In a groundbreaking study published in the International Journal for Equity in Health, researchers have unveiled stark health disparities experienced by female paid domestic workers in Peru across three critical phases: before, during, and after the COVID-19 pandemic. This comprehensive analysis exposes the persistent vulnerabilities and systemic inequalities that this often invisible workforce endures, casting new light on the intersection of gender, labor, and public health amid unprecedented global crises.
Female paid domestic workers in Peru, a group predominantly composed of marginalized women, have long navigated precarious employment conditions marked by low wages, lack of social protection, and limited access to healthcare. The pandemic acted as both a magnifier and disruptor of these existing challenges. Through meticulous data collection and comparative analysis, the study delineates how the pandemic exacerbated health inequities while also initiating subtle shifts in societal recognition and labor rights.
Before the pandemic’s onset, female domestic workers in Peru were already grappling with elevated rates of occupational hazards and chronic health issues, compounded by insufficient access to formal healthcare systems. Structural barriers, including informal employment relationships and minimal regulatory oversight, contributed to a chronic underreporting of occupational health problems. These workers often lacked adequate health insurance and basic protective measures, leaving them vulnerable not only to physical ailments but also to mental health struggles stemming from isolation and exploitation.
The arrival of COVID-19 unleashed a new array of occupational and health threats. Domestic workers faced heightened exposure risk due to their essential role in maintaining households during lockdowns, where social distancing was nearly impossible. The study highlights significant disparities in COVID-19 infection rates among these workers compared to the general population, fueled by inadequate personal protective equipment and limited workplace safety protocols. Many reported a reduction in work hours or job loss, which further destabilized their economic security and, by extension, their access to nutrition and healthcare.
As the pandemic progressed, the researchers observed critical shifts in the health landscape for female domestic workers. Government-imposed mobility restrictions and widespread economic disruption meant that many had to choose between risking exposure and facing unemployment. Mental health deteriorated notably as anxiety, depression, and stress escalated, exacerbated by social isolation and uncertain futures. The study underscores the compounded vulnerability arising from intersecting factors of gender, socioeconomic status, and racial or ethnic marginalization.
One of the most compelling findings lies in the post-pandemic recovery phase, where systemic barriers continued to obstruct equitable health access for domestic workers, despite some policy initiatives aimed at improving labor protections. The research reveals that while some formal recognition and policy reforms began to emerge—such as expanded labor rights and access to social security—implementation gaps persisted. Domestic workers continued to experience unequal health outcomes relative to other occupational groups, highlighting the enduring legacy of structural inequities.
This study brings critical attention to the inadequacy of current public health and labor policies in safeguarding the well-being of female paid domestic workers. It argues for a multifaceted approach that addresses not only immediate health care access but also the underlying social determinants of health such as legal labor status, workplace protections, and social stigma. The authors advocate for inclusive health systems and robust enforcement of labor rights as pivotal steps toward reducing disparities.
The methodology employed in the study combines quantitative health indicators with qualitative interviews, allowing for a nuanced understanding of lived experiences alongside statistical trends. By blending epidemiological data with sociological insights, the research paints a holistic picture of the intersecting vulnerabilities these women face. This approach is particularly innovative in highlighting how public health crises disproportionately impact the most marginalized workforces, demanding intersectional policy responses.
The broader implications of the findings extend beyond Peru’s borders, offering valuable lessons for countries with similar domestic labor markets characterized by informality and gender-based inequities. The pandemic’s magnification of health disparities underscores the urgency for international collaborations and policy frameworks that integrate labor rights, health equity, and gender justice. Domestic workers globally remain an underprotected workforce, and this study’s insights pave the way for more inclusive and resilient health and labor policies.
Furthermore, the research sheds light on the invisible labor that supports households worldwide—work often performed by women of color and migrants. By centering female paid domestic workers in the narrative of pandemic impact and recovery, the study challenges prevailing economic and social paradigms that marginalize caregiving labor. It calls for societal recognition of the essential role these workers play and the need for systemic reforms to ensure their health and dignity.
Importantly, the study also critiques the limited social safety nets available to domestic workers, which left many without income or healthcare during the pandemic’s peak. The authors document how exclusion from unemployment benefits, sick leave, and healthcare coverage created life-threatening vulnerabilities. This exclusion from social protections is linked to the informal nature of most domestic work arrangements, which remain inadequately regulated despite recent policy efforts.
Mental health emerges as a critical dimension of the study’s findings. The layered stressors of job insecurity, health risks, and social isolation during and after the pandemic have had profound psychological consequences. The research calls for targeted mental health services tailored to the unique needs of female domestic workers, many of whom face cultural and financial barriers to accessing such care. Integrating mental health support within occupational and public health frameworks is essential according to the study’s recommendations.
Finally, the study envisions a future where female domestic workers are empowered through comprehensive legal protections, accessible health services, and societal recognition. It highlights the potential of community-based organizations and worker-led initiatives in bridging gaps in health access and advocating for systemic change. The pandemic, while devastating, offers a critical inflection point to reimagine health equity and labor justice for this indispensable segment of the workforce.
In conclusion, the detailed analysis presented in this landmark study not only documents the heightened health disparities confronted by female paid domestic workers in Peru but also charts a pathway toward equitable recovery and resilience. Addressing these disparities requires coordinated efforts across public health, labor policy, and social justice domains to dismantle the systemic barriers that have long marginalized these women. The insights gleaned bear profound significance for global health equity discourses and serve as a call to action to prioritize the health and dignity of all workers—especially those in the shadows of society’s economic engine.
Subject of Research: Health disparities affecting female paid domestic workers in Peru before, during, and after the COVID-19 pandemic.
Article Title: Assessing health disparities faced by female paid domestic workers in Peru before, during, and after the COVID-19 pandemic.
Article References:
Vera-Tudela, D., Cárdenas, M.K., Díaz, R. et al. Assessing health disparities faced by female paid domestic workers in Peru before, during, and after the COVID-19 pandemic. Int J Equity Health 24, 335 (2025). https://doi.org/10.1186/s12939-025-02617-w
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