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Care Workers NEW SOLUTIONS: A Journal of

Environmental and Occupational
in Argentina Health Policy
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DOI: 10.1177/1048291117740098
Francisca Pereyra1 journals.sagepub.com/home/new

Abstract
The working conditions, relative wages, and social standing of care occupations
are the result of diverse causes that can worsen, improve, or neutralize the labor
disadvantages usually found in care occupations. This article seeks to provide a per-
spective on the factors underlying care workers’ working conditions in Argentina.
It presents a comparative analysis of three highly feminized occupations—early
education teachers, nurses, and domestic workers. After highlighting the different
working conditions among these occupations, the paper focuses on the critically
important role that unionization and state policies have played in defining each
labor context in Argentina. The analysis shows how workers’ evaluation of their
occupation and working conditions are fundamentally shaped by these two variables.

Keywords
care workers, school teachers, nursing staff, domestic workers, Argentina

Introduction
The type of work that care workers perform is often held up as a powerful
example of the positive values that sustain human life. However, there are ser-
ious shortfalls in the economic recognition of this work, as expressed through
financial remuneration and labor protection, and in the working conditions it
generally entails.1 Empirical evidence, notably from developed countries, sug-
gests that these occupations tend to report lower salaries than those that are
unrelated to care.2–4

1
Universidad Nacional de General Sarmiento, Buenos Aires, Argentina
Corresponding Author:
Francisca Pereyra, Universidad Nacional de General Sarmiento, J.M. Gutiérrez 1150, Los Polvorines,
Buenos Aires 1613, Argentina.
Email: fpereyra@ungs.edu.ar
2 NEW SOLUTIONS: A Journal of Environmental and Occupational Health Policy 00(0)

However, it is also important to highlight that any analysis of the factors

determining care in workers’ working conditions in the Global South involves
particular challenges relating the heterogeneity of these labor markets. The con-
text is one of widespread inequality, defined by high levels of labor market
segmentation, notably along lines of formality/informality,a gender, income,
and educational qualifications. In such contexts, identifying and untangling
the factors that derive specifically from care work itself is often an analytical
challenge.5
Comparative studies on care work have been particularly fruitful in this
regard. Such research has explored the several dimensions that combine with
care to increase, temper, or even neutralize the unfavorable working conditions
that are often endemic to these occupations.3,5–7
This paper summarizes some of the findings of a four-year research project
carried out in Argentina between 2011 and 2015b which sought to analyze the
factors determining the working conditions of three specific care occupations in
a comparative fashion. These occupations were chosen because of the high levels
of emotional commitment that they imply, as well as for their importance in
supporting the current social organization of care in Argentina. The study takes
an in-depth look at the current state of nursing, early education and primary
school teaching, and domestic service. It is based on a quali-quantitative strategy
that included the analysis of statistical data from Argentina’s Permanent
Household Survey and in-depth interviews and focus groups with workers and
key informants from each care occupation.
After introducing a short methodological section, the article provides a gen-
eral overview of care occupations in the Argentinean labor market, examining
how dissimilar working conditions are in these three occupations. The following
section ponders the importance of the interplay between trade union politics and
the role of the State is in each case. We also examine the ways in which these two
factors shape—and, in turn, are shaped by—the subjectivity of care workers.
This entails exploring among individuals in these care occupations whether the
traditional association between care work and gender stereotypes is validated or
disputed and the extent to which adverse working conditions are naturalized or
questioned. Our findings bear policy implications we tease out in the concluding
section.

Methodology
This work is based on a quanti-qualitative approach. Quantitative analysis has
drawn on labor market data from Argentina’s Permanent Household Survey for
the second quarter of 2015. Wage regressions summarized later in this paper are
ordinary least squares regressions on the natural logarithm of hourly wages for
female and for male wage workers. A care occupation dummy variable was
included in some of the regressions, while other regressions disaggregated
Esquivel and Pereyra 3

occupations into broad groups—doctors and other medical occupations, professors

and teachers (including teachers’ aides), domestic workers, and other care occupa-
tions (including therapists, nannies, and so forth.). It should be noted that, given
the survey’s classification of occupations, it is not possible to identify nurses (who
are classified as ‘‘other medical occupations’’) or early education teachers (who are
classified as ‘‘professors and teachers’’)—therefore, neither the regressions nor the
descriptive data shown later in this article include such disaggregation.
In the case of the qualitative analysis, the field work was conducted in the city
of Buenos Aires and its surroundings (the Greater Buenos Aires Area) between
September 2011 and July 2014. A series of in-depth interviews were conducted
with key informants of each occupation. While in all cases, union leaders were
interviewed, in the case of nursing, informants also included heads of nursing
departments in public and private universities and hospitals. For teachers in
particular, headmasters and supervisors of public and private schools also
were interviewed.
In parallel, a series of interviews were conducted with nurses, teachers, and
domestic workers. The sampling sought to reflect the demographic characteris-
tics of each occupation in terms of age and gender. For domestic workers,
nationality and working hours also were considered. In the case of nurses, the
sampling also sought to represent the different levels of professionalization
(nurses’ aides, technical nurses and those with university degrees).
Additionally, the interviews of teachers and nurses were divided in equal num-
bers in terms of the sector where workers perform their activities (public and
private). Taking all these variables into account, 15 workers of each occupation
were interviewed. Given that institutional key informants for domestic work
were scarce, and with the purpose of delving deeper into the dynamics of
labor relationships of the sector, we ran two focus groups with employers of
domestic workers (each one included seven participants). The first group con-
sisted of employers of middle and lower-middle income who hired domestic
workers by the hour, while the second group included employers of upper-
middle income who hired these services on a full-time basis.
The design of questionnaires and data analysis paid particular attention to
the way interviewees conceive and handle the care-related aspects of their occu-
pation, the extent to which gender stereotypes regarding care work are accepted
or challenged, the working conditions each group described and the way these
working conditions were perceived and evaluated. This is a rich amount of
information, and for reasons of space, only some of the dimensions we identified
are summarized in the following sections.

