Care work is immensely valuable to society, yet for centuries, it has largely remained behind the scenes—hidden behind the closed doors of homes and social institutions. Globally, women and girls perform three-quarters of unpaid caregiving at home, and more than two-thirds of professional caregivers are also women. Ukraine is no exception: the labor market in education, healthcare, and the social sector is similarly highly feminized. In other words, these fields are predominantly staffed by women, and among those providing care services—including home care services—women make up the overwhelming majority.
For International Women’s Rights Day, we are publishing an article based on a study that examines the impact of the full-scale war on the working conditions of social workers. This research was conducted by the Commons author Natalia Lomonosova for the Cedos think tank, with support from the Friedrich Ebert Foundation in Ukraine. The article explores the working conditions of social workers, their wages, and how the full-scale war has affected their labor.
Where and how do visiting carers work?
Since 2020, Ukraine has been undergoing a reform of its social services system. This reform focuses on efficiency, budgeting and financing, standardization and digitalization, as well as service providers and recipients. However, it is important to remember that behind all these terms are real people. First and foremost, these are those who are in urgent need of social support—families experiencing difficult life circumstances, people with disabilities, and elderly individuals. But there is another group that, unfortunately, is rarely discussed: the people whose daily work makes social policy in Ukraine a reality. Social services, alongside social assistance payments, are key instruments for implementing this policy. They encompass a wide range of support measures—from providing care for the elderly to offering social support for families dealing with alcohol addiction.
The 2020 reform was based on the principle of developing a “market” for social services, where various providers—municipal institutions, private companies, and non-governmental organizations—would operate under equal conditions and have equal access to funding from local and state budgets, from which their services would be purchased. The plan was to gradually move away from fully maintaining municipal institutions and instead finance only the services they provide. According to the logic of the reform, competition among different providers was expected to improve the quality of social services and ensure better access to them. This market-driven approach to reform is also characteristic of other care sectors, such as healthcare and education.
However, as in other care sectors, the intention to create such a “market” and the corresponding legislative prerequisites have so far not led to the dynamic development of private providers of social services for various reasons. Currently, most registered entities in the open Register of Social Service Providers are municipal institutions. These institutions provide social services in most communities across Ukraine, while the activities of civil society organizations and private companies in this field remain limited and highly unevenly developed. Therefore, when discussing working conditions in the field of social services in communities, we are, in the vast majority of cases, referring to social work specialists, social workers, visiting carers, department heads, psychologists, drivers, and others employed at municipal territorial centers for social service (hereafter referred to as territorial centers), social service provision centers, and social service centers.
As part of the decentralization reform—similar to the changes in education and healthcare—the responsibility for ensuring access to social services was transferred mainly to local authorities and, consequently, to their local budgets. This shift has exacerbated inequalities in access to social services between communities with varying levels of financial resources. Additionally, remuneration and working conditions may differ from one community to another.
The issue of unequal access to social support across different communities, caused by the implementation of the decentralization reform, was drastically exacerbated by the Russian invasion. The full-scale war has negatively affected both the population’s access to social services and the working conditions of those providing them. In frontline communities, as well as in those that have received significant numbers of internally displaced persons (IDPs), the capacity to deliver support has been severely limited. At the same time, a large portion of social services must be provided directly and in person—either at home or within the community where people reside. All of this has had a considerable impact on the working conditions of social workers.
“We comfort ourselves with the thought that someone else might have it worse”: How care work is remunerated
Unfortunately, when we talk about the public sector in Ukraine, it is often implicitly associated with low salaries. This is typically the main challenge for those working in this sector. Social services, in particular, are known for having some of the lowest wages within the public sector. So, how much do workers in this field earn, and why has this situation developed?
In 2021, just before the full-scale invasion, the average monthly salary in the field of social assistance (including salaries of workers at territorial centers, social service provision centers, and social service centers) before taxation was 10,095 UAH (327 EUR). By comparison, the average monthly salary in healthcare in the same year was 11,825 UAH (384 EUR), and the average nominal salary across Ukraine in December 2021 was 17,453 UAH (567 EUR). Thus, in 2021, the average salary in the social assistance sector was 1.7 times lower than the national average.
