years), linking local governments and civil society. Argentina recognized care as a right in its National Equality Plan, while Chile is advancing a gender- and territory-focused National Care System.

An inspiring example of territorial coordination is Bolivia’s Cochabamba Department, which in June 2025 became the first to advance a Departmental Care Law. This legal proposal seeks to institutionalize a more just, sustainable, and shared model of care, aligned with Bolivia’s National Care Policy 2021–2031.

This effort didn’t arise in a vacuum. Research in eight municipalities (e.g., Cochabamba City, Colcapirhua, and Arbieto) revealed that care work—especially in migrant households—disproportionately falls on women, limiting their participation in work, education, and politics. These local diagnoses, along with forums and dialogues with public and social actors, highlighted the urgent need to move toward shared responsibility among the State, men, communities, and employers.

Cochabamba has also been actively engaged in care governance initiatives, such as those led by UN Women, and is designing institutional mechanisms to coordinate future municipal and departmental services.

Although municipal-level services remain limited, this legislative step marks a historic milestone for Bolivia and a replicable model for other regions. It is no small matter: women drive more than 70% of Bolivia’s popular and community economy. Yet this economic leadership coexists with the burden of unpaid care work, which deeply limits their development, autonomy, and well-being.

🔍 According to the study "Toward a Care Society," Bolivian women dedicate an average of 28.5 hours per week to unpaid care, while men average only 12.5. This means 83.5% of unpaid care falls on women, directly impacting their access to employment, decent income, mental health, and free time.

Most concerning is that Bolivia still lacks a comprehensive care system with clear governance, consolidated institutions, or sustainable funding.

💡 What Can We Do About It?

In a context where care is increasingly recognized as a pillar for life’s sustainability and human rights, civil society organizations have been key players in building and promoting a transformative care agenda. The official launch of Bolivia’s National Care Policy is a major milestone, consolidating years of advocacy, territorial coordination, and collective work led by groups like the Gregoria Apaza Women’s Center, the Coordinadora de la Mujer, and the National Platform for Social and Public Co-Responsibility in Care.

This event, supported by organizations like UN Women, ILO, CIUDADANÍA, ActionAid, INSP!R Bolivia, and others, showcases civil society’s ability to advance public policy frameworks that address structural inequality—particularly for Indigenous women, informal workers, and female heads of household. The presence of Bolivia’s Ministry of Equal Opportunities underscored the importance of a State response aligned with its commitments to human rights, gender equality, and social justice.

More than a policy declaration, the National Care Policy symbolizes a civic achievement that demands the State strengthen a care system with an intersectoral focus—redistributing responsibilities among the State, society, and families, and recognizing care as a collective right and public priority.

At Nexus for Social Advancement, we believe data should not remain in reports: it should drive real action in viable, co-created, and sustainable public policies. Applied research is the bridge between knowledge and transformation. But designing from the top is not enough. It’s urgent to rethink what we do through collaborative, inclusive, and territory-based logics.

As Geoff Mulgan puts it, "Social innovation happens when we change not just what we do, but how we do it—and who does it."

🤝 Co-Creating with Territories

Top-down mandates won’t work. Care system transformation must be built with those who care every day: mothers, grandmothers, community leaders, local governments, and neighborhood networks. These actors must not be passive recipients of policy—they must be co-designers, implementers, and evaluators.

A hopeful example is Cochabamba, the first department to advance a municipal care law. This milestone was achieved thanks to leadership by the Municipal Government of Cochabamba and coordination with social organizations, supported by UN Women Bolivia through a regional program to strengthen care systems. This pioneering regulation is a concrete step toward a more equitable, co-responsible, and just society.

Building a care system in Bolivia is not just a technical task, nor solely a gender issue—it’s a historic opportunity to redefine our social, economic, and human priorities. If we can unite scientific evidence, social innovation, and territorial co-creation, we can design public policies that redistribute time, recognize invisible labor, and dignify caregiving as a right—not a solitary sacrifice.

Building Networks, Co-Creating Care, and Transforming Through New Masculinities

At Nexus for Social Advancement, we believe care system transformation must be part of a broader vision for social innovation and structural justice. That’s why integrating gender approaches, territorial development, and new masculinities is key to driving sustainable systemic change.

In this effort, our active participation in the Women Leaders of the Americas Directory in Bolivia [MLA - Angela] has been a strategic space to deepen these challenges. In our recent roundtable “The Importance of Weaving Connection Networks,” we emphasized a critical point: there can be no real co-responsibility unless we critically examine traditional models of masculinity that continue to associate care with femininity and perpetuate unequal burdens.

Addressing new masculinities is not a side issue: it’s essential for redistributing time, power, and recognition. This means educating, raising awareness, and actively inviting men to take on caregiving roles—not as "help," but as ethical and civic responsibility. At the same time, recognizing and strengthening women’s community networks must go beyond delivering services—it must begin with valuing their leadership and situated knowledge.

From this perspective, both Nexus for Social Advancement and the Bolivia Women Leaders of the Americas Directory—of which we are active members as a network of professional women, entrepreneurs, and change agents—fully support the emerging push for a National Care System in Bolivia. This directory, led by Claudia Erika Cortez Sanchez, Jimena Sainz, Silvia Oquendo, Catherine Heather Zuazo Avila, and myself, promotes a collective, intersectional vision that recognizes care as a pillar for equality and the sustainability of life. We believe public policy design must be grounded not only in rigorous evidence, but also in active listening to those who care and resist daily, with a strong commitment to co-creating solutions from the ground up.

We see this process not just as a technical reform, but as a historic opportunity for collective, intersectional, and territorial co-creation. We believe that only by integrating technical knowledge with the wisdom of territories can we build a care system that is truly just, co-responsible, and sustainable.

Social innovation happens in the territories. And when we speak of caring for life, the most transformative knowledge lives in those who sustain it every day—even if their names don’t yet appear in laws or their work is unpaid in statistics.

📖 This reflection is inspired by the study “Toward a Care Society to Achieve Women’s Economic Autonomy in Latin America and the Caribbean”, developed by WSM – INSP!R Latin America and the Caribbean Network with support from ECLAC. This document offers a deep dive into how to advance more just development models by recognizing care as a driver of equality and autonomy. Link

We also invite you to explore the national proposal in “Guidelines for a Public Care Policy: Toward a Comprehensive National System,” a key contribution from the National Platform for Social and Public Co-Responsibility in Care. This document lays the foundation for building a care system based on rights, intersectionality, and social co-responsibility. Link

Both studies are essential tools for those committed to structurally transforming care systems in Bolivia and across Latin America. Join the change: get informed, share, and act.