Integrating care and climate adaptation into a holistic fiscal framework at the country level – Brookings

Report on Integrating Care Services Infrastructure into Climate Adaptation Finance

Introduction: The Nexus of Climate Action, Gender Equality, and Sustainable Development

Global efforts to address climate change are intensifying, yet financing for adaptation remains critically insufficient. Current climate finance analyses reveal a significant oversight: the exclusion of comprehensive care services infrastructure. This report posits that investing in care—encompassing childcare, education, healthcare, and long-term care (LTC)—is a vital climate adaptation strategy that directly supports the achievement of multiple Sustainable Development Goals (SDGs). A robust care infrastructure builds community resilience, strengthens preparedness for climate hazards, and advances key development objectives.

• SDG 13 (Climate Action): Well-functioning care services enhance a community’s capacity to withstand and recover from climate shocks.
• SDG 5 (Gender Equality): The global care crisis disproportionately burdens women, who perform over 76% of unpaid care work. Investing in public care services alleviates this burden, enabling women’s economic empowerment.
• SDG 3 (Good Health and Well-being) & SDG 4 (Quality Education): Universal access to high-quality healthcare and Early Childhood Care and Education (ECCE) is fundamental to building resilient societies.
• SDG 8 (Decent Work and Economic Growth): Formalizing the care sector creates decent jobs and strengthens the workforce’s ability to respond to emergencies.

Despite the clear linkages, sectors like ECCE and LTC are largely absent from National Adaptation Plans (NAPs). This report outlines a methodological framework to integrate these critical sectors into climate adaptation planning and finance, thereby creating a more inclusive and resilient approach to sustainable development.

Conceptual Framework: Care as a Pillar of Climate Resilience

The Compounding Crises of Climate and Care

The climate crisis and the global care crisis are interconnected emergencies that undermine community resilience. Climate-related disasters disrupt or destroy essential care facilities, increase the demand for care services, and place immense strain on both paid and unpaid caregivers, who are predominantly women. This dynamic entrenches gender inequality, in direct opposition to SDG 5, and weakens the social fabric necessary to cope with climate impacts, hindering progress on SDG 11 (Sustainable Cities and Communities) and SDG 13 (Climate Action).

Vulnerable populations, including children, older persons, and individuals with disabilities, are disproportionately affected by climate change due to their reliance on consistent care. The failure to invest in care infrastructure is a failure to protect the most at-risk members of society, undermining SDG 10 (Reduced Inequalities).

Addressing Gaps in National Adaptation Plans (NAPs)

Current NAPs often include investments in climate-resilient hospitals and schools but overlook the comprehensive needs of the care economy. Key omissions include:

1. The specific infrastructure for ECCE (e.g., daycare centers) and LTC (e.g., nursing homes).
2. Funding for the expansion and training of the care workforce, which is essential for achieving SDG 4 and SDG 8.
3. Support systems for unpaid caregivers, who are the frontline responders during climate emergencies.

This report proposes a framework to systematically cost and integrate these overlooked elements into national climate strategies.

Methodology for Costing Climate-Adapted Care Infrastructure

A Step-by-Step Approach for Integration into NAPs

This framework provides a practical methodology for policymakers to estimate the investment required to build a climate-resilient care infrastructure. It adapts the International Labour Organization (ILO) care policy investment simulator to account for climate-specific impacts, ensuring alignment with national development priorities and the SDGs.

Step 1: Projecting Climate-Induced Care Needs

The initial step involves projecting future care needs based on country-specific climate scenarios. This requires a multi-faceted analysis:

• Climate Projections: Utilize national climate models (e.g., projected temperature increases, rainfall variation, sea-level rise) as outlined in existing NAPs.
• Health Impact Analysis: Use datasets like the Global Burden of Disease to correlate environmental risk factors with potential increases in morbidity and the subsequent need for care, directly informing strategies for SDG 3.
• Demographic Data: Incorporate age- and sex-disaggregated population data to identify vulnerable groups and tailor interventions to meet their specific needs, supporting SDG 10.