Care Workers in Argentina: An Overview

Argentina’s labor market improved noticeably between the crisis years (1998–
2005) and 2015. Average real incomes have improved (by 20 percent), the
4 NEW SOLUTIONS: A Journal of Environmental and Occupational Health Policy 00(0)

unemployment rate is relatively low (6.6 percent), and informality among wage
workers has shrunk by almost 14 percentage points (from 46.6 to 33 percent).
Yet, Argentina’s labor market continues to be highly segmented along gender
lines. Women’s labor force participation stands at 46 percent while men’s
reaches 70 percent, their unemployment rate is approximately 8 percent
(compared to men’s 6 percent), and as much as 40 percent of female wage workers
are informal (a figure that stands at 30 percent for men). Although employed
women are on average more educated than men, women’s hourly wages are
equal to men’s. Given women’s lower average working hours per week (32 com-
pared to men’s 42), the gender pay gap among wage workers is 23 percent.
Against this background, as much as 38 percent of all women employed, and
43 of women in wage employment are care workers. Table 1 shows that only
44 percent of these workers are formal (16 percentage points lower than the
figure for all female wage workers), and 30 percent are public employees.

Table 1. Care Workers in Argentina: Selected Dimensions.

Women Men

Care occupations
Teachers, professors, and school aids 30.9% 55.9%
Medical doctors, nurses, and health aids 16.8% 34.6%
Domestic workers 39.0% 4.3%
Other care occupations 13.3% 5.2%
Total 100.0% 100.0%
Selected characteristics (as proportion of female/male care workers)
Formal 44% 81%
Public employees 30% 53%
Educational credentials
Less than secondary school 36% 11%
Secondary school 18% 16%
University or higher 46% 73%
Skills
Professional skills 8% 22%
Technical skills 38% 56%
Medium-level skills 3% 10%
Low-skilled/unskilled 51% 11%
Selected characteristics (averages for female/male care workers)
Monthly wages (in AR$, 2015) 5242 8686
Hourly wages (in AR$, 2015) 50 70
Working hours per week 25 32
Esquivel and Pereyra 5

Although nearly half of them (46 percent) have high educational credentials,
over a third have very low educational credentials. Half of them (51 percent)
have low skills and the other half (38 percent and 8 percent) have medium to
high skills.
Such contrast is the result of two very disparate groups of female care work-
ers summarized in Table 1. Roughly half of the female care workers are teachers,
professors, medical doctors, nurses, or health aides—all occupations that require
relatively high educational credentials and professional skills. Only 14 percent of
them are informal, possibly deriving from the fact that almost 60 percent of
them work in the public sector. Yet, on the other side of the spectrum, 40 percent
of female care workers are domestic workers, who have low educational creden-
tials and are ‘‘unskilled.’’ As much as 70 percent of female domestic workers
have not finished secondary school, and almost 80 percent of them are informal.
Indeed, the figures in Table 1 on hours worked and wages of women in care
occupations average these two contrasting groups of female care workers.
In comparison, only 5 percent of men in employment and 6 percent of men in
wage employment are care workers. Male care workers are relatively homogeneous:
almost all are medical doctors, teachers and professors, more than 70 percent of
them have high educational credentials, 22 percent are professional and 56 percent
have technical skills. More than 80 percent of male care workers are formal and
over half of them (53 percent) work in the public sector. As a result, their hourly
wage is 40 percent higher than the average female care workers.
A recent calculation of care wage penalties among wage care workers indi-
cates that these exist and persist as compared to a decade ago.5,8 A care wage
penalty of 4 percent is evident for female care workers (and not for men),
after controlling for personal and work-related characteristics, formality (regis-
tration) and employment in the public sector. When care occupations
are disaggregated, there is a significant (in statistical terms) wage penalty for
healthcare occupations again for women but not for men of 6 to 7 percent
(depending on model specification). This means that the lower wages that
domestic workers receive are fully explained by their lack of registration and
the feminization of the occupation—there is no care wage penalty beyond these
two dimensions. These results bear policy implications, as sectoral dynamics
combine with the two main drivers of pay gaps in Argentina: being registered
(which explains a wage premium of 40 percent for men and 39 percent for
women) and working in the public sector (which brings a 6 percent wage pre-
mium to women).

Working Conditions in Three Selected Care

Occupations: A Comparative Perspective
Against the background of care workers’ working conditions in Argentina, we
present an in-depth comparative analysis of three care occupations: nursing,
6 NEW SOLUTIONS: A Journal of Environmental and Occupational Health Policy 00(0)

early and primary education, and domestic service. These care occupations were
selected because of their high levels of emotional commitment and their import-
ance in supporting the social organization of care in Argentina.
Domestic service is a form of employment that takes place within private
households—a fact that brings about significant difficulties in terms of effective
state regulation and labor inspection. In contrast, primary and early education
teachers and nurses work in sectors where the state plays a vital role both as
service provider and regulator. Indeed, studies on care occupations have high-
lighted the role of the public sector in determining working conditions either as a
regulator of these services or as a direct provider of them, pointing out that
working conditions are more protected in the public sector.3,6,9
In Argentina, the state is a key provider of educational and healthcare ser-
vices (generally at no cost to the user at the point of use). In the education sector,
about 70 percent of teachers work in the public sector.10 In healthcare, public
sector employment represents a smaller but still significant proportion of the
labor force (about 43 percent).11
The teachers’ legal framework (the ‘‘Teachers’ Statute’’) largely reflects and
expresses the challenges the sector faces and, in many ways, goes beyond the
Labor Law (Ley General de Contrato de Trabajo, Law 20.744), which regulates
the work of all private salaried workers. This is particularly true in the public
sector, where most teachers are employed.c The advantages of this regulatory
framework include greater job stability, broader and longer leave entitlements,
and entry and promotion mechanisms in which both training and tenure length
play a part.5 Mechanisms that enable teachers to pursue further training, which
include special leave for these purposes and the creation of training institutes,
are explicitly described in these regulations (Table 2).12
Nursing, in contrast, is regulated by employment regimes that are specific to
each jurisdiction, in the public sector, and by the Labor Law, in the private
sector. The National Law on Nursing Activities (Law 24.004 passed in 1991)
establishes a set of very general provisions that act as guidelines for both the
different province-level regulations and for those of the private sector. The law
contemplates reduced working hours, stress-related leave entitlements, and early
retirement in specific areas that are seen as ‘‘critical’’ (such as neuropsychiatric
institutions and intensive care units). However, unlike teaching, the Nursing
Law does not include leave entitlements acknowledging the general physical
and emotional toll the occupation takes, nor does it contemplate leave for
training purposes. The latter is a particular source for concern given the high
numbers of under-qualified nursing staff. Indeed, although the Nursing Law
establishes that nurses must have completed a tertiary qualification (of at least
three years), in practice, the so-called nursing aides are almost half of those
employed in nursing (48 percent) and have only one year of training in low-
complexity care. Of those remaining, 41 percent hold a tertiary qualification and
11 percent hold university degrees.d
 Table 2. Dimensions Used to Characterize the Labor Conditions of Selected Care Workers.

