Colombia

A national care-policy agenda. A detailed local experience in Bogotá.

National profile

Sources reviewed 13 November 2026

In brief

Colombia’s national care policy sets an agenda for 2025–2034. Bogotá offers a more detailed local record of services, implementation and evaluation.

The two levels answer different questions. National commitments describe the wider policy direction; Bogotá’s findings concern a specific city and its service models.

For policy practice

Read the commitments alongside evidence of delivery. A policy’s adoption does not establish that every eligible caregiver receives support.

CONPES 4143: National Care Policy

Caregiver health in policy

The national policy includes psychosocial support, community networks and respite-related measures for specified caregiver groups.

Scroll across the table to read all three columns.

Examples of national commitments
Support	Who it addresses	Evidence status
Psychosocial accompaniment	Signatories caring for older people or people with disabilities or high-cost illnesses, and family caregivers of signatories in those groups (ARN, 2025–2031)	Policy commitment
Community networks and psychosocial support	Young women caregivers affected by racialization and poverty in urban and rural peripheries	Policy commitment
Physical activity and respite measures	Caregivers within the policy’s sports and recreation actions	Policy commitment

These examples do not establish a single universal caregiver-health benefit. Delivery still needs action-level verification.

Support while someone else provides care

Medellín describes its Círculos de Cuidado as free spaces offering wellbeing, rest, training, psychosocial and legal support to caregivers while children, older people or people with disabilities in their care receive attention. The city's directory also lists physiotherapy, physical-health support, leisure and economic-autonomy activities. The offer may vary by venue and schedule.

CONPES 4143: National Care Policy

Policy and institutions

2025

A national framework

CONPES 4143 was approved on 14 February. Its implementation period extends to 2034.

2025–2034

Shared responsibilities

Actions are assigned to implementing institutions, with six-monthly physical and financial reporting consolidated by DNP.

Communications on the right to care and caregivers’ rights

A wider territorial landscape

In its 2025–2026 accountability report, the Ministry of Equality and Equity identified 12 operating territorial care experiences across cities, departments and Bogotá. These include Círculos de Cuidado in Medellín, Club Care in Manizales, Barrios que Cuidan in Pereira, CuidArte in Cali and Territorio de Cuidado in Cumbal. The list records the ministry's assessment; it does not establish comparable coverage or health outcomes across places.

Accountability report 2025–2026

Implementation and financing

National implementation

DNP’s first-year account offers an administrative snapshot. These figures describe implementation reporting, not changes in caregivers’ health.

133actions in the national implementation plan

30actions met or exceeded their 2025 annual target

DNP report for the 2025-II cutoff, officially closed in June 2026. The reporting base for the 30 actions is unclear; these figures should not be read as a completion rate.

Medellín: participation and access

On 5 November 2026, Medellín reported 12 care circles and one community laundry. The city also reported that more than 4,500 women had participated in respite activities, without specifying a full reference period in that account. Its directory says caregivers can approach their nearest circle to enroll or use services, and links each venue to its programme.

Bogotá: local service reach

The city directory inspected on 9 November 2026 lists 27 Care Blocks offering free services. The June report records 506,161 people and 3,969,762 service encounters in Care Blocks, cumulatively from 1 November 2020 to 30 June 2026.

These are city service-use records, not national coverage or counts of improved health. Encounters can repeat, and service reclassification limits trends.

DNP also reports 57 actions with double approval and 33.4% progress against annual targets. Reported financial execution for this cutoff was COP 118,896.41 million. The policy’s indicative COP 25,655,382 million cost covers 2025–2034. These amounts have different purposes and periods; their ratio is not a valid policy-completion measure.

Findings and limits

This profile presents no evaluation of the national policy’s effects. The study below concerns Bogotá only.

Local evaluation / Bogotá Care Blocks / Reported February 2024

Wellbeing findings need careful interpretation

An adjusted comparison of 702 Care Block users and 702 non-users estimated a 7-percentage-point higher share reporting happiness among users. Differences in self-rated health and emotional symptoms were not statistically significant.

What this can tell us

The study offers evidence about a particular city service model. It compares groups and may retain unmeasured differences; it does not demonstrate national policy effects.

A caregiver intervention studied in Cali

Arango-Lasprilla and colleagues randomized 69 family caregivers of people with dementia recruited through an Alzheimer's foundation in Cali to an eight-week cognitive-behavioral group or an educational comparison group. After adjustment for baseline differences, the intervention group reported lower depression and burden and greater satisfaction with life at the end of the programme and at three months; the study found no significant difference in perceived stress. Outcomes were self-reported, follow-up was short, and participants came from one foundation. The study did not evaluate Cali's public CuidArte system.

Evaluation of a group cognitive-behavioral dementia caregiver intervention in Latin America

The wider Bogotá study included 2674 people across several service models and used propensity-score matching and entropy balancing. Its results table marks the happiness difference at the 95% significance level. The table and narrative disagree on some details; the figures here follow the table and its legend. These are comparisons between groups, not changes in the same people over time.

Evaluation of Bogotá’s District Care System: results report, deliverable 4

City case / Colombia

Go deeper: Bogotá

A full collection connecting policy history, institutions, neighbourhood services and evidence.

The policyThe territoryThe evidence

Enter the Bogotá collection

Includes the Los Mártires case and resources developed in the Care for Health context.

Where Medellín lists its care circles

The municipal directory listed the following venues when accessed on 13 November 2026. Contact the city or consult the linked programme before visiting, as schedules and services can change.

Care circles listed by the city
Area	Venue
1. Popular	Casa de la Cultura
2. Santa Cruz	Casa de Justicia Villa del Socorro
3. Manrique	UVA La Armonía
4. Aranjuez	Centro Integral de Servicios Ambulatorios para la Mujer y la Familia
5. Castilla	UVA Sin Fronteras
6. Doce de Octubre	Centro de Desarrollo Social
7. Robledo	Parque Biblioteca Tomás Carrasquilla, La Quintana
8. Villa Hermosa	UVA La Imaginación
9. Buenos Aires	Centro de Emprendimiento y Empleo
10. La Candelaria	Centro Integral para la Familia
13. San Javier	Parque Biblioteca San Javier
60. San Cristóbal	Parque Biblioteca Fernando Botero

The directory lists 12 venues, matching the city's 5 November 2026 release, although an older answer on the same directory page still says nine.

Sources

National implementation

Action-level evidence is still needed to establish delivery of the specific health-support commitments.

Comparable service reporting

Bogotá’s monthly reports and dashboard need careful reconciliation of periods, people and encounters.

Beyond Bogotá

Other territorial initiatives require their own source review; this collection does not represent all Colombian local care policies.

Time use: the denominator matters

DANE's time-use survey for September 2024 to August 2025 provides estimates for 24 departments and Bogotá. In Antioquia, 91.4% of women and 64.3% of men aged ten or older participated in unpaid work and related activities. Among those who participated, average daily time was 6 hours 10 minutes for women and 2 hours 43 minutes for men. The time measure includes unpaid domestic work as well as care, and its denominator differs from the participation rate.

Unpaid work across Colombia’s departments

Daily hours among people aged 10 or older who performed unpaid work and related activities, September 2024–August 2025. Includes domestic work and care. The table follows DANE’s territorial order.

Search the table

Unpaid work across Colombia’s departments
Department or district	Women, h:mm (95% interval)	Men, h:mm (95% interval)
Antioquia	6:10 (5:54–6:26)	2:43 (2:30–2:56)
Atlántico	6:33 (6:19–6:47)	2:42 (2:32–2:52)
Bogotá, D.C.	6:58 (6:43–7:13)	3:41 (3:29–3:53)
Bolívar	7:02 (6:42–7:22)	2:13 (1:59–2:27)
Boyacá	6:48 (6:19–7:17)	2:26 (2:04–2:48)
Caldas	7:04 (6:33–7:36)	2:42 (2:24–2:59)
Caquetá	9:14 (8:42–9:46)	2:47 (2:29–3:05)
Cauca	7:40 (7:20–8:00)	2:49 (2:38–3:00)
Cesar	6:46 (6:28–7:04)	2:39 (2:25–2:52)
Córdoba	8:31 (8:08–8:55)	2:54 (2:34–3:15)
Cundinamarca	9:14 (7:37–10:51)	3:49 (3:05–4:34)
Chocó	5:40 (5:18–6:02)	3:17 (2:59–3:35)
Huila	9:03 (8:23–9:44)	2:45 (2:24–3:06)
La Guajira	7:12 (6:51–7:34)	2:33 (2:17–2:49)
Magdalena	12:41 (11:53–13:29)	4:41 (4:06–5:16)
Meta	8:52 (8:18–9:27)	3:15 (2:53–3:37)
Nariño	7:30 (7:07–7:52)	3:03 (2:47–3:18)
Norte de Santander	7:29 (7:06–7:52)	2:59 (2:49–3:10)
Quindío	5:11 (4:45–5:38)	1:40 (1:24–1:56)
Risaralda	9:08 (8:34–9:41)	4:09 (3:35–4:43)
Santander	8:20 (7:52–8:48)	2:55 (2:39–3:12)
Sucre	7:51 (7:09–8:33)	2:38 (2:15–3:02)
Tolima	6:52 (6:33–7:10)	3:01 (2:45–3:16)
Valle del Cauca	8:21 (7:41–9:00)	4:35 (3:23–5:47)
San Andrés	6:04 (5:41–6:28)	2:28 (2:14–2:41)

Intervals are DANE’s published 95% confidence intervals. These are averages among participants, not all residents or only caregivers. The CSV also preserves participation rates, their intervals and coefficients of variation. The workbook’s update note says 14 August 2026; its survey reference period is September 2024–August 2025.

