Building caregiver-centered health systems
Reflections from four health ministers at the World Health Assembly 2026.
“Ten years from now, what might it look like to have a world that truly supports family caregivers?”
We posed this question to ministers of health from Bangladesh, Egypt, Indonesia, and the Maldives at a ministerial side event at the World Health Assembly 2026 (WHA) in Geneva on May 18, co-hosted by Noora Health, the Government of Indonesia and The Agency Fund.
What emerged was not a single vision, but several distinct yet deeply connected aspirations. In Egypt, formal and family caregivers working together within one integrated system. In Indonesia, 280 million people equipped to keep themselves and their families healthy. In Bangladesh, an economy and health system built to compensate and sustain the people who step in to care. And in Maldives, a system of community-based care that is organized and better resourced.
One common thread ran through all of these visions: Family caregivers are not secondary actors in healthcare. They are essential partners, and it is time for health systems to recognize and support their contributions.
For over a decade, Noora Health has believed that services for family caregivers — learning opportunities, coaching, emotional support — must become part of the fabric of health systems themselves. These services must be embedded within our national and regional policies, to endure beyond any one program or institution. This is why the evening at the 79th WHA felt especially meaningful: It was a precious space, in a week of global health conversations, to reflect honestly on the role caregivers already play, and on what still needs to change.
Here are some reflections that stayed with us.
1. Family caregiving is not an additional layer to health systems, but an invisible one
We’ve spent years watching what happens after a patient leaves the hospital. Patients on the ward turn over, the clinical team moves on, and yet care continues — in homes, between family members, in the small daily decisions that are rarely counted as healthcare but absolutely are. Hearing this echoed by health ministers at the WHA was, for us, quietly affirming.
In the Maldives, with a population of half a million spread across 198 islands, families have long been the most consistent point of care for aging relatives and people living with long-term conditions. Geela Ali, Minister of Health, Family, and Welfare, shared that 84 percent of deaths in the country are now attributed to noncommunicable diseases — diabetes, cancer, dementia, hypertension — each requiring sustained family support to manage. Care, she reflected, increasingly sits within households, not institutions. She added:
“In the Maldives, the elderly and parents live with their children. They live within extended families, and a family member takes responsibility for caring for the elderly and for anyone else who needs support.”
In Egypt, Dr. Abla Al-Alfy, Deputy Minister of Health and Population for Population and Family Development, brought us closer to what this means day-to-day. Family caregivers are the first to notice a warning sign, a missed medication, a complication. And yet, she said, they are left largely to piece together what they know on their own, from brief conversations with overstretched doctors, to suggestions from neighbors, the internet, or other families navigating similar conditions. During COVID-19, family care became impossible to ignore: responsibility moved into homes almost overnight, and families carried the weight of care continuity with very little support behind them.
It is this gap that we have built our work around. Caregiving doesn’t sustain itself. It needs training, financial support, psychosocial support, and systems that actually acknowledge the work being done.
Watch the event highlights! Click here for the full conversation, including remarks from WHO Director-General Dr. Tedros Adhanom Ghebreyesus.
2. Family caregiver support should recognize — not reinforce — the gendered burden of care
Caregiving within households doesn’t fall equally. This is something we see constantly in our work, and it came through in the discussion at the WHA. Caregiving follows existing patterns of domestic labor, and those patterns are gendered.
Dr. M. A. Muhit, Minister of State, Ministry of Health and Family Welfare, Bangladesh, named it clearly. Within families, it is most often a mother or sister who takes on the caregiving role, and this can push young women out of the workforce entirely. Concerns about the disproportionate burden of caregiving on women surfaced repeatedly.
“Women are responsible for the home, the children, schooling, and everything else, in addition to caring for the sick person. The burden we place on family caregivers without supporting them is genuinely unfair.” — Dr. Abla Al-Alfy, Deputy Minister of Health and Population for Population and Family Development, Egypt
In a special message to the room, World Health Organization Director-General Dr. Tedros Adhanom Ghebreyesus also underscored this reality, noting that caregiving is delivered primarily by women, and that without unpaid caregivers, health systems would not be able to function.
