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Table 3.3Care arrangements for older people in China, Mexico, Nigeria and PeruPeru Mexico China NigeriaUrban Rural Urban Rural Urban RuralPrincipal caregiver isfemalePrincipal caregiverhas cut back on paidwork to care86% 89% 83% 82% 67% 50% n/d16% 23% 25% 37% 4% 48% 39%Paid caregiver 33% 8% 4% 1% 45% 2% 2%Source: Based on Mayston et al. 2012, Table 1.Towards an integrated response: Care andthe definition of national social protectionfloorsCare services are crucial for the achievementof substantive equality for women and girls. Inorder to address the rights of caregivers and carereceivers comprehensively, however, a combinationof investments are required: in basic socialinfrastructure, from water and sanitation to publictransport systems; in social services, from primaryhealth care to school feeding programmes; andin social transfers, from disability benefits to paidparental leave. This should also be kept in mindin the design of national social protection floors.Setting priorities for investment in social protectionshould include a thorough assessment of the needsof caregivers and care receivers to make sure thatpolicies contribute to the recognition, reduction andredistribution of unpaid care and domestic work.The combination of transfers and services that willbest respond to this goal depends on the nationalcontext. Low-income countries with serious deficitsin basic social services might choose initially tofocus on expanding access to safe drinking water,particularly in rural areas, to reduce the demandson women and girls’ time and energy. Middle- andhigh-income countries, on the other hand, mightplace greater emphasis on work-family conciliationpolicies, including parental leave and child andelderly care services. In both cases, priorities forsocial protection should be determined throughopen dialogue, involving all stakeholders, and withthe active participation of women.Uruguay has pioneered such a process with thecreation of a National Care System (SistemaNacional de Cuidados) in 2011. Starting in 2007,the Government engaged in extensive civilsociety consultations in order to redesign its socialprotection framework. Women’s rights advocateshave actively participated in this process, placingcare squarely onto the government agenda (seeBox 3.12). The ensuing National Care System isexplicitly framed around gender equality and thehuman rights of caregivers, both paid and unpaid,as well as care receivers, including children, olderpeople and people with disabilities.