The experience of the state-level intersectoral committee for integrated care policies development in Rio de Janeiro

Background: Recently, the Brazilian Government enacted Law Nº 15.069, establishing the National Care Policy turning care into a right, while considering gender equality issues. In the state of Rio de Janeiro, Decree Nº 49.660/2025 established the Intersectoral Committee for Care Policies (ICCP) aiming to implement the State Plan for Care Policies (SPCP). Despite the existence of a social welfare system in Brazil, including services and benefits associated with care provision, they are not sufficient.

Furthermore, the Brazilian population is ageing, and family sizes are shrinking, raising the amount of people needing care while decreases the number of people able to provide it. Over the next 30 years, the number of people aged 60+ will double and those aged 80+ will triple, making integrated care essential. Historically, Black women have played a significant role in providing care, both within households and in paid settings, from the perspectives of gender and race. The SPCP will act as a foundation for promoting equity in Rio de Janeiro by strengthening the state's commitment to delivering care through comprehensive public policy initiatives.

 

Approach: The ICCP, made up of state agencies and civil society representatives, meets monthly and must deliver its final document within a year. As the first step, members consolidated and systematized all public policies developed by their agencies, creating a database to support a diagnosis and guide new projects focused on the priority groups: women, children, the elderly, and people with disabilities.

The next step is to develop lines of action in the short, medium, and long-term to improve ongoing care policies and to assess sources of funding, to also ensure guidance and training for public policy managers at municipal level.

 

Results: The development of the SPCP, in synergy with national guidelines, has potential to consolidate and structure intersectoral and inter-federative actions in ​​care, turning them, in fact, public policies guaranteed by the State. The process will also result in the expansion of municipal care strategies, strengthening local support networks, and the integration between sectors such as health, social assistance, and work. Initiatives will be based on principles of comprehensive, universal, and equitable care, recognizing care as a human need across all life cycles. The state plan should also promote the confrontation of social determinants and territorial inequalities, besides social and economic recognition of care provision, whether paid or unpaid.

 

Conclusion: The SPCP stands out as both a social innovation and a key instrument for intersectoral governance, addressing the complex and interconnected dimensions of care. Inspired by the National Care Policy, the initiative proposes a new federative and social pact that recognizes care as a right of citizenship and a pillar of social sustainability. In addition, its implementation represents an opportunity for historical reparation, regarding the main groups involved in care, towards valorization, and social protection of caregivers. The proposal should contribute to the consolidation of a community and territorial based care system supporting diversity of life trajectories and promoting well-being and dignity.