Step 2: Calculating Adaptation Costs for Care Services and Infrastructure

Once needs are projected, adaptation costs are estimated by applying markups to baseline investment calculations for both human capital and physical infrastructure.

Human Capital Development for Climate Resilience

Investing in the care workforce is critical for effective adaptation. This includes:

• Training and Capacity-Building: Integrating climate awareness, disaster preparedness, and emergency response protocols into the curricula for all paid care workers (teachers, nurses, community health workers). This enhances the quality of services, contributing to SDG 4.
• Coordination with Unpaid Caregivers: Developing programs that train and coordinate with unpaid caregivers (e.g., parents, family members) to ensure a cohesive community-wide response to climate events.
• Inclusive Planning Mechanisms: Establishing local care councils and participatory workshops to ensure that planning processes are inclusive and responsive to community needs, a core principle of SDG 11.

Physical Infrastructure Adaptation

The built environment for care must be made resilient to climate hazards. Costing should include:

• Retrofitting and Construction: Applying markups for climate-proofing existing and new care facilities (daycares, LTC homes) and private homes. Studies suggest markups may range from a minimal amount for nature-based solutions to around 20% for significant retrofitting (e.g., flood-proofing or structural reinforcement).
• Prioritizing Nature-Based Solutions: Emphasizing strategies such as green roofs, urban gardens, shade trees, and permeable surfaces to mitigate heat and flooding. These solutions support both SDG 11 and SDG 13.

Conclusion and Policy Recommendations

Overcoming Challenges and Advancing the SDGs

A primary challenge in implementing this framework is the lack of granular geospatial and socioeconomic data on care services. Addressing this requires a concerted effort to improve data collection at national and local levels, a key component of achieving SDG 17 (Partnerships for the Goals).

Recommendations for a Sustainable Future

To build truly resilient societies, policymakers, urban planners, and the climate finance community must recognize care infrastructure as a cornerstone of climate adaptation. Key recommendations include:

1. Integrate Care into NAPs: Systematically incorporate ECCE and LTC into all climate adaptation planning and financing strategies.
2. Invest in Data Collection: Partner with national statistical agencies to gather disaggregated data on care needs, services, and infrastructure costs.
3. Promote Gender-Responsive Policies: Design all care-related climate interventions with a focus on empowering women and promoting gender equality, thereby accelerating progress on SDG 5.
4. Foster Partnerships: Build collaborations between government, civil society, and the private sector to ensure a holistic and effective implementation of climate-adapted care systems, in line with SDG 17.

By adopting this comprehensive approach, nations can simultaneously address the climate crisis, reduce gender and social inequalities, and build a more sustainable and resilient future for all.

Relevant Sustainable Development Goals (SDGs)

Analysis of SDGs Addressed in the Article

• SDG 3: Good Health and Well-being: The article extensively discusses the importance of healthcare and long-term care (LTC) services in building resilience to climate change. It highlights how climate hazards impact health, especially for vulnerable groups like older persons and individuals with chronic illnesses, and stresses the need for universal coverage of high-quality health services to mitigate these risks.
• SDG 4: Quality Education: The article identifies Early Childhood Care and Education (ECCE) as a critical but overlooked sector in climate adaptation. It discusses the need to invest in educational facilities like daycare centers and schools, making them resilient to climate impacts, and to train teachers to respond to emergencies.
• SDG 5: Gender Equality: A central theme is the link between the care crisis and gender inequality. The article states that women perform over 76% of unpaid care work, a burden that increases with climate disasters. It argues that investing in public care services is essential to relieve this burden, empower women economically, and build community resilience.
• SDG 8: Decent Work and Economic Growth: The article calls for “decent jobs for the care workforce,” including better working conditions and training. It points out that paid care workers are under stress during climate disasters and that investing in this workforce strengthens social preparedness and economic resilience.
• SDG 11: Sustainable Cities and Communities: The article focuses on adapting the “built environment where care provisioning takes place,” including homes, daycare centers, nursing homes, and schools. It discusses retrofitting buildings to be resilient against floods and heatwaves and promotes nature-based solutions like green spaces in urban areas to enhance community resilience.
• SDG 13: Climate Action: The entire article is framed around climate change adaptation. It proposes a framework for integrating care services into National Adaptation Plans (NAPs) and disaster risk response plans, arguing that a robust care infrastructure is a fundamental climate adaptation strategy to strengthen resilience and adaptive capacity.