Download CSV National Time Use Survey: departmental annex, September 2024 to August 2025

Decilion + Acción Pública

About the observatory

Understanding care policy through unpaid caregivers’ health.

Our purpose

Conceptual illustration of hands supporting a neighbourhood, connecting care and community life.

Caregivers’ health at the centre

How do care policies recognize, support and measure the health of people who provide unpaid care?

The Care and Health Observatory brings together public policy documents, service information and research to help policy practitioners explore that question across Latin America and the Caribbean.

It connects readable country profiles with source records and deeper local cases. Readers can examine what a policy promises, what is documented about its delivery, and what research can tell us about caregivers’ health.

The observatory brings together Decilion and Acción Pública. Its focus is unpaid caregivers; information about paid care workers or people receiving care is identified in context when it helps explain a policy or service.

Compare policy approaches

From Bogotá to a regional view

Our connection to Care for Health

Decilion develops the regional observatory, drawing on its Bogotá policy and documentary work with Care for Health (C4H). C4H, led by Acción Pública, studies the health impacts of Bogotá’s Manzanas del Cuidado, or Care Blocks. Decilion contributes to its policy work.

The Bogotá collection remains a detailed resource for that project, bringing together policy history, institutions, territories, services and public evidence. The observatory extends the documentary perspective to other countries while keeping Bogotá’s local context visible.

Two connected kinds of work

C4H’s empirical study assesses health impacts in Bogotá. The observatory organizes and interprets public documentary evidence across policies and places. Its regional profiles do not report C4H participant results or extend that impact assessment to other countries.

The regional profiles use public sources. They contain no participant-level C4H data, private correspondence or unpublished interviews.

Explore the Bogotá collection

Visit Acción Pública’s Care for Health project

A starting collection, with uneven depth

The ten profiles cover Colombia, Uruguay, Costa Rica, Chile, Brazil, Mexico, Ecuador, the Dominican Republic, Argentina and Peru.

Colombia Uruguay Costa Rica Chile Brazil Mexico Ecuador Dominican Republic Argentina Peru

This collection is not a representative sample or a census of care policies in the region. A wider search also identified useful material in Panama, Paraguay, Cuba and Jamaica; those countries do not yet have full profiles here.

Bogotá is a local case within Colombia; Mexico City’s measures are distinguished from Mexico’s federal developments. A city finding cannot be read as a national result. Countries also differ in the amount and type of material available.

How sources enter the collection

We select public sources that help explain policy design, caregiver support, implementation, financing and health evidence. The collection gives priority to legislation, official plans, administrative reports, statistics and published evaluations.

Traceable findings

Each country profile links findings to their sources and keeps the population, place, period and study design visible. We distinguish what a policy promises from documented delivery and measured outcomes.

Reading the original

The library links to original documents and their publication pages. Country profiles identify material limits in the evidence.

Source checking

Findings are checked against their sources. Conflicting figures and unavailable full texts are identified where they affect interpretation.

Browse the source library

What different evidence can tell us

Sources answer different questions. Their findings should not be combined into a single measure of policy success.

Policy commitments: Laws, plans and budgets document rights, intentions and allocations. They do not establish that services reached people or that allocated money was spent.
Services and implementation: Administrative reports describe activity and reach. Encounters can repeat; people, households, facilities and places are different units. Official reporting is not independent verification of delivery.
Health measurement: Surveys and monitoring can describe health, wellbeing or care burden. These outcomes are not interchangeable. Associations and self-attributed consequences do not by themselves establish policy effects.
Evaluation findings: Interpret results within the study’s design, population and intervention. A small pilot or a local observational comparison does not establish the effects of a whole national care system.

No ranking of health impact

The comparison supports reading across policy commitments, services and evidence. It does not pool effects, assign country scores or rank countries by caregiver-health impact.

This is not a systematic literature review, a comprehensive legal or fiscal audit, or a complete directory of available services.

Explore the health-evidence comparison

Read every finding with its date

Sources reviewed on 13 November 2026. Each figure retains the period it describes.

Publication dates and the periods covered by the data may differ. Programme conditions and source websites can change.

What an open gap means

A gap may be an inaccessible source, a contradiction within the evidence, unverified current implementation, or a topic outside this review. “Not established in this collection” does not mean that a policy, service or study does not exist.

Country profiles identify their remaining questions beside the relevant findings. Use those notes, the source details and the dated evidence together when interpreting or reusing the material.

Read the country profiles

Contact

Help improve the observatory

Have you spotted an error, found a useful document or worked on a care initiative? We welcome contributions from the countries included here and from those we have not yet covered.

Suggest a correction

Tell us which page or figure needs updating and include a source when possible.

Share a document

Send a report, evaluation, dataset or policy document that could strengthen the collection.

Collaborate

Get in touch to contribute country knowledge, research or an experience of care policy.

info@decilion.com

Johnattan García Ruiz · Decilion

Compare care and health policy

Ten countries, three questions. Commitments, services and evidence, with their limits.

Source review 13 November 2026 How to read this comparison

Choose countries

Countries to compare

Reading the evidence

Commitment is not delivery

Laws, plans and frameworks describe different duties and intentions. A documented service offer or allocation does not establish that every eligible caregiver receives support.

Geography matters

National policies and city experiences are explicitly labelled. Bogotá and Mexico City inform local learning; they cannot stand for national coverage or effects.

Evidence answers different questions

A survey describes experiences; monitoring tracks selected users; evaluations use different comparison designs. A missing or inaccessible report is not evidence of no effect.

This is a targeted documentary comparison of ten countries, not an exhaustive regional review or a ranking of policy effectiveness. Source periods and populations differ. Budgets, service counts and health percentages are not combined into a common score.

Read the full country profiles

Uruguay

An established care system. Caregiver support in a new plan.

National profile

Sources reviewed 13 November 2026

View sources

In brief

Uruguay’s National Integrated Care System combines personal assistance, teleassistance and day centres. Its 2026–2030 plan explicitly commits to spaces for mental-health attention for unpaid caregivers.

For policy practice

Separate the services already reported from support promised in the new plan. Personal-assistance subsidies pay for an assistant; they are not unrestricted income for the family caregiver.

Caregiver health in policy

Scroll across the table to read all three columns.

Documented support and evidence status
Support or measure	Who it addresses	Evidence status
Self-care, guidance and spaces for mental-health attention	Unpaid caregivers addressed by the new plan	Plan commitment; delivery unverified
Subsidized personal assistance	People with severe dependency within the age criteria; subsidy level depends on household resources	Established service with restricted eligibility
Teleassistance and day centres	Eligible users of the respective services	Reported service use; caregiver-health effects not established

Age boundaries and assistance hours differ across the reviewed documents. Check the service’s access channel before treating a particular rule as universal.

Care and time for family caregivers

A MIDES qualitative evaluation conducted in 2018–2019 found that some interviewed families described personal assistance as relief. They used the time it made available for work, rest, recreation and social activities. Its phase-one table lists 145 interviews, including 63 with family members.

In Juan Lacaze, a small 2023 study interviewed eight mothers or sisters caring for people with intellectual or psychosocial disabilities. Six scored in a burden category on the Zarit scale. This local convenience sample describes participants, not national prevalence or an effect of SNIC.

Policy and institutions

Law 19.353

An integrated system

SNIC operates through interinstitutional governance, with distinct service and financing responsibilities.

2026–2030

A new support agenda

The plan assigns unpaid-caregiver support design and implementation to the Secretaría Nacional de Cuidados.

Who can use day centres?

