BOGOTÁ, A CARING CITY
In Bogotá, a high percentage of full-time caregivers were unable to leave their homes due to the conditions of the persons in their care, who required constant attention.
BOGOTA
Between 2022 and 2025, the government of Bogotá, Colombia, established the "home-to-home" service to support residents who could not leave their homes as they had to attend to people requiring care. This is the story of how Bogotá managed to take care of those who need it the most.
Bogotá is the most populated city in Colombia, with more than 7.8 million inhabitants. Its population is diverse and distributed across 20 localities, combining dense urban areas and rural zones, where inequalities in access to services persist.
Bogotá is the most populated city in Colombia, with more than 7.8 million inhabitants. Its population is diverse and distributed across 20 localities, combining dense urban areas and rural zones, where inequalities in access to services and care persist.
The Home Assistance Program established a “door-to-door” service based on the 3Rs of the care system:
Recognize the value of unpaid care work, making visible its physical and emotional effort.
Redistribute care responsibilities among women, men, households, the public sector, and the private sector.
Reduce unpaid care through services and policies that provide women with free time and allow for their personal and professional development.
The Home Assistance Program consists of four services delivered to caregivers’ households:
At-home respite for people with disabilities and/or older adults with functional dependency, emphasizing the development of capacities for autonomy and independent living, and reducing caregivers’ workload.
Service for people with disabilities and/or older adults with functional dependency
Legal counseling for caregivers of people and/or older adults with functional dependency to access social services and take action against gender and sexual violence.
Service for caregivers
Official recognition and certification of caregivers’ skills, improving access to formal employment opportunities.
Service for caregivers
Awareness workshops to transform gender and disability stereotypes, promoting a fairer and more inclusive care culture.
Service for families
CONTRIBUTING TO THE IMPLEMENTATION OF THE 2030 AGENDA
POPULATION AND TERRITORY
TOTAL: 757 beneficiaries
359
Caregivers
(direct support)
398
Care recipients
(direct support)
Caregivers
The program helped reduce the care workload and redistribute household tasks, creating more time for personal and social well-being.
Care recipients
In-home care strengthened autonomy and improved the quality of life of care recipients, facilitating their active participation in daily life.
Caregivers and care recipients who participated in the services of the Home Assistance Program.
The Home Assistance Program was organized in 4 cycles, each lasting 3 months in years 2023 and 2024. Groups were structured according to geographical proximity.
Households served, by cycle and locality
GENERAL OVERVIEW OF THE POPULATION
Caregivers. Adults over 18 years old, dedicating at least six (6) daily hours to unpaid care for people with disabilities and/or older adults with functional dependency.
359
Caregivers (direct support)
Gender
Caregivers with disabilities
*Caregivers with disabilities face a double burden of work and care, having to manage their own health conditions as well as the needs of the person in their charge.
Number of caregivers responsible for one or more peRSONS
Relationship between caregivers and care recipients
The largest percentage are mothers, sons/daughters, and spouses of those requiring care.
Care recipients. People with disabilities over 18 years old and older adults with functional dependency who require intermittent or limited support to perform daily activities. The program implements actions with people at dependency levels:
398
Care recipients (direct support)
Gender
Age in years
In Bogotá, the disability certificate allows people to access institutional benefits and support programs.
The Home Assistance Service did not require the existence of a disability certificate, expanding access to people who had never received support before.
Percentage with Disability Certificate
Percentage by Disability Category
*The disability certificate allows identification of those requiring high levels of support, ensuring appropriate care and access to government services and benefits.
Reading territorial diversity allows the identification of hidden conditions of vulnerability, such as silent poverty, or the consequences of armed conflict in Colombia.
Victims of armed conflict, by households (%)
Households served by
socioeconomic stratum (%)
undetected poverty: a new reality identified in the territories.
Hidden poverty affects those who, despite seeming stable, struggle to cover their basic needs, due to low income or high expenses. It is difficult to detect, as it is often concealed by the associated shame feeling.
RESULTS AND IMPACT
CHANGES FOR CAREGIVERS
Reduction in care workload
Caregivers report a reduction of 1.23 hours (measured by the time-use survey).
50% experience a lower care burden (measured by the Zarit Caregiver Burden Scale).
Reduction in weekly hours
3 fewer hours per week serving and preparing meals.
9.7 fewer hours per week on general household activities.
Reduction in daily hours
0.4 fewer hours per day administering medications.
0.9 fewer hours per day preparing and serving meals for the care recipient.
Self-care
72% of caregivers state that the program improved their own self-care.
Care and social life
19.8% reduced the perceived impact of care on their social life, indicating a better balance between caregiving and personal life.