Domestic service Domestic service

Labor conditions Early education teachers Nursing before 2013 after 2013

Institutional Sector Most teachers (nearly The private sector has gained Private households Private households
70%) work in the public terrain and employs nearly
sector 60% of workers
Labor regulation Dedicated Law Very general guidelines pro- Special Regime established New Special Regime for
(‘‘Teachers’ Statute’’). vided by the National Law by the Decree 326 of the sector established
Broader rights when on Nursing Activities (Law 1956. Very restricted by the Law 26.844 of
compared to the Labor 24.004). Labor Law applies rights when compared 2013. Tends to equalize
Law for the private sector. to the Labor Law Rights with the Labor
Different public regimes of Law
work (municipal, provin-
cial, and national) in State’s
institutions. Public regimes
with some more added
rights when compared to
Labor Law
Leave scheme Much broader leaves’ Private sector: leaves estab- Absence of basic leaves A leave scheme similar to
entitlements when lished by the Labor Law. (like maternity leave) the Labor Law
compared to the Labor Public sector: broader
Law (i.e., includes leaves’ scheme than the
leaves related to con- Labor Law, without cater-
tinuous training) ing for the occupation’s
needs (i.e., those related
to nursing physical and
emotional toll, training
needs, etc.)

7
(continued)
8
Table 2. Continued.
Labor conditions Early education teachers
Promotion Strictly regulated through
mechanisms a legally binding ‘‘scale’’
which contemplates
continuous training and
number of years in
service
Required educa- At least tertiary (of four
tional level years)
Wages National collective bar-
gaining to establish
‘‘base’’ salaries
throughout the coun-
try. Relatively high sal-
aries for national
standards
Working hours Teachers mostly work one
shift (4.5 hours in front
of the class) in one
establishment
Nursing
Non-specified, highly
discretional
Tertiary (of three years).
However, nurses’ aides—
still a majority in this
workforce—have only one
year of training
Fragmented collective bar-
gaining along the public/
private divide, and
between the public sectors
in different jurisdictions
(national, provincial, and
municipal). Relatively low
salaries
Work overload: extended
moonlighting, extra shifts/
extra hours
Domestic service Domestic service
before 2013 after 2013
Lack of promotion Lack of promotion
possibilities possibilities
No specific requirements No specific requirements
The executive branch Collective bargaining since
established salaries uni- 2015. Still very low
laterally. Very low salaries
salaries
12 daily hours 8 daily hours (the same
workload stipulated by
the Labor Law)
Esquivel and Pereyra 9

Although in the last years there have been more than ten draft bills seeking to
overcome these problems and inequalities in nursing—proposing different poli-
cies in order to increase the number of nurses and their continuous training as
well as a wider scheme of stress-related leaves in order to address usual situ-
ations of occupational burn-out, they have not succeeded yet in being treated by
the Congress.11
In contrast, the proportion of early education and primary school
teachers to have completed higher education (tertiary or university) qualifica-
tions is high—between 80 percent and 90 percent of the labor force. Data
from the most recent Teacher Survey available indicate that once these
teachers are qualified, they continue to take part in training and education
initiatives. Some 72 percent of early education teachers had taken part in a
training course in the last five years while 75 percent of primary school tea-
chers had done so.10
Among the three occupations this study focuses on, teaching has the
highest hourly wage. This relatively better salary position directly impacts work-
loads: Seventy-five percent of early education and primary school teachers
work at a single establishment and their average working hours are
between 22 and 24 hours per week of teaching time.10 In contrast, those
employed in nursing receive lower salaries, often critically so in smaller jurisdic-
tions and companies, and nursing is characterized by widespread and well-
documented moonlighting and overwork due to overtime.13–15 As those
we interviewed pointed out, ‘‘a nurse with just one job is very unusual.’’ This
particular situation poses major challenges in terms of the quality of services
provided.
Finally, those employed in domestic service are in the most precarious
situation on the spectrum of the occupations in our study. Their regulatory
framework has improved in recent years, through the sanctioning in 2013 of
the Special Labor Regime for Employees in Private Households (Régimen
Especial de Trabajo para el Personal de Casas Particulares, Law 26.844),
which seeks to equalize domestic workers’ rights to those enjoyed by all
employees who fall under the Labor Law. Yet, the high levels of informality
in this occupation mean that these legal entitlements have limited influence.
As mentioned before, lack of registration and the feminization of the occupa-
tion explain why wages in this occupation are far below those of teaching
and nursing. Domestic service is by far the most common form of employ-
ment among working-class women. The fact that no educational or other
specific qualifications are required to carry out such jobs suggests that it is
an occupation with very low barriers to entry. In a context such as
Argentina, where levels of inequality are high, it is also an occupation with
a large labor reserve, a factor that tends to keep salaries down and worsen
working conditions.
10 NEW SOLUTIONS: A Journal of Environmental and Occupational Health Policy 00(0)

Understanding Differences: The Role of Politics,

Regulations, and Unionization
Given the differences we have observed among the three selected care occupa-
tions, it is worth considering the factors that are behind them. In particular,
State intervention combined with the political pressure that different occupa-
tions are able to exert through their trade unions play a fundamental part in
explaining the acute differences in working conditions observed. Likewise, the
interplay between these two factors also influences and is influenced by the way
in which these care workers construct perceptions about their work and the
working conditions it entails.
This section explores how the interaction of these variables has contributed to
shape the labor conditions of the three care occupations considered. However, before
introducing each specific case, a few words about the changing role of the State
regarding the provision of public services are necessary to contextualize the analysis.

