Dr. Russel Lawrie, a senior healthcare leader from India, was nominated by the International Labour Organization (ILO) and the All India Organisation of Employers (AIOE) to represent India at the South-4-Care Learning Hub on Advancing Decent Work in the Care Economy in South Asia, held in Colombo, Sri Lanka.
At the recent South-4-Care Learning Hub in Colombo, Sri Lanka, convened by the International Labour Organization, I had the opportunity to represent India as part of the employers’ voice in a multi-country dialogue that brought together stakeholders from across South Asia—including Nepal, Pakistan, Afghanistan, Sri Lanka, and India besides the World Bank. Honourable Prime Minister of Sri Lanka Dr. Harini Amarasuriya graced the inauguration of the 4 day long South-4-Care Learning Hub, Colombo, Sri Lanka. What made this platform particularly significant was not just the diversity of participation, but the recognition that the care economy is no longer a peripheral issue—it is central to the future of work.
Across my four interventions—Employer-Led Initiatives in the Care Economy; Role of National Actors in Strengthening the Care Economy; Employers’, Workers’ and Government Priorities for Action; and Social Protection and the Care Economy—I consistently argued that the care economy must be approached through systems thinking rather than sentiment, and that healthcare offers perhaps the most mature and scalable model within this space.
Drawing from over three decades of leading hospital systems, I highlighted that many of the challenges now being discussed at a macro level—workforce shortages, burnout, skill gaps, and rising demand—are realities that healthcare institutions have already been navigating for years. In that sense, healthcare is not just part of the care economy; it is where its complexities are most visible and where its solutions are already being tested.
In my intervention on Employer-Led Initiatives in the Care Economy, I emphasised that employers must move beyond viewing care as a welfare obligation and begin institutionalising it as a workforce strategy. I noted that in healthcare, the absence of structured workforce planning, flexible deployment models, and process-led efficiency directly impacts care delivery outcomes. Extending this learning across sectors, I suggested that governments must actively support employers through policy incentives, co-funded care infrastructure, and enabling frameworks that make care investments viable and scalable. These perspectives also formed the basis of my interactions with the media, where I was asked to share employer-side expectations from public policy.
During the session on the Role of National Actors in Strengthening the Care Economy, I was asked what I see as the most pressing workforce challenge in delivering care services today. My response was clear: the issue is not merely a shortage of people, but the sustainability of the workforce under continuously rising demand. I shared that within healthcare systems, we have addressed this through the adoption of structured quality frameworks, standardisation of processes, and the integration of patient-centred models 1 of 2 such as PROMs and PREMs—approaches that improve both workforce productivity and care outcomes simultaneously.
When discussing Employers’, Workers’ and Government Priorities for Action, I emphasised that the most critical reform needed to strengthen and retain the care workforce is formalisation. Care work, particularly in South Asia, remains fragmented and undervalued. My view, which I articulated during the forum, is that without clear skilling pathways, certification systems, and defined career progression, the sector will continue to struggle with attrition and underperformance. Healthcare accreditation systems have demonstrated that standardisation drives both quality and efficiency—this principle must now be extended to the broader care economy.
In the session on Social Protection and the Care Economy, I pointed out a fundamental disconnect that I have observed both within healthcare and across the wider care ecosystem—the gap between policy design and ground realities. I argued that social protection systems must become more portable and inclusive, particularly for care workers who often operate across informal, fragmented, and mobile contexts. Without this shift, the goal of achieving decent work in the care economy will remain largely aspirational.
One of the recurring themes I brought into these discussions was the need for convergence. The care economy cannot evolve through isolated interventions. It requires coordinated action between employers, governments, and institutions, supported by investments in infrastructure and aligned policy frameworks. From my experience, healthcare systems already function within such interconnected environments, making them a valuable reference point for designing scalable care models.
What also stood out during the regional dialogue was a paradox I highlighted repeatedly—South Asia continues to export care talent globally while simultaneously facing significant gaps in its domestic care systems. In my view, this is not just a challenge but a strategic opportunity. With the right alignment of policy, workforce strategy, and institutional leadership, the region can move from being a supplier of care labour to becoming a leader in care systems innovation.
As someone who has spent over 30 years working at the intersection of healthcare delivery, workforce strategy, and institutional transformation, I see the care economy as the next frontier of structured growth. But its success will depend on how effectively we translate dialogue into systems that work at scale.
The future of the care economy will not be shaped only by policy frameworks—it will be defined by execution. And in that journey, the role of employers—particularly those from healthcare who have navigated these challenges firsthand—will be critical.
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