Whether it’s thanks to shouldering the majority of unpaid care work, or facing poor conditions in their roles as paid carers, women laboring in the care economy face serious threats to their health.

“Everyone in the community knew that I was the next [to get pregnant], but I was so determined that until I achieve my dream of becoming an accountant, I will not drop out of school, and I will not get pregnant,” said Rebecca Acio, a 19-year-old Ambassador for the Strengthening School-Community Accountability for Girls’ Education (SAGE) DREAMS Project, Uganda. She spoke at a recent Wilson Center event on emerging lessons from the DREAMS Innovation Challenge. As a peer educator at her school in Lira, Uganda, and a temporary dropout herself, Acio “knew what it cost to be a dropout” and worked to identify other at-risk girls to encourage them to stay in school.

In the 1980s, the government of Malawi began providing piped water to low-income households in 50 districts, establishing community-run tap committees to collect bills and manage systems. Men made up 90 percent of committee memberships—and problems quickly became apparent.

The care economy raises a huge range of problems and opportunities for governments, but one issue that is more or less constant across the world is the uneven distribution of unpaid care work: this tends to fall far more on women.

“Adolescence is a time to support young peoples’ access to information, to education, to skills and to services that can result in a healthy and safe transition into adulthood,” said Sarah Barnes, Project Director of the Maternal Health Initiative, at a recent Wilson Center event on engaging youth and protecting their sexual and reproductive health and rights. “It’s time to make adolescents a priority,” said Barnes.

This year, “we went from 815 million people food insecure to 821 million—for the third year in a row increasing,” said Ambassador Ertharin Cousin, referencing the latest State of Food Insecurity and Nutrition Report in a recent Smart Women, Smart Power conversation held at the Center for Strategic and International Studies. Ambassador Cousin served as executive director of the World Food Program between 2012 and 2017, and before that, she served as executive vice president and chief operating officer of America’s Second Harvest, now known as Feeding America.

Poor quality care is now a bigger barrier to reducing mortality than insufficient access to healthcare, said Dr. Margaret Kruk, Chair of The Lancet Global Health Commission on High Quality Health Systems in the Sustainable Development Goal Era. She spoke at a recent Wilson Center event on strategies to improve and sustain high-quality reproductive, maternal, and newborn care at scale. “We estimate that 8.6 million lives are lost every year due to lack of access to high quality care, and of that 8.6 million, five million lives are lost by people who have already reached out to the health system.”