The SNIC directory describes day centres for people living at home with mild or moderate dependency. Attendance is fully subsidized and offered two, three or five days a week, following a dependency assessment. The directory says people must be older than 65; a 2025 SNIC announcement says 65 or older, so the exact age boundary needs confirmation.

The directory describes cultural, recreational, physical and cognitive activities led by a professional team, as well as support to caregiving families. It gives 0800 1811 as the application channel; the person seeking care or a representative may call. A centre team interviews an accepted applicant before admission.

National Care Plan 2026–2030

Implementation and financing

The ministry reports distinct service-user snapshots: 5927 personal-assistance users in October 2025, 978 active teleassistance users and 266 active day-centre users in November 2025. These are not unique unpaid caregivers or counts of health improvement.

Read these figures with their scope

The November 2026 update describes a unified access window and interoperable information as work in progress. Training 6000 people is an announced workforce-development commitment, not completed training or caregiver-service reach.

Financing

BPS reports 2025 execution of UYU 2,020,825,630 for personal assistance and UYU 22,337,829 for teleassistance. These program lines do not cover all SNIC expenditure. Separate expansion appropriations are UYU 40 million for 2026 and UYU 80 million annually from 2027; they do not establish services delivered.

From assessment to assistance

The 2024 program design describes a home assessment of dependency and household circumstances, followed by a subsidy decision and selection of an authorized assistant. It required the pairing to be formed within 120 calendar days after notification; otherwise the person had to apply again. Current operational rules should be confirmed.

A 2025 programme analysis quotes the 2023 annual report’s pairing proportions by subsidy level and interprets the gradient as a possible disincentive from copayments. The figures are observed differences; without group sizes and adjustment for other factors, they do not establish that copayments caused the difference.

In November 2022, SNIC recorded 5,407 active personal-assistance users nationally, including 1,547 in Montevideo and 876 in Canelones. Those are historical counts of people using a service, not estimates of all people needing care or of caregiver health outcomes.

The 2024 design reports 6,048 active personal-assistance users in December 2023 and a presence in all 19 departments. It also reports 4,263 assistants working in the individual provision model. Users and paid assistants are different populations, and neither count measures unpaid family caregivers who received support.

Personal-assistance pairing among applicants assessed in 2021–2023
Subsidy awarded	Formed at least one pairing
100%	78.3%
67%	42.1%
33%	22.6%

Each percentage uses assessed applicants in that subsidy category as its denominator. Group sizes were not reported.

BPS’s monthly-average beneficiary counts and the ministry’s October snapshot have different reference periods and cannot be compared as an unqualified trend.

Findings and limits

Implementation and experience

An official compendium records a 2020 evaluation of management, outputs and stakeholder valuation. A later mixed-method study examines collective personal assistance through three initial cooperatives.

Interpretation and limits

These records support learning about delivery and experience. They do not establish a causal effect on unpaid caregivers’ health.

What evaluations can tell us

A 2024 day-centre evaluation covered all centres operating at the time. When its results were presented in October 2025, SNIC reported that all interviewed users and families would recommend the programme. The announcement did not state the number interviewed or a comparison design, so satisfaction should not be read as a measured effect on health or dependency.

February 2026 consultative committee minutes record the National Care Secretariat’s Susana Muñiz describing the personal-assistance waiting list as structural. University of the Republic representative Karina Batthyány referred to more than 7,000 applicants when asking for cost and timing estimates. Her statement is not an audited current waiting-list count.

The personal-assistance qualitative evaluation interviewed recipients, family members, assistants and institutional actors across selected northern and southern localities. Its purposive design helps explain experiences and implementation problems, but cannot measure the programme’s causal impact or represent every family.

Local cases

Territorial perspective / Uruguay

Tacuarembó and Salto

Three initial personal-assistance cooperatives are the setting for the CIEDUR study. Interviews and surveys of assistants and care referents offer a territorial implementation perspective.

The local examples describe selected services and do not cover every territorial initiative.

Day centres listed by SNIC

The undated SNIC service directory lists these nine centres across eight departments. A separate MIDES listing names Minas instead of Montevideo. Confirm the location, eligibility and available places with the care system before making a visit.

The listed centres are managed by cooperatives, civil-society organizations and other local entities. The directory provides individual addresses and opening hours, but it does not provide a live count of available places or establish that every locality has a centre.

Locations in the SNIC directory, accessed 13 November 2026
Department	Locality	Listed operator
Montevideo	Montevideo	Cooperativa Iniciativa Latinoamericana
Canelones	Pando	Cooperativa Soy porque somos
Canelones	La Paz	Fundación Centro de Educación Popular
Rivera	Tranqueras	CLAEH
Rocha	Rocha	Cooperativa Yapeyú
Colonia	Juan Lacaze	CADIS
Cerro Largo	Melo	Cooperativa IMPACTA
Paysandú	Paysandú	Cooperativa Ágora
Tacuarembó	Paso de los Toros	Casa del Adulto Mayor Isabelino

Directory listing, not a verified current availability or vacancy count.

Sources

The available records do not provide a consistent current series of service users, waiting lists and caregiver-health outcomes. Programme counts and budget lines cover different institutions and periods.

Reading the financing figures

A 2025 sustainability analysis reports UYU 2,304 million in MIDES-SNIC execution for 2024. It says its 2020–2024 series excludes reported execution by INAU and ANEP and uses a different reporting boundary from 2016–2019. It is therefore not a whole-system total or a consistent series across both periods.

Analysis of the financial sustainability of Uruguay’s National Integrated Care System

Costa Rica

Care support and access. Emerging evaluation evidence.

National profile

Sources reviewed 13 November 2026

View sources

In brief

Costa Rica’s SINCA framework recognizes caregiver support, quality of life and training. Current plans add stress management and respite targets, while two strands of evaluation reporting provide evidence to examine carefully.

For policy practice

Check eligibility, actual service assignment and the outcome being measured. Registration does not guarantee immediate support, and a small pilot does not establish the effects of the national system.

Caregiver health in policy

Scroll across the table to read all three columns.

Documented support and evidence status
Support or measure	Who it addresses	Evidence status
Self-care and burnout prevention	Caregivers addressed by action 5.1.5	2024–2026 plan commitment
Training and respite	Heredia trainees and proposed municipal respite-centre users	Targets, not verified achievements
Severe-dependency benefit	Households with a male or female caregiver and a co-resident person assessed with severe dependency	Current IMAS benefit rule

Some professional-college training is restricted to nursing professionals or assistants. It cannot all be counted as support for unpaid family caregivers.

Time devoted to unpaid care

In Costa Rica’s 2022 time-use survey, women who actively cared for a totally dependent household member aged 12 or older reported more time in that activity than participating men. Active care is direct care; simultaneous monitoring while doing something else is measured separately. The averages describe people who performed the activity, not all adults.

INEC estimated that 2.6% of the surveyed population lived in a household with a totally dependent person aged 12 or older. Among people aged 12 or older, 2.0% of women and 1.3% of men participated in this care. INEC marks the men’s participation estimate as unreliable (coefficient of variation 25.8%). Neither figure measures receipt of a SINCA service.

Weekly active care of a totally dependent household member, October–November 2022
Participants aged 12 or older	Average hours:minutes per week
Women	13:32
Men	6:25

Average among people who performed this activity, by sex. The person receiving care was aged 12 or older. The male time estimate is imprecise: 47 survey respondents, 95% confidence interval 4:04–8:47, coefficient of variation 18.8%.

Policy and institutions

Law 10.192

A national framework

SINCA’s technical secretariat sits in IMAS. Regulation 44.242 prioritizes dependency and, within equal dependency, socioeconomic vulnerability.

2024–2026

An adopted action plan

Monitoring duties and dependency-assessment obligations are documented. A subsequent four-year plan was being formulated in October 2026; it is not substituted for the adopted plan here.

Eligibility and finding support

The IMAS procedures manual approved in March 2026 describes the severe-dependency benefit category for a female or male caregiver who lives with the household member assessed as severely dependent. The dependency assessment and other applicable rules determine eligibility; a category description alone does not guarantee a benefit.

IMAS says Cuidar.cr, launched at the end of 2024, lets households find trained individual caregivers and care organizations or businesses to contact for hiring. It also offers the Cuidar+ credential. A directory entry does not itself provide a public subsidy or guarantee availability.

Implementation and financing

The action plan targets 150 participants in Heredia caregiver training across 2024–2026 and two municipal Casa cuidador respite centres, one each in 2024 and 2025. Completion has not been verified in this review.

Read these figures with their scope

Training and respite targets are not verified achievements. Registration does not guarantee immediate service assignment, which depends on resources and technical assessment.