The reason for low wages in the social sector and the public sector as a whole lies in state wage policy. The salary of each employee is based on their base salary, which is calculated according to the tariff grades of the Unified Tariff Grid. However, these tariff grades have not been revised for a long time. As a result, the purchasing power of salaries set by these outdated grades continues to decrease.
In addition, the base salaries for some tariff grades are lower than the minimum wage. This is because, since 2017, base salaries have been linked to the subsistence minimum rather than the minimum wage, as was the case previously. Since it is prohibited to pay a salary lower than the minimum wage, employers are forced to make additional payments to “bring” the salary up to the minimum wage level. Given the very small base salaries at the lowest tariff grades—such as for visiting carers who provide home care—these additional payments often nearly completely absorb the bonuses and supplements (e.g., for length of service, high intensity work, etc.) that employees are entitled to. As a result, their monthly salary is effectively equal to the minimum wage or just slightly above it. A slight improvement in the financial situation of visiting carers occurred after the minimum wage was increased to 8,000 UAH (184 EUR) last year.
“We comfort ourselves with the thought that someone else might have it worse. And we are still getting a salary, and thank God we are working. There are people who have been left without a job. […]” - Visiting carer, city, Dnipropetrovsk Region
“If the ministry had looked at this situation and made the pay grades higher for us, then our salary would be higher too. There is [only] a bonus, yes, our management [of the facility] negotiates it with the local authorities.” - Visiting carer, city, Chernihiv Region
The consequences of the decentralization reform are another factor contributing to issues with wage payments. With its implementation, local self-government bodies gained significant powers, including in the social sector. As the founders of communal institutions that provide social services, they are responsible for paying salaries from local budgets. These budgets vary greatly in income levels, depend on the economic development of each community, and can differ dramatically, especially between rural communities and large cities. The availability of funds in local budgets directly affects the ability to pay supplements and bonuses, leading to varying salary levels. Wealthier communities can afford to offer more generous supplements to base salaries, pay bonuses for Social Worker’s Day, or provide year-end bonuses. However, with the reduction in local budget revenues following the start of the full-scale war, local authorities may decide to cut or eliminate some of these supplements entirely.
“I feel for our workers. And you know, you can’t even look such a person in the eye because you can’t give them more. You can’t. You give them an 80% bonus, but still, 6,000–7,000 [UAH], that’s not the kind of money you can live on nowadays. [...]” - Director of a territorial center, city, Kyiv Region
“We [...] stayed here at our facility both day and night. But we didn’t receive any additional payments to our salary for that. We have the same base salaries. No changes, no night shift payments or anything else. Yes, we were at work [all the time], but our salary remained the minimum one that is currently set by the approved tariff categories.” - Social work specialist, day center, city, Dnipropetrovsk Region
With the onset of Russia’s full-scale invasion, which triggered an economic crisis, the government once again resorted to an austerity policy: effectively freezing the subsistence minimum and minimum wage. As in 2014, these measures led to the stabilization of wages for some social sector workers at levels close to the minimum. In the context of the economic crisis, this resulted in a decline in purchasing power and, consequently, a deterioration in workers’ welfare.
Without days off: How the workload of social workers increased during the war
Workload is a key issue in care work. Unlike traditional “production” sectors or some of the service industries, care work does not follow the logic of increasing efficiency by producing more goods or serving more clients. In kindergartens, schools, hospitals, care facilities, and when providing home care, the quality of work is inversely related to the number of people a worker cares for. In other words, smaller groups in kindergartens, fewer students in schools, and fewer patients per nurse or clients per visiting carer allow for better care. Conversely, an increased workload always negatively impacts both the quality of care and the well-being of workers.
The Russian invasion and the changes it caused in the socio-economic landscape led to an increase in the workload of social sector workers. We will now examine how this happened. However, it is important to emphasize that, due to the previously mentioned issues with wage formation in the social sector, the increase in workload has had little to no impact on wage levels in this sector.
