Promoting health standards of the workers in the informal sector: A global concern

Dear Editor,

The workers represent almost half of the world’s population, and thus maintenance of optimal health is an essential determinant of the family’s income, and nation’s productivity, economic and social development.^[1] However, their health is not only dependant on the workplace hazards, but also on the social and individual attributes and access to the health services.^[2] Moreover, it is an issue of great concern that despite the availability of effective measures to prevent workplace hazards or promote health standards, wide gaps persist under different settings, and hence only a very small minority of workforce has access to desired occupational health services.^[1],[2] Infact, more than 85% of the workers from informal sector across the world have no access to any kind of health services, which raises serious concerns about their health and quality of life.^[1]

As economically active people spend almost one-third of their time at the workplace, the prevailing working conditions tends to cast a significant impact on their health and result in the development of morbidities (viz. musculoskeletal problems, hearing loss, respiratory diseases, injuries, malignancy, depression, etc.).^[1],[2],[3] Further, people working under stress are more likely to have an unhealthy lifestyle (high risk of smoking, less exercise, an unhealthy diet, sleep disturbances, etc.), and eventually facilitate early onset or rapid progression of the non-communicable diseases.^[2],[3] Infact, it has been estimated that on an average, most of the nations has a financial loss of significant proportion of their GDP due to occupational hazards, and that 7 out of every 10 workers have no support of any insurance to support them at times of such incidents.^[1]

Although, good physical working conditions will play a crucial role in ensuring social protection, development of personality, and improvement of social relations and self-esteem of the workers, yet only 33% of the nations have effective programs to deal with the work-related health concerns.^[2] In addition, the presence of specialized occupational health services will aid in the risk assessment and the formulation of specific recommendations to prevent occupational diseases.^[2] However, the reality is that only 15% of the workers have access to such specialized services.^[2] Also, deficiencies have been also been observed with regard to the sensitization of the health professionals to promptly detect and manage work-related ailments, and the holistic nature of the medical surveillance to obtain a precise estimate of the different morbidities.^[1],[4]

To significantly improve the health status of workers, the ultimate aim is to accomplish universal health coverage, comprising of ensuring access to the holistic package of health services (including specific protection against health determinants), and provision of financial protection to avert ill health leading to poverty.^[2],[5] It has been demonstrated that appropriate workplace health initiatives is expected to not only minimize sickness absenteeism, but even brings down the healthcare associated cost for the industries, both with more than 25%.^[1],[2]

On the global scale, measures like:

• increasing international movement of the jobs, products and technologies to enable spread of the innovative solutions for prevention of occupational hazards,
• developing an action plan with elements to ensure comprehensive welfare of the workers, formulating a national policy framework in collaboration with different stakeholders,
• developing approaches to prevent occupational diseases and injuries based on the nation’s priorities,
• implementing measures to reduce the gap between different cadres of workers with regard to their exposed level of risk and health status,
• building a systematic protocol for the assessment of workplace for the risks against which workers can be exposed and strategies to minimize the same,
• taking steps to strictly implement legal provisions in industries,
• building capacities for ensuring prevention of occupational hazards or injuries, conducting research work to determine health needs of workers in heterogeneous workplace settings, and
• strengthening communication strategy to periodically motivate workers to undergo periodic medical examination or report any morbidities to the authorities, have been taken.^[1],[2],[5]

Furthermore, a wide range of interventions have been proposed to improve the health coverage of workers in the informal sector and small industries, such as;

• improving the awareness and skills of primary healthcare professionals to enable them to extend basic occupational health services,
• initiating special courses to empower health professionals in the field of occupational health,
• expanding the coverage and augmenting the quality of specialized occupational health services,
• strengthening the surveillance and improving the environment of the workplace,
• fostering linkages between occupational health services and primary healthcare facilities,
• implementing workplace health initiatives to improve the health scenarios, and
• formulating a strategic plan to improve the access of workers to essential and affordable services.^{[1],[2],[3],[4],[5]}

To conclude, maintenance of the optimal health standards of workers is one of the key priorities of the policy makers, especially because of their magnitude and consequences resulting because of ill health. Thus, the need of the hour is to streamline the existing measures, and build and implement a comprehensive action plan for the holistic welfare of all the workers.

Acknowledgement

SRS contributed in the conception or design of the work, drafting of the work, approval of the final version of the manuscript, and agreed for all aspects of the work.

PSS contributed in the literature review, revision of the manuscript for important intellectual content, approval of the final version of the manuscript, and agreed for all aspects of the work.

JR contributed in revising the draft, approval of the final version of the manuscript, and agreed for all aspects of the work.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1755-6783.196494