Financing

The 2025 annual report’s severe-dependency-only category lists 6299 households, 6311 persons and CRC 5,261,251,885. A separate combined severe-dependency/basic-needs category lists 10 households and CRC 6,480,000. The categories may overlap and are not summed here. These are program figures, not total SINCA expenditure. The table’s footer says March 2025, while matching totals point to year-end 2025. IMAS has not confirmed the reference period, which remains unresolved.

From a local pilot to a system

An IMAS report covering April 2023 to December 2024 recorded 214 Heredia teleassistance devices installed and 103 pending at its reporting snapshot. It said the remaining installations would follow completion of the control group. The report also describes coordination with San José and Cartago to consider implementation in 2025; it does not confirm deployment there.

The 2024–2026 action plan assigned Heredia targets of 150 caregiver-training participants and two municipal Casa cuidador respite centres. These are planned targets; the sources reviewed do not establish completion.

The same IMAS report documents work to apply the dependency assessment in several regional areas, including Heredia and an Indigenous territory, and to integrate assessment records into SINIRUBE. It describes these actions during the 2023–2024 management period; it is not a census of people currently served.

Findings and limits

Testing cash and teleassistance

The cash pilot preceded SINCA. Its small sample, short follow-up and self-reported outcome questions limit interpretation.

A randomized cash-for-care pilot surveyed 46 unemployed women caring for a co-resident, with 23 in each group. The intervention provided USD 141 monthly for four months; surveys took place in November 2021 and February 2022. The authors reported reduced distress, but their table shows the treatment group’s affirmative responses for fear, stress, feeling depressed and anguish rising from pre-test to post-test. This unresolved inconsistency prevents a reliable conclusion about the direction of those outcomes. The authors found no significant within-group gain in employment or leisure; their spending question compared intended with actual use of the transfer, not whether basic needs were adequately met.

A 2026 Heredia municipal announcement reports a randomized teleassistance evaluation with 636 people, while a 2025 conference abstract reports 634 older adults and family caregivers. The full 2026 article was not accessible for appraisal, and the caregiver outcome denominator, instruments and attrition remain unclear. The reports may concern the same trial.

The 2025 teleassistance abstract reports reduced caregiver burnout, but gives no usable effect size or separate caregiver denominator.

The cash pilot used simple yes-or-no questions about feelings attributed to caregiving, including exhaustion and feeling depressed. These responses can reveal experiences within the study, but they are not clinical diagnoses. Treatment and control groups also differed in household size and the availability of another caregiver at baseline.

The table’s control group also shows rising affirmative counts, often by more than the treatment group: fear 11 to 18 versus 10 to 17, stress 6 to 19 versus 9 to 18, depression 9 to 19 versus 7 to 14, and anguish 7 to 19 versus 5 to 13. The post-test between-group contrasts and the authors’ reduction narrative therefore need to be read together with the unresolved coding or reporting problem; these counts alone do not demonstrate harm.

A randomized controlled trial of home teleassistance for older adults in need of care in Costa Rica

Local cases

Territorial perspective / Costa Rica

Heredia

The caregiver-training target and teleassistance evaluation identify a useful local setting. Their populations and activities differ; they should not be combined into a single measure of municipal performance.

The Heredia case describes a local service; it does not establish national coverage.

Heredia’s teleassistance service

A 2025 national mapping study reported 317 users of Heredia’s municipal teleassistance and estimated a local-government cost of CRC 8,900 per user per month in its study context. The count matches the 214 installed and 103 pending devices in the IMAS report; their overlap with the trial’s intervention group has not been independently established. In October 2026, the municipality reported that it had subsequently added the former control group as active users. The historical count does not establish current availability.

The IMAS management report also describes an institutional service catalogue by dependency level and a georeferencing tool for care organizations. The underlying datasets were not retrieved, so their coverage and present availability remain unverified.

Sources

National survey results, local service reports and small trials describe different populations. The available sources do not provide a national service register or comparable measures of access, spending and caregiver-health outcomes.

What the figures represent

The time-use results come from a national household survey; the Heredia service milestones come from local administrative and study reports. They measure different populations and cannot be added together. The cash pilot measured individual questionnaire responses over a short period, rather than clinical diagnoses or national programme outcomes.

Chile

Care rights and local networks. A clearer wellbeing focus.

National profile

Sources reviewed 13 November 2026

View sources

In brief

Chile’s enacted care-system law recognizes care, receiving care and self-care, including priority mental-health access for unpaid caregivers. Established local programs document practical support and wellbeing monitoring.

For policy practice

Distinguish legal rights, program eligibility and actual access. Administrative wellbeing measures are useful, but unresolved denominators prevent treating them as reliable performance headlines.

Caregiver health in policy

Scroll across the table to read all three columns.

Documented support and evidence status
Support or measure	Who it addresses	Evidence status
Priority mental-health access	Unpaid caregivers under article 9	Statutory provision; program requirements apply
Home support and specialist services	Households assessed through the local support network	Operating framework; receipt not universal
Psychosocial support and replacement care	Community Care Centre participants	Documented program offer

Community centres describe brief individual support, groups and referrals. A referral does not guarantee a primary-care or mental-health appointment.

Caregiver support and health

The local network offers a care plan, home support and specialist services that can include occupational therapy, kinesiology and psychology, according to assessed needs.

The caregiver credential gives priority attention at participating public institutions, including Fonasa. This is an administrative access benefit; it does not itself guarantee a clinical appointment.

Policy and institutions

16 February 2026

A law in force

Law 21.805 creates the National Support and Care System and recognizes care-related rights.

14 August 2026

An amended framework

Law 21.835 places the care secretariat under the Subsecretaría de Servicios Sociales. The regulation deadline is twelve months from publication of the original law; issuance remains to be verified.

How to access support

People with moderate or severe functional dependence should keep their Social Household Registry information current. The local team assesses potential users, and admission depends on places available in the commune. People can also ask their municipality about local coverage.

A separate stipend supports eligible unpaid caregivers of people with severe dependency. A primary-care team applies on their behalf; the March 2026 sheet states a maximum of CLP 32,991 per month, subject to eligibility and budget availability.

The stipend sheet lists an order of priority: severity assessed with the Barthel Index, then how long the application has been waiting, oldest first, then the care recipient’s socioeconomic classification. Registration for a credential and eligibility for this payment are separate processes.

Law 21805: the right to care and the National Support and Care System, PDF as of 14 August 2026

Implementation and financing

The 2025 management report describes the local support network’s expansion from 155 to 215 communes. It records agreements for 68 community care centres with capacity for 5630 caregivers, separately from the 7 centres inaugurated in 2024 and 57 in 2025.

Read these figures with their scope

Agreements, capacity, inaugurations and actual participants are different measures. The 2026 goal of 100 centres under agreement is a target, not a count of operating centres.

Financing

The ministry attributes CLP 42,845,817,703 in investment to the local support network in its 2025 management report. This is not presented as consolidated expenditure for the whole care system.

Coordination with primary care

The 2025 monitoring record for home care describes collaboration between the health programme and the local care network. It reports that coordination at local level was under assessment and joint technical guidance was being developed.

Home care for people with severe dependency: year-end 2025 monitoring report

Undersecretariat of Social Services: comprehensive management report 2025

Findings and limits

Wellbeing is being measured

Community Care Centres monitor life satisfaction, care/personal-time balance, social life and emotional balance. This documents an explicit caregiver-wellbeing focus.

Interpretation and limits

The monitoring file records improvement for 370 of 671 people in subjective wellbeing and 302 of 592 in emotional balance, but separately lists 471 intervention exits. Some exit-information modules were still being developed. These inconsistent counts prevent a clear interpretation of improvement rates.

What monitoring can establish

The reviewed records support an account of statutory rights, program reporting and intended outcome measurement.

Interpretation and limits

They do not establish a completed causal caregiver-health effect estimate for the national system. Before-and-after reports among selected completers also need a credible comparison to support causal claims.

What evaluation can tell us

An independent 2020 evaluation of RLAC covered 2016–2019. Its panel found that the data available at the time could not support an evaluation of intermediate or final outcomes. This is a historical finding, not a judgment about the current monitoring system.

A separate 2009 study validated original and abbreviated Zarit caregiver-burden scales in 32 caregivers at a Melipilla clinic, with repeat testing in 22. It assessed measurement, not the effects of RLAC.

The validation study compared the scales with a subjective burden question and a depression survey. Its small, single-centre sample supports a cautious account of how burden can be measured; a burden score is not itself a diagnosis of illness.

Local cases

Territorial perspective / Chile

Local support networks and community centres

These are territorial delivery models within the national policy landscape. This collection documents their operating framework and aggregate reporting; it does not yet offer a verified commune-by-commune service directory.

The available sources do not establish current operating locations, actual users or waiting lists for every commune.