One of the main reasons for the increased workload for social workers was the mass forced displacement of the population. This added work at every stage: social workers were actively involved in organizing the reception of displaced people, resettling them, and providing various types of assistance in the early stages. Additionally, in communities that received a large number of internally displaced persons, the demand for care and other social services increased, while the number of workers in the relevant municipal institutions remained almost unchanged—and, in some cases, even decreased. This was particularly noticeable in the first year of the full-scale war when some workers relocated to safer areas.
“You know, it was so hard psychologically—it was so tough. The employees left. My husband and I stayed in the city. I’m telling you this now, and everything inside me is shaking. But we survived. Well, what else could we do? I just went on, kept going, and went again the next day. Although we stayed home for a week [without going out]. We stayed for a week, and then I went. What could I do? The child needs food [...]. So, I went again. Crawled, you could say. Well, it was okay; somehow, we got through that year. This year is a little easier.” - Visiting carer, city, Kharkiv Region
The main factor behind the increased workload for visiting carers providing home care services was the rise in the number of elderly people who were left without support. Their relatives, who had previously provided care, were forced to leave due to danger, were mobilized, or died. The greatest increase in workload occurred in frontline communities, as well as in communities that accepted a large number of displaced persons.
The home care service, depending on an individual’s needs, covers a wide range of tasks. This can include assistance with self-care (e.g., bathing), assistance with bill payments, teaching how to use rehabilitation aids (e.g., prosthetics), help with household chores—shopping for groceries, cooking, laundry, cleaning, etc. In rural areas, visiting carers’ duties often extend to assisting with work on household plots and many other tasks.
In general, there is a workload standard for home care provided by visiting carers—8–10 people per worker in cities and 6–8 in rural areas. However, in practice, these figures can be much higher. For example, participants in focus group discussions conducted as part of the Cedos study reported workloads of 12–14 people, and in some cases even 16–18, which is twice the established standard. Caring for individuals who are permanently in bed due to health conditions is especially difficult and physically exhausting. According to the standards, one visiting carer should not have more than one person who is unable to leave bed under their care, but this limit is often violated as well.
In addition to their usual duties, with the onset of the full-scale invasion, especially in 2022, visiting carers and other employees of municipal institutions providing social services were actively involved in receiving and distributing humanitarian aid. This often involved shifts at aid distribution points and warehouses, which further increased their workload.
The workload for social workers also increased due to other consequences of the war that were not directly related to population displacement. For example, social work specialists provide support in cases of domestic violence, the number of registered cases of which, comparing 2021 and 2023, has doubled. The volume of work related to the registration of the status of children affected by the war has also significantly increased. Additionally, at the beginning of the full-scale invasion, in many communities, social workers were tasked with checking bomb shelters for accessibility for people with limited mobility and informing people about their locations. Finally, social workers are also involved in assisting the families of military service members and veterans. In this area, the amount of work, of course, has increased and will continue to grow.
Obstacles to movement
As in other countries, visiting carers in Ukraine who assist people at home are constantly on the move. Their workplace is geographically dispersed across homes, various infrastructures, and institutions. They have to travel between residences, often buying necessary groceries or medicine along the way, and sometimes accompany people to various facilities. The direct and indirect consequences of Russia’s full-scale invasion have significantly complicated this process, creating additional challenges for the workers and increasing their workload.
In fact, even before February 2022, visiting carers faced difficulties related to movement as part of their job. In many settlements or between them, especially in small towns and villages, public transportation was insufficiently developed. As a result, visiting carers, particularly in rural areas, often use bicycles—either their own or those provided by the institution, which are often purchased with funds from donors. In winter, the situation worsens due to weather conditions and road clearing problems. Some visiting carers use their own cars or ask relatives for help if they need to transport heavy or bulky goods. This is because most municipal institutions providing social services do not have functioning vehicles on their balance sheets.