State Intervention and the Configuration of Public Services:

Changes in the Last Decades
Since the first Peronist governments (1946–1955), the State in Argentina
assumed an important economic and social regulatory role. Although public
services like health and education obviously register earlier develop-
ments—which date from the emergence of the country as a unified nation
towards 1880—the active State intervention that gained momentum by the
1950s acted as a strong organizational force in these fields. The search of uni-
versal coverage through centralized planning, the expansion of direct public
provision, as well as a strong role of the State in financing and supervising
these services characterized the period.16,17
Although with some fluctuations, the general guidelines traced for public
services like health and education persisted until the 1970s. It was during that
decade that the last military dictatorship endured by the country, in line with
global trends, implemented a drastic political and economic re-orientation with
a strong neoliberal imprint. In terms of public services’ provision, the new dir-
ection of policy-making implied a movement towards administrative and finan-
cial decentralization which seriously damaged their quality and sustainability.
The decentralization process involved a transfer of responsibilities from the
central government to provinces and municipalities without a corresponding
transfer of the necessary funding. In parallel, the deregulation of both healthcare
and education allowed the private sector to grow as service provider. The trends
towards decentralization and deregulation were to be further intensified during
the 1990s; this time under a democratic regime. As public services went downhill,
many families were forced to find private education and healthcare solutions,
which has further accentuated existing socio-economic inequality.
Esquivel and Pereyra 11

The transfer of responsibilities for infrastructure, administration and the finan-

cing of human resources from the central government to the provinces made
maintaining these services extremely difficult, especially for jurisdictions with
more limited resources navigating protracted crises. Working conditions were
deeply affected by the difficulties in upkeeping and expanding basic infrastructure,
supplies, and training needed in both the education and the healthcare sectors. In
particular, not only did care workers’ wages deteriorate markedly, they also
became much more disparate depending on geographical jurisdiction in the
public sector, or the size of the company employing them in the private sector.18,19
The increasing deterioration of the economy and the population’s living
standards finally imploded in 2001 in the form of a severe political outburst,
which led to a change in direction in macro-economics and in the approach to
labor regulation. Particularly since 2003, in a context of economic recovery, a
new and more progressive government reinstated State regulation of key eco-
nomic and social areas. The increase of public expenditure in education and
health20,21 created a favorable context for potential improvements in the labor
situation of the care occupations under analysis.

Dynamics Shaping Each Care Occupation’s Labor Conditions

Undoubtedly, the extent to which each care occupation was affected by the
economic and political forces described in the previous subsection—alongside
the different levels in which unions could exercise pressure and/or resist-
ance—has been highly variable. In what follows, the dynamics of such inter-
actions is analyzed for each care occupation considered as well as the way in
which these processes reflect, and are reflected in, workers’ evaluation of the
nature of their work and their labor rights. Throughout the following text,
subjects’ comments appear in quotes within parentheses, and are drawn from
the data collected to buttress our analysis.

Early education teachers. Early education and primary school teachers unionized
relatively early in Argentina. In the 1950s, pressure from different teaching
organizations led to the creation of the Teachers’ Statute. Even though there
have not been changes in the Statute, the labor situation of teachers has changed
significantly in recent decades in Argentina.
The neoliberal process of decentralization and deregulation described earlier
posed a great challenge to the sustainability of both educational services and
teachers’ working conditions, particularly in terms of their salaries. The possi-
bility of teachers’ unions engaging in joint action to react to these reforms was
facilitated by three factors: the general similarity in workers’ qualifications, their
occupational hierarchy (84.4 percent of all employed in early and primary edu-
cation hold teaching positions as opposed to administrative or other roles10),
and the fact that the majority work in the public sector.
12 NEW SOLUTIONS: A Journal of Environmental and Occupational Health Policy 00(0)

From the 1990s onward, one of the largest and most combative teachers’
unions, the Confederation of Education Workers played a major role in mobiliz-
ing workers and resisting these structural reforms in the education system.
Confederation of Education Workers’ main demand was the inclusion of a central
government financing mechanism to improve salaries, prompted by the difficulties
that the poorest provinces were experiencing in covering the costs of providing the
education services that the central government had transferred to them. The con-
flict became a high-profile, nationwide issue partly as a consequence of measures
such as the ‘‘White Tent’’—a large white tent that stood outside Congress for
three years where protesting teachers went on hunger strikes and were visited by
celebrities and public figures who supported their actions.
This strategic positioning of the problems teachers faced, combined with a
new, more progressive direction of public policies from 2004 onwards, laid the
foundations for a series of significant achievements. Undoubtedly, the most
significant was the passing of the Educational Financing Law (Law 26.075) in
2005. One of the key aspects of this law was the setting of a minimum wage for
all teachers in the country that would be negotiated each year between the cen-
tral government and all nationwide teachers’ unions, including those for private
teachers.21 A ‘‘salary compensation program’’ was created to provide resources
for those provinces that could not cover the costs of wages emerging from these
negotiations.e Not only did this achievement strengthen the role that unions
played in defending teachers’ working conditions, it also constituted a limited
(but nonetheless significant) vindication of the adverse consequences that decen-
tralizing the education system had brought.f
It is also important to mention that this law established clear targets for
public spending on education, which needed to reach 6 percent of the country’s
gross domestic product in 2010. The target was met: the total public spending in
education went from 4.6 percent of the country’s gross domestic product in 2005
to 6.2 percent in 2010,20 bringing with it many positive benefits for teachers’
working conditions in addition to improved wages (such as better infrastructure,
supplies, training, and so forth.).
The relative effectiveness of teachers’ unions in successfully achieving their
demands seems both shaped by and shaping the critical perception of teachers
themselves about the way their work is perceived and rewarded. On the one
hand, among the selected occupations, primary and early education teachers are
the more prone to challenge the association of their work with traditional gender
stereotypes in a way that tends to undervalue the ‘‘professional’’ nature of
teaching. In this sense, the care content of their activities would appear to be
nuanced by what they define as being the core of their role, which is to ‘‘teach’’
or ‘‘transmit knowledge’’ (‘‘It’s about making someone feel that they can
change, giving them tools, when you’re teaching someone you’re not just baby-
sitting, d’ you know what I mean?’’). Although teachers recognize that teaching
is associated with traditional gender stereotypes that naturalize caring as little
Esquivel and Pereyra 13