A territorial footprint

ChileAtiende reported in its 13 July 2026 update that RLAC operated in 215 communes. Access remains subject to places available locally.

The Ministry’s 2025 social development report listed the communes expected to have the network that year, across all 16 regions. This is a historical planning snapshot; inclusion does not establish that a household received a particular service or that a place is available now.

Find a commune in the 2025 network plan

The ministry’s 2025 report lists 215 communes across 16 regions expected to have the local support and care network. Search a commune or region below.

Search the table

Find a commune in the 2025 network plan
Region	Commune
Arica y Parinacota	Putre
Arica y Parinacota	Camarones
Arica y Parinacota	Arica
Tarapacá	Pozo Almonte
Tarapacá	Colchane
Tarapacá	Huara
Tarapacá	Alto Hospicio
Tarapacá	Iquique
Antofagasta	Sierra Gorda
Antofagasta	María Elena
Antofagasta	Taltal
Antofagasta	Tocopilla
Antofagasta	Calama
Antofagasta	Antofagasta
Antofagasta	Mejillones
Atacama	Huasco
Atacama	Tierra Amarilla
Atacama	Alto Del Carmen
Atacama	Chañaral
Atacama	Caldera
Atacama	Vallenar
Atacama	Copiapó
Coquimbo	Punitaqui
Coquimbo	Vicuña
Coquimbo	Paiguano
Coquimbo	Combarbalá
Coquimbo	Salamanca
Coquimbo	Monte Patria
Coquimbo	Los Vilos
Coquimbo	Illapel
Coquimbo	Ovalle
Coquimbo	Coquimbo
Valparaíso	Puchuncaví
Valparaíso	Llaillay
Valparaíso	El Tabo
Valparaíso	Quillota
Valparaíso	Papudo
Valparaíso	Catemu
Valparaíso	Olmué
Valparaíso	Putaendo
Valparaíso	Casablanca
Valparaíso	Los Andes
Valparaíso	Limache
Valparaíso	Quintero
Valparaíso	San Antonio
Valparaíso	Calera
Valparaíso	San Felipe
Valparaíso	Villa Alemana
Valparaíso	Valparaíso
Valparaíso	Viña del Mar
Valparaíso	Petorca
Valparaíso	La Ligua
Valparaíso	Quilpué
Metropolitana	Lampa
Metropolitana	Colina
Metropolitana	El Bosque
Metropolitana	Quilicura
Metropolitana	San José De Maipo
Metropolitana	María Pinto
Metropolitana	San Pedro
Metropolitana	Tiltil
Metropolitana	Pirque
Metropolitana	Talagante
Metropolitana	Lo Prado
Metropolitana	San Ramón
Metropolitana	Padre Hurtado
Metropolitana	Curacaví
Metropolitana	La Granja
Metropolitana	Independencia
Metropolitana	Lo Espejo
Metropolitana	Renca
Metropolitana	Cerrillos
Metropolitana	Pedro Aguirre Cerda
Metropolitana	La Pintana
Metropolitana	Quinta Normal
Metropolitana	Melipilla
Metropolitana	Estación Central
Metropolitana	Cerro Navia
Metropolitana	Peñalolén
Metropolitana	Recoleta
Metropolitana	Pudahuel
Metropolitana	Santiago
Metropolitana	La Florida
Metropolitana	San Bernardo
Metropolitana	Maipú
Metropolitana	Puente Alto
Metropolitana	Alhué
Metropolitana	Buin
Metropolitana	San Joaquín
Metropolitana	Ñuñoa
O’Higgins	Malloa
O’Higgins	Pichilemu
O’Higgins	Peralillo
O’Higgins	Las Cabras
O’Higgins	Coltauco
O’Higgins	Graneros
O’Higgins	Chimbarongo
O’Higgins	Coinco
O’Higgins	Placilla
O’Higgins	Doñihue
O’Higgins	Mostazal
O’Higgins	Santa Cruz
O’Higgins	San Vicente
O’Higgins	Rengo
O’Higgins	Machalí
O’Higgins	San Fernando
O’Higgins	Rancagua
Maule	Teno
Maule	Constitución
Maule	Parral
Maule	San Javier
Maule	Chanco
Maule	Empedrado
Maule	Pelluhue
Maule	Pelarco
Maule	Hualañé
Maule	Pencahue
Maule	Villa Alegre
Maule	San Clemente
Maule	Molina
Maule	Linares
Maule	Curicó
Maule	Talca
Maule	Río Claro
Maule	Cauquenes
Ñuble	Coelemu
Ñuble	Cobquecura
Ñuble	Coihueco
Ñuble	Yungay
Ñuble	San Nicolás
Ñuble	Chillán Viejo
Ñuble	Portezuelo
Ñuble	Ninhue
Ñuble	Ranquil
Ñuble	Quirihue
Ñuble	El Carmen
Ñuble	San Carlos
Ñuble	Chillán
Biobío	Cabrero
Biobío	Penco
Biobío	Tomé
Biobío	Concepción
Biobío	Contulmo
Biobío	San Rosendo
Biobío	Alto Biobío
Biobío	Curanilahue
Biobío	Hualqui
Biobío	Cañete
Biobío	Lota
Biobío	Arauco
Biobío	Hualpén
Biobío	Talcahuano
Biobío	Los Angeles
Biobío	Santa Juana
Biobío	Chiguayante
Biobío	Coronel
La Araucanía	Pitrufquén
La Araucanía	Lautaro
La Araucanía	Galvarino
La Araucanía	Perquenco
La Araucanía	Ercilla
La Araucanía	Lumaco
La Araucanía	Toltén
La Araucanía	Los Sauces
La Araucanía	Melipeuco
La Araucanía	Lonquimay
La Araucanía	Saavedra
La Araucanía	Teodoro Schmidt
La Araucanía	Nueva Imperial
La Araucanía	Purén
La Araucanía	Loncoche
La Araucanía	Collipulli
La Araucanía	Padre Las Casas
La Araucanía	Angol
La Araucanía	Temuco
La Araucanía	Traiguén
La Araucanía	Villarrica
Los Ríos	Panguipulli
Los Ríos	Río Bueno
Los Ríos	Máfil
Los Ríos	Los Lagos
Los Ríos	Futrono
Los Ríos	Paillaco
Los Ríos	La Unión
Los Ríos	Valdivia
Los Lagos	Frutillar
Los Lagos	Dalcahue
Los Lagos	Río Negro
Los Lagos	Llanquihue
Los Lagos	Castro
Los Lagos	Ancud
Los Lagos	Palena
Los Lagos	Chaitén
Los Lagos	Curaco De Vélez
Los Lagos	Quemchi
Los Lagos	Los Muermos
Los Lagos	Quinchao
Los Lagos	Quellón
Los Lagos	Calbuco
Los Lagos	Purranque
Los Lagos	Osorno
Los Lagos	Puerto Montt
Aysén	Tortel
Aysén	Guaitecas
Aysén	Río Ibáñez
Aysén	Lago Verde
Aysén	Cochrane
Aysén	Aysén
Aysén	Coyhaique
Magallanes	San Gregorio
Magallanes	Torres Del Paine
Magallanes	Cabo De Hornos
Magallanes	Porvenir
Magallanes	Natales
Magallanes	Punta Arenas

This is the report’s prospective 2025 list, not a verified directory of current operation, places or service receipt. Confirm access with the municipality.

Download CSV Social Development Report 2025

Sources

The planned commune list and announced national reach do not establish each site’s current capacity, waiting list or delivered services. Evidence on the current network’s caregiver-health outcomes remains limited.

Understanding the figures

The enacted 2026 budget initially appropriated CLP 54,800.9 million for RLAC. This is an appropriation, not actual spending; a 2026 execution figure was not verified.

For community care centres, the ministry’s 2025 monitoring record describes a weighted method for prioritising communes, using factors that include potential demand and social vulnerability. A place in the estimated ranking does not mean that a centre has opened.

Brazil

A national care framework. Early territorial implementation.

National profile

Sources reviewed 13 November 2026

View sources

Older people at Centro Dia do Idoso Nascer do Sol in Porto Alegre, Brazil. — Centro Dia do Idoso Nascer do Sol, Porto Alegre, 2022. A local care service that predates the national policy. Photo: Evelize Fabricio/FASC/PMPA

In brief

Brazil’s national care policy establishes coordination and monitoring responsibilities. Public records describe a multi-year plan, initial home-care pilots and services that recognize family-caregiver stress, while important full-source gaps remain.

For policy practice

An announced envelope or accession timetable does not show services delivered. Use documented service descriptions now, while withholding detailed national health-target claims until the full plan and annex are verified.

