India’s next social protection is care, not cash

Source: The post “India’s next social protection is care, not cash” has been created, based on “India’s next social protection is care, not cash” published in “BusinessLine” on  06th April 2026.

UPSC Syllabus: GS Paper-2-Governance

Context: India’s social protection system has traditionally focused on cash transfers, pensions, and food security, ensuring basic consumption needs. These measures are insufficient to address the daily realities of older adults, such as loneliness, chronic illness, limited mobility, and lack of social support. The elderly population in India is projected to rise from 149 million in 2022 to 347 million by 2050, accounting for over 20% of the total population. Therefore, there is an urgent need to integrate care-based social protection alongside financial support to ensure holistic well-being.

Need for Care-Based Social Protection

1. Cash transfers and pensions prevent hunger but do not ensure access to medicines, regular health check-ups, or social engagement.
2. Older adults living alone or in migration-affected households are especially vulnerable to social isolation and neglect.
3. Global evidence shows that societies that manage ageing populations effectively rely on a community layer of long-term care, rather than depending solely on hospitals or family care.
4. The World Health Organisation recommends a continuum of home and community-based support that helps older adults maintain functional ability and dignity.

Leveraging Existing Platforms

1. India already has a strong network of self-help groups (SHGs) under the National Rural Livelihoods Mission (NRLM), which can be leveraged for community-based care.
2. These SHGs include over 102 million women in more than 9.2 million groups, forming a trusted and locally rooted network capable of last-mile service delivery.
3. SHGs have experience in financial inclusion, enterprise promotion, nutrition, health, and convergence with government schemes, making them suitable for elder care interventions.
4. Current frontline workers like ASHAs, Anganwadi workers, and ANMs provide episodic services and are not structured for continuous engagement with older adults.
5. There is a clear gap in regular check-ins, functional monitoring, and ongoing assistance, which SHGs can fill effectively.

Proposal for Community-Based Care Layer

1. SHG members can be trained to provide non-clinical, community-based elder care, functioning as care coordinators.
2. Their responsibilities can include:

1. 1. Conducting regular social check-ins to reduce loneliness and isolation.
   2. Early identification of health risks or functional decline and referral to appropriate services.
   3. Assisting older adults in accessing pensions, entitlements, and healthcare services.
   4. Facilitating linkages with local health systems and frontline workers.

3. Integrating elder care within SHG activities ensures it is part of a broader wellbeing agenda, rather than a standalone program.

Benefits of Community-Based Care

1. It closes a major gap in the social safety net, as pensions alone do not ensure functional ability or independence.
2. It creates dignified employment for women, formalising previously unpaid caregiving roles.
3. It reduces strain on the health system by ensuring treatment adherence, preventing hospitalisations, and flagging early warning signs.
4. Regular engagement addresses mental health challenges and loneliness, enhancing dignity and social inclusion.
5. The model is cost-effective, as it builds on existing SHG infrastructure rather than creating new, expensive facilities.

Examples and Evidence

1. Programs like Pune’s Vriddha Mitra and Kerala’s Kudumbashree demonstrate that community-based elder care can be organised, skilled, and scaled effectively.
2. A phased, targeted approach should prioritise remote or migration-prone areas where older adults face the greatest isolation.
3. Implementation must consider local realities and service gaps to ensure the care model is effective in diverse rural and semi-urban contexts.

Challenges and Sustainability

1. Potential challenges include overburdening SHG members, uneven quality of care, and coordination issues with health systems.
2. These challenges can be addressed through clear role definitions, structured training, supervision, and predictable compensation.
3. Care must be treated as a core function of social protection, not an optional add-on, to ensure sustainability and effectiveness.

Way Forward

1. The government should formally recognise community-based elder care as an integral part of social protection.
2. A phased implementation strategy should focus first on high-need areas such as remote or migration-affected regions.
3. Investment must be made in capacity building and training of SHG members and local cadres to maintain quality and accountability.
4. Monitoring and evaluation mechanisms should be established to track outcomes related to well-being, functional ability, and social inclusion.
5. Care programs should be integrated with existing health and welfare schemes to ensure continuity and coordination of services.
6. Encouraging community participation and awareness can foster ownership and sustainability of elder care initiatives.

Conclusion: India has the institutional foundation through NRLM and SHGs to extend social protection from cash to care. A structured community-based care layer can safeguard the dignity, functional ability, and well-being of older adults while reducing pressure on the health system. The focus must shift from scale alone to sustained, trust-based, community-driven care, ensuring older adults live with dignity, security, and social inclusion.

Question: In the context of India’s ageing population, discuss the need for community-based care as a social protection measure beyond cash transfers. How can existing institutional platforms be leveraged for this purpose?

Source: BusinessLine