less than a female ‘‘trait,’’ in the testimonies we gathered this tends to be under-
stood as the outsiders’ perspective; that is, as a factor that has shaped how
society perceives teaching and the historic construction of the profession but
not the teachers’ view (‘‘It’s really noticeable how women have always been
responsible for teaching (. . .) It’s a historic pattern’’ and ‘‘it’s like teachers are
supposed to ‘look after the kids,’ it’s closely connected to women’s role in soci-
ety’’). On the other hand, teaching is also the occupation among the three under
study where workers identify and frame problems and deficiencies in working
conditions more clearly as violations of labor and social rights. Indeed, the
allusion to rights—both the labor rights of teachers and the rights of those
they are teaching—was something that only came up among this group of
care workers (‘‘In the state system, all your rights are respected (. . .) at private
schools there’s an owner (. . .) That’s why it’s good that state schools are for
everyone, so that all children get the same opportunities and workers’ rights are
safeguarded’’).

Nursing. As stated earlier, the health sector was also deeply affected by the neo-
liberal reforms that took place between the 1970s and 1990s. However, unlike
teachers, health workers showed a weak capacity to react to those changes. As a
result, poor working conditions and high disparities—among subsectors, juris-
dictions, and different health occupations—have tended to prevail. The charac-
terization of nursing’s working conditions provides a good example of the
difficulties of health workers’ organizations to articulate common demands.
The relatively unfavorable labor context that was described for nursing in
the previous section is closely connected to a fundamental divide within the
healthcare sector between ‘‘professional’’—mainly medical—staff and the
‘‘non-professional’’ staff, which includes most nurses as well as other occupa-
tions. The medical community has historically held the authority and power
within the healthcare sector. Although those within it are in a position to spear-
head and support specific demands from nurses or other non-professional
healthcare workers, they have their own separate trade unions aiming at pro-
tecting their privileged position. Nurses, in contrast, are limited to two types of
representation. In the public sector, many nurses are represented by large,
national unions of public sector employees, although in some jurisdictions
local public sector unions play a more prominent role. Other nurses are part
of trade unions that represent all ‘‘non-professional’’ healthcare workers (this is
the case for example, in the private sub-sector). Regardless of these differences,
when nurses make demands around their occupation and the situation of the
healthcare sector more broadly, they generally do so either as part of a union of
public sector workers which includes a wide range of public employees, or as
part of a heterogeneous group of low-ranking healthcare personnel which range
from different types of technical staff—laboratory staff, physiotherapists, radi-
ologists, etc.—to hospital orderlies, cooks, administrative staff, cleaning staff,
14 NEW SOLUTIONS: A Journal of Environmental and Occupational Health Policy 00(0)

and so on. It is important to point out that the small group of nurses who have
completed university qualifications are, in the public sector, theoretically entitled
to be represented by the ‘‘professional’’ unions and to the greater relative advan-
tages that medical staff enjoys. However, this accounts for only a small minority
of those working in the sector: just 11 percent of nurses hold a university degree.
Between 2005 and 2015—a period marked by several policy efforts to coun-
teract the negative impacts of the previous neoliberal phase—public spending on
healthcare increased: consolidated expenditure which went from 1.86 percent of
gross domestic product in 2003 to 2.51 percent in 2013.g However, this increase
was largely directed at users—with important achievements in terms of pro-
grams that give more vulnerable sectors of society priority access to services
and medication16—while unions were able to achieve very limited improvements
in working conditions. Recent studies show that levels of union-related conflict
and unrest in the healthcare sector have been high in recent years.22 However,
the very structure of the union system within the sector hampers the articulation
of demands that are common to all, prevents them from being scaled up to the
national level, and limits the blanket coverage of benefits. This state of affairs
helps explain the huge variations in wage levels within the sector and the fact
that wages tend to be low for occupations with relatively less power, as is the
case for nursing.
The tensions and ambiguities in the discourses of nursing staff when they
evaluate their occupation and working conditions can be understood in light
of their relatively inferior position both within institutional structures and the
unions that represent them. Another major factor is the absence of systematic
training policies that would bring nurses’ qualifications up to the same level—a
shortfall that also tends to perpetuate their lower status as part of the wider
group of non-professional healthcare staff.
The way these care workers describe their own work often includes mentions
about their attempts to raise the profile of their occupation within the health
sector by revaluing care. Those we interviewed emphasized the importance of the
care content of their occupation in comparison with that of other healthcare
workers, especially medical professionals (‘‘doctors diagnose patients, but I spe-
cialize in care, so that’s what I know about (. . .) that’s what really informs my
knowledge,’’ ‘‘we’re part of an interdisciplinary team that decides on treatments
to care for patients’’). However, expressions that seek to characterize care work
as a specialization tend to be nuanced by other perceptions. For example, a
gendered imaginary that associates the ability to provide care with certain
skills and inclinations that are ‘‘inherently’’ female was firmly present in the
reflections of the women nurses that we interviewed. There were numerous ref-
erences to qualities supposedly typical of women that make them more suited to
providing care, such as ‘‘intuition’’ (which ostensibly helps them get a better
sense of what the patient is going through), the ‘‘innate’’ inclination to protect,
and/or how mothering is a good training for nursing.
Esquivel and Pereyra 15