Specific SDG Targets

Identification of Relevant Targets

• Target 3.8: Achieve universal health coverage. The article advocates for “Universal coverage through affordable, accessible, and high-quality services” in healthcare and long-term care as a way to build resilience for families and communities against climate shocks.
• Target 4.2: Ensure that all girls and boys have access to quality early childhood development, care and pre-primary education. The article specifically highlights the need to integrate Early Childhood Care and Education (ECCE) into climate adaptation planning, noting that an estimated 23% of children globally lack access to necessary childcare.
• Target 5.4: Recognize and value unpaid care and domestic work through the provision of public services, infrastructure and social protection policies. The article directly addresses this target by arguing that investing in public care provision can “relieve those who provide unpaid care,” who are predominantly women, thereby reducing gender inequality and improving their financial resilience.
• Target 8.8: Protect labour rights and promote safe and secure working environments for all workers. The article points to the need for “better working conditions and training to respond to emergencies” for paid care workers, who face increased stress and constrained conditions during climate disasters.
• Target 11.5: Significantly reduce the number of deaths and the number of people affected and substantially decrease the direct economic losses relative to global gross domestic product caused by disasters. The article’s focus on adapting physical infrastructure (care facilities, homes) and training caregivers for disaster preparedness directly contributes to reducing the adverse impacts of climate-related hazards on vulnerable populations.
• Target 13.2: Integrate climate change measures into national policies, strategies and planning. The core proposal of the article is to create a “methodological framework for integrating ECCE and LTC into climate adaptation planning and finance,” specifically mentioning that the approach can be incorporated into any country’s National Adaptation Plans (NAPs).

Indicators for Measuring Progress

Mentioned or Implied Indicators

• Proportion of population covered by essential health services (Indicator 3.8.1): The article implies this indicator by advocating for “universal coverage” and citing statistics on the lack of access, such as the “23% of children globally need childcare but do not have any access to it.”
• Proportion of time spent on unpaid domestic and care work, by sex, age and location (Indicator 5.4.1): The article directly references this by stating, “Globally, women already perform more than 76% of unpaid care work,” which serves as a baseline measurement for this indicator.
• Number of countries that have communicated the establishment or operationalization of an integrated policy/strategy/plan which increases their ability to adapt to the adverse impacts of climate change (related to Indicator 13.2.1): The article’s primary focus on incorporating care services into National Adaptation Plans (NAPs) makes the content and comprehensiveness of these NAPs a key indicator. The text notes that the NAPs of countries like Bangladesh and Mozambique currently have gaps, implying that the inclusion of ECCE and LTC would be a measure of progress.
• Financial investment in climate-resilient infrastructure: The article suggests specific financial metrics that can be used as indicators. It mentions cost markups for retrofitting buildings, such as a “20% markup” for schools in Mozambique and “markups of 15-20%” for flood-proofing houses. These figures represent tangible investments in adaptation.
• Number of care workers trained in climate disaster response: The article emphasizes the need for “training and capacity-building of caregivers” to respond to climate-induced disruptions. The number of trained workers and the integration of climate awareness into their curriculum would be a direct indicator of progress.

Summary of SDGs, Targets, and Indicators

Source: brookings.edu