AUTONOMY FOR CARE RECIPIENTS
Barthel Index results show substantial improvements in functional independence. Care recipients showed a notable increase in their ability to perform daily tasks.
POST TEST OF IMPROVEMENT IN PERFORMANCE BY EACH WHODAS 2.0 DOMAIN (FROM LOWER TO HIGHER)
WHODAS 2.0 post-test showed improvements across cognition, personal care, daily activities, relationships, and participation.
Differential analysis of dependency level Pre test – Posttest, Barthel Index (From Lower to Higher)
Barthel Index: analysis showed improvements in basic activities such as eating, moving from bed to chair, and personal hygiene.
The instruments, WHODAS 2.0 and Barthel, were applied in the first session as part of the initial assessment, and again in the final session, in order to measure and compare the results obtained and to determine the changes observed as an outcome of the program’s impact.
CHANGES FOR CAREGIVERS
The WHODAS analysis confirms the existence of significant improvements in various dimensions of functionality, with notable progress in the areas of cognition, self-care, and activities of daily living.
LEVEL OF DISABILITY
26% reduction in functional disability level (WHODAS).
COGNITIVE
FUNCTION
30% improvement in cognitive function.
SELF-CARE CAPACITY
35% improvement in self-care capacity.
DAILY
ACTIVITIES
40% improvement in ability to perform daily activities.
SOCIAL
ACTIVITIES
23% improvement in ability to engage in social activities.
AUTONOMY
30% improvement in autonomy (Barthel Index).
SIGNIFICANT IMPROVEMENTS
Major improvements (40–50%) in basic self-care and moving from chair to bed.
MODERATE PROGRESS
Moderate improvements (25–35%) in mobility (dressing, eating, climbing stairs).
CERTIFICATION OF CARE KNOWLEDGE
Formal recognition of caregiving skills through evaluation and certification processes carried out with the National Educational Service (SENA), validating experience acquired in family contexts.
Gender
Level of certification obtained by the total number of caregivers
RELATIONSHIP BETWEEN LOCATIONS/CERTIFIED INDIVIDUALS
Ratio of certified individuals to total caregivers per cycle
⬤ Number of participants
⬤ Participants certified by SENA
LEGAL SUPPORT SERVICE
This service helped reduce indirect care workload by applying strategies that streamlined legal procedures, improved access to social services, and alleviated responsibilities assumed by caregivers.
Households served by
the legal support service
Beneficiary
Population
Total Activities Carried Out
CULTURAL TRANSFORMATION
Awareness workshops with families and communities promoted cultural change by questioning the sexual division of labor and fostering the inclusion of people with disabilities and/or older adults with functional dependency.
Beneficiaries
per cycle
Beneficiary Population within
the Framework of the Service
Average satisfaction level with services provided
Respite
service
9,64
Legal
counseling
9,18
SENA certification
of skills
9,58
Cultural transformation
workshops
9,58
IMPACT ON THE 3Rs
The results show concrete progress in the recognition, redistribution, and reduction of unpaid care work in the households served.
Reduce the time
dedicated to care
1. Greater autonomy and independence of care recipients, with reduced functional dependence
- 25–30% global improvements.
- Important improvements in basic self-care and daily activities.
- Cognitive and social function improvements, though more limited progress in body control and continence.
2. Reduction of caregiving burden in household tasks and direct care activities
- Decrease of 3.05 hours per week in food preparation and administration.
- Decrease of 9.7 hours per week in household activities.
- Decrease of 0.38 daily hours administering medications.
- Decrease of 0.41 daily hours assisting with personal hygiene.
Recognize
unpaid work
3. Increased
recognition
of care work
- 90% of caregivers received formal certification of their work.
- Families agreeing that care should be shared increased by 12 percentage points, showing a positive shift toward more balanced caregiving.
Redistribute unpaid work
4. More time available for other activities
- Rest increased by 1.3 weekly hours.
- Payment of bills and administrative tasks reduced by 0.5 weekly hours.
5. Caregivers’ overload perception decreased (Zarit Index)
- Caregiving-related tension reduced by 0.38 points.
- Impact on social life reduced by 19.8%.
- Impact on private life reduced by 0.44 points.
6. Increased participation of men in caregiving
- No significant increase in men’s participation in household tasks was observed during the study period.
- Redistribution of caregiving tasks occurred between caregivers and care recipients.
Achievements and lessons show that organized implementation, real-time data, and a territorial approach were key, even though challenges remain.
Having clear procedures was essential for program goals and systematic service delivery.
An evidence-based monitoring system with real-time data enabled progress assessment and evaluation of 3Rs compliance.
Prior household profiling and knowledge of local institutional services facilitated more effective interventions and equitable access.
While progress was made in recognizing care, challenges remain in redistributing responsibilities and significantly reducing caregivers’ workload.
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