Caregiver health in policy

Scroll across the table to read all three columns.

Documented support and evidence status
Support or measure	Who it addresses	Evidence status
Daytime support and shared care	Dependent older people and people with disabilities facing specified vulnerabilities, including family-caregiver stress	Centro-Dia service description
Guidance for families	Families using Centro-Dia services	Documented offer; local access varies
National caregiver-health targets	Population and action-specific scope still to verify	Detailed plan targets not assessed in this profile

The documented service offer does not establish universal access, treatment of caregiver illness or measured health benefits.

Support for caregivers in day services

Centro-Dia offers daytime support for older people and people with disabilities who depend on care for daily activities and whose limitations have been aggravated by rights violations, such as isolation, inadequate care or high family-caregiver stress. The federal service description includes guidance and support for family caregivers, alongside care and social activities for the person attending.

Accessing day centres

Policy and institutions

December 2024

A national policy

Law 15.069 establishes the care policy.

July 2025

Shared coordination

Decree 12.562 regulates the plan, with coordination across the ministries responsible for social development, women and human rights. Annual monitoring duties are not proof of completed reports.

A cash benefit and a care service have different purposes

The Benefício de Prestação Continuada (BPC) pays one monthly minimum wage to eligible low-income people aged 65 or older and people with disabilities. It is an individual assistance benefit, not a payment for being a caregiver. A person who cares for someone may qualify in their own right if they meet the rules.

The federal Centro-Dia description says the service can also orient families about access to BPC and other assistance. Receiving information about a benefit does not establish eligibility for it.

Implementation and financing

The accession timetable opened progressively to states, the Federal District and municipalities during December 2025–June 2026. An official October 2026 account reports Cuidar em Casa pilots beginning in Fortaleza, Colombo and Juazeiro (Bahia) during 2026.

Read these figures with their scope

An open accession process does not establish the number of participating governments or operating services. The reported pilot locations do not imply nationwide coverage.

Financing

The accessible official plan overview describes 79 actions across five axes and BRL 24.9 billion over 2024–2027. This is an announced multi-year envelope, not verified spending or entirely new caregiver-health funding.

Finding and using a Centro-Dia

The federal service page describes Centro-Dia as free and says a person may attend for a morning, afternoon or full day according to the family or individual plan. It describes a five-day week with ten hours a day, without closing at lunchtime. The page directs families to the MOPS service locator and the free telephone line 121; waiting and access depend on the individual plan and local availability.

Accessing day centres

Findings and limits

Evaluation activity is documented

IDB project BR-T1684 is listed as in implementation and supports integrated home-care piloting and evaluation. BR-T1741 is listed as in preparation, proposing causal evaluation of unpaid-caregiver burden, mental health, employment and time use.

Interpretation and limits

Preparation is not approval. Neither project record supplies completed health-effect results. This review has not established a completed national-policy caregiver-health effect estimate.

Two trials of support for family caregivers

In southern Brazil, Bierhals and colleagues randomized 48 family caregivers of older stroke survivors to three nurse home visits with education and emotional support or usual guidance. Over one year, there was no significant group-by-time effect for overall quality of life, while social relationships showed a significant interaction. An autonomy interaction was reported in the subgroup of 15 caregivers aged 60 or older, six in the intervention group and nine in the control group; baseline autonomy scores differed substantially. Participants came from one region and the nurses had specialized training.

In Manguinhos, Rio de Janeiro, Lino and colleagues tested six hours of home assistance weekly from an itinerant community caregiver over six months. The study found no statistically significant reduction in caregiver burden or depression but reported a significant reduction in measured risk of violence against the older person. The authors report 81 pairs randomized and 48 completers in the body, but 38 pairs in the abstract. Attrition and per-protocol analysis limit interpretation. Neither study evaluated the national Cuidar em Casa pilot.

Local cases

Territorial perspective / Brazil

Fortaleza, Colombo and Juazeiro (Bahia)

These three cities are named in the official account of initial Cuidar em Casa pilots. The account provides a starting point for territorial follow-up, not a complete city dossier or an evaluation of effects.

The available account does not establish the operating units, access rules or caregiver reach of each municipal pilot.

Territorial rollout and existing infrastructure

A federal cooperation work plan counted 422 active Centro-Dia facilities in Minas Gerais on 24 March 2026. The same table lists 377 facilities that completed the 2024 SUAS census. The dates and bases differ; neither number is a count of caregivers served.

The federal government reported that Belo Horizonte joined the national plan in February 2026 and was selected for support to implement a cuidoteca. An accession and a selection do not establish that a service has opened. The Cuidar em Casa pilot was reported in Fortaleza, Colombo and Juazeiro in 2026.

Joining the National Care Plan

Sources

The sources describe national policy, selected local services and small trials. They do not establish nationwide coverage, executed spending or health effects of the new national pilots.

Reading the evidence

The federal service page describes an intended offer and how to seek it. Registry counts describe facilities, not unique people or successful treatment. The two peer-reviewed trials provide intervention-specific results from small samples and should not be used to infer the effect of the national plan.

Mexico

Caregiver-health measurement. Federal and city care policies.

National profile

Sources reviewed 13 November 2026

View sources

In brief

Mexico combines dedicated caregiver-health survey data with a developing federal care framework. Mexico City’s enacted care-system law is a separate local development, with explicit mental-health and respite provisions.

For policy practice

Keep three kinds of evidence separate: a federal framework, city-level legal duties and survey reports of caregiving-related symptoms. None alone establishes policy effects or completed service delivery.

Caregiver health in policy

Scroll across the table to read all three columns.

Documented support and evidence status
Support or measure	Who it addresses	Evidence status
Respite and self-care	Groups addressed by the federal framework	Framework presentation; delivery not established
Mental-health and psychosocial support	Caregivers under Mexico City’s law	City-level legal provisions
Health-experience measurement	ENASIC respondents in the specified caregiver populations	Survey self-reports, not diagnoses or policy effects

Mexico City’s provisions are not a federal entitlement. The federal law-inventory check did not identify a comprehensive national care-system law by title, but it does not establish an absence of care-related legal protections.

Caregiver health in the survey

In INEGI’s 2022 care survey, people who care for someone in their own household reported effects they attributed to care. Among women in this group, 39.1% reported tiredness, 31.7% less sleep, 22.7% irritability, 16.3% feeling depressed and 12.7% affected physical health. Among men in this group, 15.2% reported tiredness, 17.3% less sleep and 7.4% irritability. The population includes people caring for someone temporarily ill in the previous week. These are self-reports, not clinical diagnoses or policy effects.

The survey also estimated average care time for principal caregivers: 38.9 hours a week for women and 30.6 for men. That is a different measure and population from the health indicators.

Policy and institutions

October 2025

A federal framework

The SNPC presentation describes interinstitutional coordination and phased development of SIDECU. It is not a comprehensive statute.

July 2026

A separate city law

Mexico City’s law was promulgated on 2 July and entered into force on 3 July. It provides for staged governance, regulation and program development.

A city support programme

The 2025 rules for Ciudad que Cuida a quien Cuida planned support for 1,000 caregivers aged 18–56 who care for one or more people with very high dependency. The benefit was up to MXN 4,000 per person in 2025, in two bimonthly instalments of MXN 2,000, with payment depending on the month of entry. The planned transfer total was MXN 4 million; the rules do not establish actual spending.

The programme rules also describe home visits, information about UTOPÍAs and Casas de las 3R, and help arranging appointments. The rules describe intended delivery; they are not a count of completed visits or appointments.

Ciudad que Cuida a quien Cuida: programme operating rules 2025

Implementation and financing

A 10 July 2026 ministry release reports 104,326 facilities in SIDECU’s initial phase and a timetable for state diagnostics and action plans. Completion of those plans has not been verified. The earlier inventory’s 118,618 facilities has a different date and unreconciled scope; the difference is not evidence of closures.

Read these figures with their scope

Neither the facility inventory nor the budget annex counts caregivers whose health improved. City mental-health/respite delivery and the completion of implementation steps remain unverified.

Financing

Approved PEF 2026 Annex 31 totals MXN 468,641,530,004 in cross-cutting care-related appropriations. It is not expenditure already incurred or wholly additional funding. Separately, Mexico City’s law charges its 2026 costs to existing approved budgets without authorized expansion.

Services reported in the first Casa

The city’s first government report says Casa de las 3R Ximena Guzmán Cuevas opened in May 2025. It reports 388 free laundry services and 320 spa services there by the report date. These counts describe services provided, not the number of distinct users.

The same report states an investment of MXN 13 million in that Casa. It sets a longer-term goal of 200 care centres, a target distinct from the number already opened.