In terms of working conditions, although demands and perceptions of

inequality exist, building a common discourse around labor rights has proven
tricky for nurses. Among female nurses in particular, descriptions of adverse
working conditions coexist with another vein in their discourse in which they
frequently describe themselves and their occupation using a language of voca-
tion and dedication.23,24 This association between care occupation and vocation/
sacrifice/surrender tends to be at odds with the possibility of perceiving, articu-
lating, and contesting unsatisfactory working conditions (‘‘Yes, what motivates
us all is our vocation, taking care of patients, making sure that they’re okay.
Sometimes I’m absolutely exhausted (. . .) after all the hours on my feet (. . .) I
haven’t had time to eat anything (. . .) but the satisfaction of seeing that you’re
helping someone, that you are taking care of them, and that they need you,
that’s very powerful and it gives you strength’’).

Domestic service. Unions representing domestic workers have existed for several
decades. Yet, they have been almost entirely unable to make their voices heard up
until very recently. This has to do with the fact that until the 2000s, almost all
those working in this sector were informally employed. Also, and up until
recently, the occupation was regulated by substandard legislation, whose many
shortcomings included the total absence of any wage bargaining mechanisms
between employees and employers, which ultimately fettered the role of unions.
However, domestic workers have seen significant improvements in recent
years, as a result of the government’s top-down political decision to support
this occupation. Factors such as the importance of this occupation in the coun-
try’s female employment structure, the alarmingly low rate of formalization, and
international initiatives such as the ratification of ILO Convention 189—which
promoted a series of agreements and consensuses on decent work for domestic
workers—may have worked in favor of this government initiative. It translated
into two major areas of intervention.
First, there was a series of campaigns that sought to increase levels of formal
employment through different tools, including advertising, tax incentives, and
indirect monitoring mechanisms. Second, up until 2013, domestic service was
regulated by a decree that guaranteed very limited rights in comparison with
those of the Labor Law. The most significant forms of exclusion and inequality
in this earlier legislation were the lack of maternity leave entitlements—a
particularly serious shortfall given that this occupation is performed almost
exclusively by women—and the exclusion of workers who labored less than 16
hours per week for a single employer, a fact that left 40 percent of workers
without any legal protection whatsoever, given the significant weight of by-
the-hour work.25 As a result of this situation, the executive branch sent a
draft bill to Congress aimed to improve these workers’ rights, which was even-
tually passed in 2013. Thus, the Special Regime for Labor Contracts for
Employees in Private Households replaced the earlier, more precarious
16 NEW SOLUTIONS: A Journal of Environmental and Occupational Health Policy 00(0)

legislation, including all domestic workers regardless of their working hours.

The new law established a regime for tri-partite wage bargaining negotiations
between existing domestic workers’ unions, a series of ad hoc organizations
representing employers and the Ministry of Labor. These negotiations began
to be implemented in 2015.
While the share of formally employed domestic workers stood at 5 percent in
2003, policies applied generated an increase—modest but significant in relative
terms—that led to 22 percent of registered domestic workers by 2015. Without
belittling the enormous progress achieved, it must be stressed however that is
still the case that the rights enshrined in the law reach a very limited proportion
of workers.
Given this scenario, it is unsurprising that domestic workers have the greatest
difficulties not only in perceiving their own work in a ‘‘valuable’’ fashion, but
even in understanding their activity as ‘‘a real job’’ granting labor rights.
The association between care work and skills and duties that are supposedly
inherent to the female condition is the strongest of all in the discourse of these
care workers. Forms of employment with longer working hours are most fre-
quently associated with direct care for people, especially children: in such cases,
the workers’ own understanding of the tasks they perform as part of their job are
often blurred by the idea that they somehow belong to the employers’ family.
Expressions such as ‘‘I was there when the children [of the employers’ family]
were born, when they got married, we’ve been through some hard times
together,’’ ‘‘I’m like a grandmother to them,’’ or even ‘‘we’re like family’’
come up frequently and water down the perception that what connects the
parties is a labor relationship.
In turn, workers with part-time or hourly arrangements tend to perceive their
own labor as being somehow insignificant. They frequently refer to the money
they make as being a ‘‘help’’ or a ‘‘contribution’’ to their household economies
rather than as a salary that they earn by doing a job.
Finally, although perceptions of working conditions tend to be highly nega-
tive, domestic workers’ concerns tend to revolve around the pressing issue of low
salary levels, while other (serious) breaches of labor rights on the part of employ-
ers tend to be either naturalized or set aside as being less of a priority.