The destruction of transport infrastructure and public transport fleets caused by shelling after February 2022 has significantly worsened the situation, especially in frontline and deoccupied communities, which have long been or are still in active combat zones. Restrictions on public transport during air alerts create additional difficulties. All these obstacles worry the social workers, reduce their ability to complete tasks on time, and lead to even greater workloads. As a result, they try to adapt, for example, by “productively” using time during air alerts, such as filling out or processing paperwork with clients in bomb shelters.
In addition to the issues with work schedules caused by shelling and air alerts, there is another problem—power outages caused by Russian attacks on energy infrastructure. Without electricity, visiting carers are sometimes unable to cook meals for the people they care for or assist with laundry; they have to carry heavy bags of groceries on foot to apartments on high floors. Given these challenges, the social workers adapt their workflow: they try to plan their work according to the power outage schedules, often preparing food for the people in their care at home during off-hours, and sometimes—ignoring air alerts and continuing to perform their duties.
“It’s hard for you, you can’t manage anything for yourself, but you can’t abandon them. How could you abandon them?”
Work in the social sector requires a high level of emotional involvement. This is especially evident in the work of visiting carers who provide home care for people.
In addition to household chores and assistance with domestic tasks that require physical effort, visiting carers often help with personal care. For those individuals who are unable to leave their beds, this is a challenging task. However, home care is not limited to a set of actions that the worker must perform—since they are caring for another person, it always involves a certain personal connection, communication, and emotional involvement. When it comes to lonely, immobile elderly people, visiting carers may be the only ones with whom they can share their concerns and thoughts. With the onset of the full-scale invasion, many people experienced high levels of stress, fear, uncertainty, and needed psychological support. Visiting carers, even outside of working hours, often become the only accessible source of psychological support and assistance for this category of the population. For internally displaced persons, social workers are the first people they meet in a new place, the first ones who provide them with emotional and psychological support. This often leads to emotional burnout among social workers, which is hardly ever addressed systematically in the workplace.
“[...] Everyone was anxious, the old ladies didn’t know what was happening or when. [...] So you could say that visiting carers were on the phone with them 24 hours a day, because they could call at night or anytime, needing answers to their questions. ‘Halia, there’s an air raid alarm right now. Halia, is there anything falling, is there anything banging?’” - Head of primary trade union organization, regional capital city
“Even though this isn’t the first time they [elderly people] have experienced something like this, the state of war and everything else. We try to support them in any way we can, both physically and emotionally. In any way possible. [...] we are psychologists, we are compassionate, we are kind, we support them physically and support their moral spirits.” - Visiting carer, city, Dnipropetrovsk Region
As in other care sectors, emotional reward and the gratitude of those they assist play a crucial role in sustaining the motivation of social workers. In numerous interviews and focus group discussions conducted by the co-author of this text with social workers, the importance of public recognition for their work—often invisible to society—emerged repeatedly. Social workers who provide daily support to those affected by both the direct and indirect consequences of the war deserve decent working conditions and fair remuneration.
“[...] I believe that our profession is somewhat underestimated in society in terms of its importance. When I tell someone that I’m a visiting carer, the reaction is like, ‘Oh, ew.’” - Visiting carer, city, Kyiv Region
“We often talk about how our work is undervalued. We have a huge workload, and it’s always there and will always be because social workers are always in demand. At the very least, if the salary were at the level of teachers—around 15–20 thousand UAH—that would be a fair wage for our work.” - Social work specialist, social service center, city, Chernihiv Region
“The salary itself isn’t very attractive to people. And today, unfortunately, as before, there is a need for skilled specialists. But today, unfortunately, this need has grown. [...] [Everything] is further complicated by the lack of competencies in the people we hire, professional competencies, so it’s very hard for them to work. [...] And the person, how can I put it? They struggle, like a fish out of water. They try to do things well, but they experience both emotional and physical overload. [...] all social workers need a more careful review of salaries in order to encourage people. To make them stay here. To see this job as the calling of their lives.” - Director of a social service center, city, Kharkiv Region
You can read the full report on the working conditions of social workers during the war on the Cedos think tank’s website.