First Government Report 2024–2025: strategic area 1

Findings and limits

ENASIC: health experiences, not policy effects

ENASIC 2022 counts 31.7 million caregivers aged 15 or older across their own and other households; 75.1% were women. The health percentages use a narrower group: those providing care within their own household, separately by sex, including care for temporary illness in the preceding week.

Explore the survey’s caregiver-health findings

Policy evaluation remains an open question

The city law provides for evaluation and participatory quality feedback. Evalúa CDMX’s diagnostic and design report examines the system for 2023 and was published in 2024. It predates the July 2026 law.

Interpretation and limits

The diagnostic report does not evaluate the July 2026 law. The sources reviewed do not establish a measured caregiver-health effect of the federal SNPC.

Evidence from an IMSS day centre

A 2024 IMSS and Inter-American Development Bank evaluation followed 66 of 110 caregivers in a day-centre pilot, with 21 in the centre group and 45 in the waiting group. The report found higher subjective wellbeing in the centre group using a binary attendance measure; differences in caregiver burden and depression were not statistically significant.

Selection began with random invitations, but some selected nonattenders joined the comparison group and the analysis used actual attendance. Attrition, the small sample and multiple outcomes limit the strength and generalizability of the findings. This pilot is separate from the national care system and the Mexico City law.

The evaluation also reported more care activities for other household members as attendance increased. It could detect only relatively large caregiver effects, with a reported minimum detectable effect of 0.75 standard deviations; an inconclusive result should not be read as proof that an effect is absent.

Impact evaluation of the first IMSS day centre on the wellbeing of older people and their caregivers

Local cases

Territorial perspective / Mexico

Mexico City

Article 49(III) assigns a duty to offer mental-health services to caregivers who request them. Article 53 provides for progressive mental-health and psychosocial support; article 58 addresses respite/support spaces and peer support.

The city’s policy framework, service examples and diagnostic report describe different stages of implementation.

Two care sites in Mexico City

City venue listings describe care and health services alongside community facilities at Utopía Mixiuhca and Utopía Ceylán. The hours below apply to the venue; individual services may have different requirements, hours or appointment systems.

Illustrative city venues
Venue	Borough	Venue hours
Utopía Mixiuhca	Iztacalco	09:00–18:00, daily
Utopía Ceylán	Azcapotzalco	08:00–20:00, Tue–Sun

Schedules and individual services should be confirmed before visiting.

Sources

National policy, Mexico City programmes and the IMSS case have different scopes. The available records do not provide comparable current measures of operating sites, service capacity, spending and caregiver reach.

A territorial diagnosis

Evalúa CDMX’s 2023 diagnostic and design assessment, published in 2024, mapped service supply and potential demand. It identified 95 candidate zones for new disability-care centres. These were proposed locations, not a count of operating facilities.

The assessment used territorial clustering and available infrastructure to identify potential sites. Published in September 2024, it predates the 2026 city law and does not evaluate that law’s implementation or effects.

Diagnostic and design evaluation of the Mexico City Care System, 2023

Ecuador

A caregiver-support standard makes burden and emotional wellbeing measurable, while local community initiatives and national time-use accounts show different parts of the care landscape.

National profile

Sources reviewed 13 November 2026

View sources

Three distinct windows on care

Ecuador’s April 2026 technical standard for the Servicio de Atención y Fortalecimiento a Personas Cuidadoras (AFPC) treats caregivers as direct recipients of support. Its focus is caregivers linked to disability services of the Ministry of Human Development, rather than all people performing unpaid work.

INEC’s national accounts and Quito’s neighborhood initiatives add context at different scales. They should be read alongside the service standard, without treating either as a measure of AFPC coverage.

Measuring wellbeing

The AFPC admission and results protocol requires the Zarit burden scale and Goldberg anxiety/depression scale at baseline and annually. A perception questionnaire covering the service’s dimensions repeats every six months; assessment of nearby support networks repeats annually.

These are concrete tools for following caregiver wellbeing. The standard supplies instruments and records, but no completed cohort with repeated scores, attrition or a comparison group from which to estimate health effects.

Technical standard for the Caregiver Support and Strengthening Service: Agreement MDH-DM-2026-0007-A

Who the AFPC standard includes

The standard prioritizes family or community caregivers of dependent people linked to ministry services. Entry criteria include being at least 18, voluntary participation, willingness to join a caregiver committee and residence in the intervention territory.

The listed documents include identity, proof that the person receiving care uses ministry services, participant registration and consent, and an admission form signed with the support-network technician. This describes the prescribed entry process; it does not provide a verified open appointment channel or waiting-time guarantee.

Technical standard for the Caregiver Support and Strengthening Service: Agreement MDH-DM-2026-0007-A

Committees and territorial accompaniment

AFPC is designed around periodic accompaniment by support-network technicians. The operational model assigns one technician to an attention unit with 20 committees of 30 caregivers; committee size may range from 15 to 40 according to technical judgment and local circumstances.

These are staffing and organization parameters. Assessing delivery requires actual staff in post, active committees, attendance and completed health assessments, rather than multiplying the model’s ratios into a national beneficiary total.

Technical standard for the Caregiver Support and Strengthening Service: Agreement MDH-DM-2026-0007-A

Unpaid work is broader than direct care

INEC estimates that in 2023 women doing unpaid work devoted 28.7 hours per week to it, compared with 11.4 for men. The denominator is people aged 12 or older who performed unpaid work; the numerator covers 66 activities. These estimates include domestic work and are not hours spent exclusively caring for dependent people.

The satellite account is a national statistical synthesis with provisional figures. Its methods combine source surveys and population projections, adjusting and estimating activities not fully observed in the 2023 module. It does not measure caregiver depression or evaluate AFPC.

Weekly unpaid-work hours, 2023
Population	Hours
Women aged 12+ doing unpaid work	28.7
Men aged 12+ doing unpaid work	11.4

INEC satellite account, provisional estimates; 66 activities, not direct-care hours alone.

Quito: neighborhood care networks

Quito’s municipality reports that Vecindades de Cuidado has operated since 2025 with zonal administrations and support from UN Women. Its Escuela de Cuidados covers rights, gender and masculinities, community leadership and protection routes against violence.

The January 2026 account identifies participation by women leaders in the rural parish of Pacto. It provides a concrete territorial example of community organization, but no measured change in burden or mental health and no basis to identify it as AFPC delivery.

More support for caregivers: Quito’s community care network

Read standards, data and local reports separately

The official register confirms the AFPC publication date and title; the full gazette contains the operational rules and annexes. INEC’s results should be read with its methods, while the Quito article is a municipal report of activities.

Browse the source library

Dominican Republic

Home-care pilots, workforce development and self-care support in Azua and Santo Domingo Este.

National profile

Sources reviewed 13 November 2026

View sources

From territorial pilots to wider provision

The 2024 UN joint-programme report describes Comunidades de Cuidado as a pilot for the national care policy in Azua and Santo Domingo Este. Work combined institutional coordination, workforce development and information about household demand and local services.

By September 2026, Supérate reported hired home-care workers in those initial territories and preparations to expand elsewhere. This documents an implementation trajectory, rather than proof of nationwide service availability.

Self-care support reaches the pilot territories

Supérate reports two workshop sessions in Azua and Santo Domingo Este on 31 October 2026. The content included recognizing stress, fatigue and burden, identifying responsibilities that can be shared and preparing a personal self-care plan. The report describes trained care personnel, including continuity with Infotep training; it does not distinguish unpaid family caregivers as a separate recipient group.

The account describes a six-dimension wellbeing wheel and says psychology professionals are available to support care personnel. It does not report a validated health scale, attendance denominator or repeated outcomes, so the workshops cannot be presented as demonstrated reductions in stress.

Supérate strengthens caregivers’ self-care and wellbeing in Santo Domingo Este and Azua

A staged route into home care

Supérate’s third-quarter 2026 report describes an operational pathway: identify eligible vulnerable households using SIUBEN data, contact them, visit to assess demand and willingness to receive care, and refer case files to CONAPE. Programme participants in intervention territories are prioritized.

This is a targeted referral pathway documented by the implementing institution. The documents do not establish an unrestricted national application entitlement, a maximum wait or the capacity available to a particular household.

Annual Operational Plan 2026 monitoring and evaluation report: third quarter

Referral is a separate milestone

For the third quarter of 2026, Supérate records 500 people from vulnerable households with dependency channelled for care against a target of 500. Although the product heading says people receive care, the indicator actually counts referrals.

The same table marks follow-up through CONAPE after six months as not applicable. The 500 therefore cannot be counted as confirmed recipients, completed home-care episodes or unique caregivers supported.