Conclusion
Being a female care worker in Argentina is associated with a care wage penalty
of 4 percent, that exacerbates pay differences explained by so-called objective
characteristics (i.e., levels of education) and by deficient labor market insertions
(i.e., being informal or working in a feminized occupation). Against this back-
ground, the three care occupations this paper has focused on, early education,
nursing and domestic service, are illustrative of the adverse working conditions
of female care workers in Argentina.
Esquivel and Pereyra 17

Yet, our wider research project aimed at going beyond these commonalities to
understand differences between care workers. Disentangling the factors under-
lying care workers’ working conditions other than providing care contributes to
de-naturalize the equalization of care work with undervaluation and underpay,
providing insights on how to improve these workers’ situation. In this article in
particular, we have focused on differences associated with levels of unionization,
and its relationship with public policies in place. The fact that this relationship is
not univocal—the progressive change in legislation regulating domestic service
in spite of weak unions serves as a reminder—underscores the role of govern-
ment’s political orientation in framing policies directed towards care sectors.
We have also explored how workers’ views about their occupation vary, even
between three care occupations that present relatively high levels of emotional
commitment and are highly feminized. In particular, we have found a high level
of association between the extent to which traditional views about care are
challenged, the ability to question our own deficient working conditions, and
the capacity to contest them through workers’ organizations. We cannot go as
far as to single out which one of these dimensions ‘‘determines’’ the others—but
we can affirm that they go hand in hand and mutually reinforce each other.
Professionalization through higher education and training appears to be one
of the avenues to contest gender stereotypes around care. It is firmly present in
early education teachers’ discourse and, to a lesser extent, among nurses. On the
contrary, the emphasis on the affective dimensions of care provision, which
ultimately make care ‘‘its own reward,’’2 present in nursing as well as in domestic
service, seems to conspire against contesting unsatisfactory working conditions.
Contesting working conditions, in turn, is associated with workers’ ability to
organize to pose claims, in particular to the State. The Teacher’s Unions, which
managed to come together to overcome the effects of fragmentation and decen-
tralization in the 1990s and ultimately brought change in legal frameworks to
support centralized wage setting mechanisms, is an example at hand. The fact
that most teachers are public sector employees played no minor role in this,
facilitating wage bargaining negotiations. In contrast, nurses have not been
able to make their voices heard, in part as a result of not being represented by
specific unions. The legal framework regulating the profession has not changed,
even though there have been numerous attempts at doing so.11 The absence of
major reforms in the health sector during the last decade must have also con-
tributed to the persistence of disadvantageous working conditions for all female
health workers, including nurses.
In turn, the government’s intention to improve the situation of domestic
workers was behind a top-down political decision to update the legal framework
regulating domestic service, including strengthening their unions. Yet, the
fact that domestic workers are typically isolated poses concrete limits to their
capacity to organize themselves. The presence of the State as a third party in
wage-setting mechanisms is a way to strengthen the domestic workers’ position,
18 NEW SOLUTIONS: A Journal of Environmental and Occupational Health Policy 00(0)

although it might not be enough to counterbalance their intrinsic weak-

ness—that of representing an occupation that takes place in private dwellings,
is highly informal and hard to inspect.
Our analysis of care workers in Argentina shows that care work is not neces-
sarily underpaid and undervalued and that a ‘‘high road’’ to care provision—one
that understands care workers’ decent working conditions are the flipside of
quality care26—is possible. It requires workers’ organization, progressive care
policies—particularly in health and education—and institutional frameworks
that protect care workers’ rights in view of their specificity. The case of
Argentina also shows that progress to a ‘‘high road’’ to care is uneven, takes
time and results from political struggles in which care workers’ unions’ involve-
ment is key.

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research,
authorship, and/or publication of this article.

Funding
The author(s) disclosed receipt of the following financial support for the research, author-
ship, and/or publication of this article: This research was supported by Argentina’s
National Agency for the Promotion of Science and Technology (PICT 0622-2011).

Notes
a. Defined by the presence or absence of employers’ contributions to social security and,
therefore, to workers’ access to social protection.
b. ‘‘Las condiciones laborales de las y los trabajadores del cuidado: procesos sociales y
polı́ticas públicas determinantes de su configuración’’ (The Labor Conditions of Care
Workers: Social Processes and Public Policies Behind Their Configuration). Co-direc-
ted by the authors and funded by Argentina’s National Agency for the Promotion of
Science and Technology (Project Code: PICT 0622-2011).
c. Private teachers are covered by a more restricted version of this statute (the Private
Sector Teachers’ Statute) which covers the education levels that are compulsory by law
(in early education, from the age of 4 onwards). Teachers who work with younger
children are excluded from the Teachers’ Statute and are instead subject to the general
conditions of the Labor Law.
d. Data for 2014. Source: Integrated System of Argentina’s Sanitary Information—
SIISA, National Ministry of Health.
e. After these negotiations, many jurisdictions re-negotiate a minimum province-specific
wage with local unions, as these can be (and often are) higher than the national minimum.
f. At the moment of writing, there is an ongoing conflict between the Teachers’ Unions
and the new neoliberal government precisely on the issue of the centralized wage-
setting mechanism, which the government disputes in spite of being mandated by
law. A new ‘‘Itinerant School,’’ also established outside Congress, has clear reminis-
cences of the ‘‘White Tent.’’
Esquivel and Pereyra 19

g. Source: Data from the Directorate for the Analysis of Fiscal and Revenue Policy,
Secretariat of Economic Policy and Development Planning, Ministry of the
Economy and Public Finance.