What also emerged, though, was that this isn’t uniform. Minister Geela Ali described a more distributed model in the Maldives, where caregiving responsibilities tend to be shared across extended families, and where men step in too, depending on who needs care. It was a useful reminder that while the gendered pattern is real and widespread, there is variation in how caregiving is organized within cultures and contexts, and these differences matter for how systems design their support.
3. Governments are already building caregiver-centered health systems, and there are clear opportunities to accelerate progress now
Across countries, health systems are beginning to recognize caregivers not as invisible support systems, but as people who need support themselves.
In Bangladesh and Indonesia — where Noora Health has the privilege of working alongside governments — caregiver training and support has started becoming a standard of care within the public health system. Egypt is mid-way through a primary healthcare reform that is trying to bring caregiver support into the system formally.
And yet, it’s not enough. Training rarely follows patients home. Financial support, where it exists, rarely covers the true cost of caregiving. A majority of caregivers experience significant emotional distress, which largely remains unaddressed. Technology offers genuine possibilities for reaching caregivers in their homes, but is still underused. Childhood disability, adolescent care needs, and the particular vulnerabilities of women caregivers remain underserved.
What we kept hearing was that the motivation for this work is strong. What’s needed now is for caregiving to move from the margins of health system design to its center.
“Our primary job (as the health ministry) is to keep people healthy, not cure them when they’re sick. That is perhaps why it is called the Ministry of Health — not the Ministry of Sickness, or the Ministry of Cure. And you cannot do that alone as a government program. You have to make it a movement and transfer ownership of healthy living to each individual.” — Budi G. Sadikin, Minister of Health, Indonesia
The people at the center of care
The evening also included a screening of Threads of Care, a film by Noora Health and The Agency Fund that follows four mothers across Bangladesh, India, Indonesia, and Nepal as they navigate the intimate, often invisible work of caring for themselves while caring for a new life. Rooted in Noora Health’s Care Companion Program, it explores what becomes possible when caregivers are met with knowledge and support that continues beyond the hospital, into the home.
Watching it together in that room, after everything the ministers had shared, felt like a way to hold both realities at once: the systems governments are trying to build, and the deeply personal experience of caregiving those systems are meant to support.
Watch the trailer for Threads of Care — full film coming soon!
What the next ten years could hold
Ten years ago, we could not have imagined how this work would evolve. That a pilot program in India, rooted in a simple belief of centering family caregiving in health systems, would find its way to a room at the WHA, with ministers of health, with a film bringing the lived experiences of caregivers to the global stage, and with partners who have come to share that conviction.
And as we look ahead another ten years, we return to the question that shaped this reflection: What does a world that truly supports family caregivers look like?
The answer that touched us most came from Dr. M. A. Muhit, who named something the rest of the discussion had left unspoken. The conversation, he said, carried an underlying tone of sadness. But caregiving, when it is truly supported, is a source of profound happiness and meaning. He shared:
“My elderly mother was living in Bangladesh, quite healthy for her age. Suddenly she had a stroke and became bedridden. And there was no one reliable to be with her at that time. So I had to take this tough decision to leave my life and job back in London and go back to Bangladesh. And then we spent two years in the same house, living together before she passed away. And those two years had the most memorable and joyful moments of my life. So if we change our lens to see caregiving not as a problem, but as an opportunity, and if we can promote that and support that. Because not many carers have the luxury to leave their job.”
This is the future we are building toward. One where systems not only reduce burden, but make moments of meaning possible for more people. Where caregiving is supported, unhurried, held, shared, and yes, even joyful.
This article was made possible by inputs from Temina Madon and editorial support from Shreya Adhikari and Tanaya Jagtiani – thank you!
Edith Elliott
Co-Founder & Co-CEO, Noora Health
Dr. Shahed Alam
Co-Founder & Co-CEO, Noora Health
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