Today, the need for care is growing worldwide, driven by demographic shifts and the rising number of persons living with chronic illnesses. I come from Japan, where the population of adults over the age of 65 has already exceeded 34 million (more than 1/4), and is projected to peak in 2042 at about 39 million (more than 1/3). Therefore for me this trend is real and close to my heart, not just “fire on the other side of the river”. We hope that many of these elderly people will lead healthy and independent lives. But even then the need for care in Japan is expected to grow even more acute after 2025, with an estimated eight million baby boomers over 75 years old. Unfortunately the supply of care services is already running short, particularly because of the poor work conditions, including relatively low wages and extensive working hours, as well as physically and mentally demanding nature of care work. In addition to these poor working conditions, the declining working population in general makes it harder to attract workers into the care sector in Japan. Hence, it is becoming even more essential now that care workers have decent working conditions if we are to provide sufficient quantity and quality of care services.

According to a recent ILO report, cooperatives are emerging as an innovative model in the care sector, both as care providers and as employers. This is particularly the case when there is an absence of viable public or other private options. Produced as a part of the ILO’s research initiative on the provision of care through cooperatives, this report complements the first report, which focused on survey findings and interviews. Through a literature review and assessment of 16 case studies from all the continents, this report aims to draw broad conclusions about the ways in which cooperative model manifests itself in the care economy, and to identify potential areas for further research and policy development in advancing this model as a viable option. I was happy to see that the report highlights the experience of Japan Older Person’s Co-operative Union that is operated for elderly and by elderly as one of the many similar innovative initiatives from my country.

Among key findings from the report, three points are worth highlighting. First, the types of care provided through cooperatives are different according to local contexts and beneficiaries’ care needs. For example, cooperatives in Sub-Saharan Africa have emerged to meet the housing and health needs of persons living with HIV and AIDS, while eldercare cooperatives are prevalent across Asia (including Japan), Western Europe, North America and parts of South America. Furthermore, there are quite a few cases of cooperatives in the care sector which are multipurpose in nature, reflecting the beneficiaries’ various yet overlapping care needs. They provide multiple services (e.g. day care, childcare, foster care and mental/developmental health care, etc.) to distinct populations including elders, children and adolescent youth, and persons living with disabilities or illnesses (mental and/or physical).

Second, the models through which cooperatives provide care are numerous and diverse, but they seem to also have a multistakeholder nature. The stakeholders involved include care providers and other workers, beneficiaries and service users, families of service users, governments and community agents, etc. The multistakeholder model is a unique innovation emerging from cooperatives’ involvement in the care sector.

Thirdly, and most interestingly, cooperatives may have advantages both for workers and service users, especially when these are members of a cooperative. For workers, they can provide improved wages and benefits, facilitate formalisation of home-based care, or promote professionalization and training of care workers. For users and their families, the cooperative model can provide a viable alternative to get better care services by enabling them to engage in care plans or encouraging their active participation in caregiving plan rather than simply treating aliments. Cooperatives address the physical, mental and social needs of beneficiaries, which stems from democratic inclusion and respect for all stakeholders’ contributions.

Meanwhile the report identifies major challenges to cooperatives thriving in the care sector. These include fragmented knowledge base and understanding of care through cooperatives, issues of strategic planning, and the lack of scalability and competitiveness. Individual cooperatives have difficulties in responding to the beneficiaries’ changing care needs in strategic ways or improving scalability and competitiveness due to the limited financial and human resources or cooperative know-how. Building a reliable knowledge base where cooperatives can share information related to these issues will be critically important, as identified in the report.

To conclude, this report sets forth three key recommendations for the way forward: 1. Scale up technical, vocational and managerial training for workers and managers in cooperatives; 2. Promote the creation and fostering of alliances across the care sector; and 3. Expand and refine data collection and further research on cooperatives in the care sector.

ILO initiatives relating to cooperatives, gender equality and decent work will continue to address these issues, including within the broader framework of the ILO Director General’s Future of Work and Women at Work Centenary Initiatives. In particular, ILO’s work on statistics on cooperatives can contribute to the third recommendation. For further information, please contact us at the ILO Cooperatives Unit, at

Photo credit: Consorzio SIS