Salvador, S., Rios, V & Alesina, L. (2025) Personal Assistants Program in Uruguay: A Bet on Gender Equality? [Policy Brief] Project Initiatives to Strengthen Care Policies in Latin America and the Caribbean.

This policy brief brings together the conclusions of the study on the Personal Assistants (PA) Program of the National Integrated Care System. The research analyzes the transition towards a pilot collective cooperative provision model in Salto and Tacuarembó, aimed at overcoming the critical bottlenecks of the traditional individual home-based hiring scheme for people with severe dependency.

The study shows that cooperative management leads to significant improvements in technical support, resolving family conflicts, sense of belonging, and the working conditions of the employees. Despite these advances, the evaluation highlights structural challenges regarding the economic and financial sustainability of cooperatives without ongoing initial subsidies, the need for specific training for complex situations (like childhood issues, autism, or mental health), and the limited coordination of replacements to redistribute unpaid care work that families take on during leave.

Based on this diagnosis, the publication recommends ensuring funding and technical support for cooperative management, strengthening training programs, actively involving the Care Advisory Committee, and designing policies that comprehensively consider both the cooperative model and the 98% of pairs that still operate under the individual scheme.