References
1. Vega C and Gutiérrez Rodrı́guez E. Nuevas aproximaciones a la organización social
del cuidado. Debates Latinoamericanos (New approaches to the social organization
of care. Latin American debates). I´conos 2014; 50: 9–26.
2. England P, Budig M and Folbre N. Wages of virtue: the relative pay of care work.
Soc Probl 2002; 49: 455–473.
3. Budig M and Misra J. How care-work employment shapes earnings in cross-national
perspectives. Int Lab Rev 2010; 149: 441–460.
4. Dong X, Fen J and Yu Y. Relative pay of domestic eldercare workers in Shanghai,
China. Fem Econ 2017; 23: 135–159.
5. Esquivel V. Care workers in Argentina: at the crossroads of labour market institu-
tions and care services. Int Lab Rev 2010; 149: 477–493.
6. Razavi S and Staab S. Underpaid and overworked: a cross-national perspective on
care workers. Int Lab Rev 2010; 149: 407–422.
7. Peng I. The expansion of social care and reform: implications for care workers in the
Republic of Korea. Int Lab Rev 2010; 149: 461–476.
8. Esquivel V and Pereyra F. Las condiciones laborales de las y los trabajadores del
cuidado en la Argentina. Reflexiones en base a tres ocupaciones seleccionadas (The
working conditions of care workers in Argentina. Reflections based on three selected
occupations). Trabajo y Sociedad 2017; 28: 55–82.
9. Lund F. Hierarchies of care workers in South Africa: nurses, social workers and
home-based care workers. Int Lab Rev 2010; 149: 495–510.
10. DINIECE (Dirección Nacional de Evaluación Educativa). Censo Nacional de
Docentes 2004. Resultados definitivos (National Teachers’ Census 2004. Final results).
Buenos Aires: Ministerio de Educación, Ciencia y Tecnologı́a, 2006.
11. Pereyra F and Micha A. The configuration of nursing labor conditions in the Buenos
Aires metropolitan area: an analysis at the intersection of the gender order and the
organization of the health system. Salud Colectiva 2016; 12: 221–238.
12. Rodrı́guez Enrı́quez C and Marzonetto G. El trabajo de cuidado remunerado. Estudio
de las condiciones de empleo en la educación básica y en el trabajo en casas particulares
(Paid care work. The study of working conditions among teachers in early education
and domestic workers). Serie de Documentos Polı́ticas Públicas y Derecho al
Cuidado No.4. Buenos Aires: Equipo Latinoamericano de Justicia de Género, 2015.
13. World Health Organisation. Nursing and Midwifery Progress Report 2008–2012.
Geneva: World Health Organisation, 2013.
14. Pautassi L. El empleo en salud en la Argentina. La sinergia entre calidad del empleo y
calidad de la atención (Health workers in Argentina. The synergy between the quality
of employment and quality of services). In: Rico M and Marco F (eds) Mujer y
empleo. La reforma de la salud y la salud de la reforma en la Argentina. Buenos
Aires: Siglo XXI Editores, 2006, pp. 193–234.
15. Novick M and Galı́n P. Flexibilidad del mercado de trabajo y precarización del
empleo. El caso del sector salud (Labor market flexibilization and precarization.
20 NEW SOLUTIONS: A Journal of Environmental and Occupational Health Policy 00(0)

The case of the health sector). Observatorio de RRHH en Salud en Argentina.

Información estrate´gica para la toma de decisiones. Buenos Aires: PAHO/WHO, 2003.
16. PNUD (Programa de Naciones Unidas para el Desarrollo). El sistema de salud
argentino y su trayectoria de largo plazo: logros alcanzados y desafı´os futuros (The
Argentinean health system and its long-term trajectory: achievements and challenges
ahead). Buenos Aires: PNUD, 2011.
17. Puigross A. Que´ paso en la educación argentina: breve historia de la conquista hasta el
presente (What happened with Argentinean education. Brief history from the con-
quest to the present). Buenos Aires: Galerna, 2003.
18. Tobar F, Olaviaga S and Solano R. Complejidad y fragmentación: las mayores enfer-
medades del sistema sanitario argentino (Complexity and fragmentation: the main
diseases of the Argentinean sanitary system). Documento de Polı́ticas Públicas,
Análisis N 108. Buenos Aires: CIPPEC, 2012.
19. Rivas A. Radiografı´a de la educación argentina (An in depth analysis of Argentinean
education). Buenos Aires: CIPPEC, 2010.
20. CIPPEC (Centro de Implementación de Polı́ticas Públicas para la Equidad y el
Crecimiento). Monitoreo de la Ley de Financiamiento Educativo. Buenos Aires:
CIPPEC, 2012.
21. Perazza R and Legarralde M. El sindicalismo docente en la Argentina (Teachers’
unionization in Argentina. Series Unions and Public Education in Latin America).
Serie Los sindicatos y la educación pública en América Latina. Buenos Aires:
Fundación Konrad Adenauer, 2007.
22. Aspiazu E, Baldi L and Lanari ME. Prestadores, prestatarios y pacientes: un análisis
de las voces y silencios de los reclamos de los profesionales de la salud (Providers and
patients: an analysis of voices and silences underlying the claims of health profes-
sionals). In: 10 Congreso Nacional de Estudios del Trabajo (ASET), Buenos Aires,
Argentina, 3–5 August 2011.
23. Arakaki J. Significados y concepciones de la enfermerı´a: el punto de vista de los
estudiantes de la carrera de la Universidad Nacional de Lanús 2008–2010 (Meanings
and perceptions of nursing: the point of view of undergraduate students of Lanús
National University 2008–2010). Salud Colectiva 2013; 9: 151–167.
24. Martin AL. Mujeres y enfermerı́a: una asociación temprana y estable (1886–1940)
(Women and nursing: an early and stable association (1886–1940)). In Biernat C,
Cerdá JM and Ramacciotti K (eds) La salud pública y la enfermerı´a en Argentina.
Buenos Aires: Universidad Nacional de Quilmes Editorial, 2015.
25. Pereyra F. La regulación laboral de las trabajadoras domésticas en Argentina: situa-
ción actual y perspectivas (The labor regulation of domestic workers in Argentina:
current situation and perspectives). In: Esquivel V, Faur E and Jelı́n E (eds) Las
lógicas del cuidado infantil. Entre las familias, el Estado y el mercado. Buenos Aires:
IDES/UNICEF/UNPFA, 2012, pp.165–199.
26. UNRISD (United Nations Research Institute for Social Development). Care policies:
realizing their transformative potential. In: UNRISD Flagship Report Policy innov-
ations for transformative change. Implementing the 2030 agenda for sustainable devel-
opment. Geneva: UNRISD, 2016.
Esquivel and Pereyra 21

Author Biographies
Valeria Esquivel is an associate professor at Universidad Nacional de General
Sarmiento (UNGS) and a researcher in CONICET, Argentina. She is on leave of
absence from these positions and currently working with the International
Labour Office (ILO). Her opinions do not necessarily reflect those of the ILO
or its constituents.

Francisca Pereyra is an assistant professor at Universidad Nacional de General

Sarmiento (UNGS), Argentina.