Third-quarter 2026 administrative milestones
Milestone	Reported status
People referred for care	500
Six-month CONAPE follow-up	Not applicable in the table

Referrals do not verify receipt of care.

Annual Operational Plan 2026 monitoring and evaluation report: third quarter

Information systems and process learning

The 2024 joint-programme report records 9246 completed household interviews and georeferenced mapping of public, private and community care provision in the pilot territories. These are information-system outputs, not the number of households receiving services.

It also reports a process evaluation of Comunidades de Cuidado that identified practices and opportunities for improvement. The summary describes implementation learning; it does not supply a counterfactual estimate of caregiver health or time released.

Care Communities: pilot design and implementation in the Dominican Republic. Joint Programme final report

Azua, Santo Domingo Este and expansion

Supérate’s September 2026 account reports 243 hired caregivers after 100 recent hires. It distinguishes this from approximately 450 additional hires planned for later months. It also reports hiring mothers and relatives caring for children and adolescents with severe disabilities after training.

Expansion preparation named San Cristóbal, San Pedro de Macorís, La Altagracia, Monseñor Nouel, Pedernales, Dajabón and Santo Domingo Norte. These are seven territories, including a municipality, despite the article’s headline referring to seven provinces. Hiring counts are not counts of households served or evidence of health benefit.

Supérate works to expand care services in seven provinces

Follow each step with its own evidence

The joint-programme report documents design and implementation through 2024. Supérate’s 2026 quarterly table is the source for referrals, while its September and October reports describe hiring and self-care activities. Each source measures a different step in the pathway.

Browse the source library

Argentina

Time-use inequality, assessed home assistance and a local basis for measuring caregiver burden.

National profile

Sources reviewed 13 November 2026

View sources

Different routes into care

Argentina offers a useful distinction between measuring unpaid work and accessing assistance. ENUT 2021 describes time use; PAMI offers a partial home-assistant subsidy to eligible older members. These sources describe different populations and cannot be combined into a national coverage rate.

Measuring burden in Buenos Aires

Tartaglini and colleagues examined the Zarit scale in two independent samples of family caregivers of people with dementia: 150 participants for exploratory analysis and 203 for confirmatory analysis. Recruitment was purposive, in Buenos Aires and surrounding areas, during 2014–2018. The study supports measurement in this setting; it does not estimate national burden or show that a service improves health.

Zarit Caregiver Burden Scale: psychometric properties among family caregivers in Buenos Aires

A proposal and an existing benefit

The 2022 Cuidar en Igualdad bill proposed an integrated care-policy system and changes to leave arrangements. It is presented here as a legislative proposal, not an enacted SINCA. The concrete national access route documented in this profile is PAMI’s home-assistant subsidy.

Applying for PAMI assistance

The subsidy addresses functional dependency in older PAMI members without an adequate support network. The member, representative or relative can apply online or through a PAMI agency. Required documents include identity, membership or payment evidence, informed consent, a medical report and a request letter. The social team assesses dependency and the family’s capacity to help; the assistance is partial.

Home care assistant subsidy

Participation and time are separate measures

In ENUT 2021, 91.7% of women and 75.1% of men performed unpaid work. Among participants, daily time including simultaneous activities was 6 hours 31 minutes for women and 3 hours 40 minutes for men. Unpaid work includes domestic work, care and support to other households or voluntary work: these are not care-only hours.

The survey covers people aged 14 and over in EPH urban agglomerations and localities with at least 100,000 inhabitants according to the 2010 census. Rural Argentina is not represented by these estimates. Table 1 also reports time without simultaneity; it must not be mixed with the figures above.

National Time Use Survey 2021: final results

Buenos Aires: day centres

The city’s day centres provide activities, meals and psychological, social and legal guidance. General admission requires city residence, independence in daily activities, identity documentation, medical clearance and an interview. A separate Centro Modelo addresses cognitive impairment and relatives. These distinct entry conditions matter when assessing whether a centre can support a particular household.

Buenos Aires day centres

What each source establishes

INDEC supplies population time-use estimates within its urban frame. PAMI and the city publish access rules. The Zarit paper supplies local psychometric evidence. None of these sources provides a linked estimate of service receipt and change in caregiver health.

Browse the source library

Peru

A national survey of time and satisfaction, a care-provider register and locally defined services.

National profile

Sources reviewed 13 November 2026

View sources

Time, experience and access

Peru’s ENUT 2024 combines time-use measurement with questions about satisfaction. Its scope includes urban and rural residents aged 12 and over in private households. Separate public sources describe a national care-provider register and municipal services for older people, offering practical access routes without establishing an integrated service package.

Satisfaction is not a clinical scale

ENUT asks how satisfied people are with the time devoted to themselves, children, parents and other relationships. It also asks about care activities, rest and free time. These questions describe experience and time allocation; they do not diagnose depression or measure caregiver burden with a clinical instrument.

A 2022 cross-sectional study applied Zarit to 57 adult caregivers of older people linked to PADOMI in Trujillo in 2020. Table 2 includes younger adults and six non-family caregivers. The convenience sample provides local descriptive evidence, not a national estimate or an evaluation of the home-care programme.

The paper’s participant table conflicts with its stated age criterion. Its abstract refers to 600 registered older people, while the methods refer to 58. These internal inconsistencies limit interpretation of the sample.

Care registration and policy

MIMP presented the National Care Register for Older People on 25 June 2026. It connects information about care providers and institutions with older people and families seeking assistance. The registration document explicitly is not professional or employment certification.

A bill to create a National Care System was received by the Chamber of Deputies on 23 October 2026. This profile treats that document as a proposal, not as proof that the system has been enacted or implemented.

What registration requires

The free register asks care providers for personal details, experience, training, availability and supporting documents such as certificates or recommendations. The ministry identifies rncpam.mimp.gob.pe/RNCPAM as the access route. The launch notice does not report completed care arrangements or service hours.

Launch of the National Care Registry for Older People

Read the question before the percentage

For time devoted to parents, ENUT reports 23.1% of women and 20.4% of men as little satisfied, and 4.2% and 3.0% respectively as not at all satisfied. This is satisfaction with time devoted to parents, not the prevalence of illness among caregivers.

For time devoted to children, the graph reports lower female percentages in both dissatisfaction categories: 13.9% versus 17.1% for little satisfied, and 1.4% versus 1.7% for not at all satisfied. The accompanying prose describes higher female dissatisfaction, contradicting its own numbers. The graph is used here; no clinical interpretation is attached to either comparison.

National Time Use Survey 2024: main results

San Isidro: municipal entry points

San Isidro’s CIAM registration is for residents aged 60 and over. Applicants bring a completed registration form and identity document showing a San Isidro address to a neighbourhood centre or CIAM. The municipal listing includes psychology, geriatrics, physical therapy, nutrition and cognitive stimulation. This is a local service offer for older people, not a nationwide caregiver-respite entitlement.

Enrollment in San Isidro’s Comprehensive Care Centre for Older People

Complementary evidence, distinct populations

The ENUT report includes the questionnaire and methods. The registry announcement, municipal access instructions and Trujillo study describe different populations. Together, they do not establish how many caregivers receive support or how it affects their health.

Browse the source library

Care and health in public policy

Start with a policy question

Explore the region

Colombia

Uruguay

Costa Rica

Chile

Brazil

Mexico

Ecuador

Dominican Republic

Argentina

Peru

Inside Bogotá

Follow the evidence

Colombia

In brief

Caregiver health in policy

Support while someone else provides care

Policy and institutions

A national framework

Shared responsibilities

A wider territorial landscape

Implementation and financing

National implementation

Medellín: participation and access

Bogotá: local service reach

Findings and limits

Wellbeing findings need careful interpretation

A caregiver intervention studied in Cali

Go deeper: Bogotá

Where Medellín lists its care circles

Sources

National implementation

Comparable service reporting

Beyond Bogotá

Time use: the denominator matters

Unpaid work across Colombia’s departments

About the observatory

Caregivers’ health at the centre

Our connection to Care for Health

Two connected kinds of work

A starting collection, with uneven depth

How sources enter the collection

Traceable findings

Reading the original

Source checking

What different evidence can tell us

Read every finding with its date

What an open gap means

Help improve the observatory

Suggest a correction

Share a document

Collaborate

Source library

Documents

Compare care and health policy

Reading the evidence

Commitment is not delivery

Geography matters

Evidence answers different questions

Uruguay

In brief

Caregiver health in policy

Care and time for family caregivers

Policy and institutions

An integrated system

A new support agenda

Who can use day centres?

Implementation and financing

Financing

From assessment to assistance

Findings and limits

Implementation and experience

What evaluations can tell us

Local cases

Tacuarembó and Salto

Day centres listed by SNIC

Sources

Reading the financing figures