Embodied harm, normalised suffering: experiences of unpaid care and domestic work among women across the life course in sub-Saharan Africa

Unpaid care and domestic work (UCDW) is an important determinant of women's health and wellbeing in sub-Saharan Africa (SSA). While its gendered burden and health consequences are increasingly documented, less is understood about how women interpret these consequences and how the unequal responsibility for UCDW becomes normalised as ordinary, unavoidable, or morally valued. Guided by necrosocial incorporation, a framework we develop by bringing ecosocial theory into conversation with necropolitics, we examine these processes across the life course in Kenya and Uganda. We conducted a reflexive thematic analysis of 36 in-depth interviews with women aged 18 to 59 and 30 oral histories with women aged 60 and above. Our analysis identified five interconnected pathways linking UCDW to poor health and diminished wellbeing. These involved persistent stress around household survival, cumulative physical strain from repetitive labour, time poverty from competing responsibilities, curtailed sleep and recovery from extended working days, and deprioritisation of women's own health and care needs. Participants' accounts also reflected three configurations through which unequal responsibility for UCDW became normalised: (1) constrained recognition, (2) resigned acceptance, and (3) joy, duty, and fulfilment through UCDW. Across these configurations, normalisation lay in women's continued primary accountability for ensuring that UCDW was completed, including where they recognised harm, desired support, or experienced care as meaningful. Read through necrosocial incorporation, these findings show how structurally produced harm becomes embodied and entwined with gendered understandings of care, duty, and moral worth. Addressing these harms requires public investment that reduces the demands of UCDW and redistributes responsibility within and beyond households.