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PubMedDate not supplied

Health impact of occupational risks in the informal sector in Zimbabwe.

Information about occupational health in the informal sector is lacking, despite its growing contribution to employment. The author describes a survey of occupational health in urban and rural informal-sector workers in Zimbabwe. Common hazards included poor work organization, poor hygiene, ergonomic hazards, hazardous hand tools, and chemical exposures, particularly to pesticides and solvents. An annual occupational mortality rate of 12.49/100,000 was half the formal-sector rate. Reported rates of 131 injuries/1,000 workers and 116 illnesses/1,000 workers exceeded formal-sector rates tenfold and a hundredfold, respectively, although the distribution of injuries by economic sector correlated significantly with formal-sector rates. The survey found high levels of musculoskeletal and respiratory illness, thought to be underdetected in formal systems. A fifth of the injuries had resulted in permanent disability, with little consequent job loss, but no compensation granted. The author recommends improvements to occupational health in the informal sector, and suggests a broader survey of occupational morbidity in all sectors of employment.

Community-Institutional Relations↗

PubMedDate not supplied

Occupational safety, health, and hygiene in the urban informal sector of sub-Saharan Africa: an application of the Prevention and Control Exchange (PACE) program to the informal-sector workers in healthy city projects.

In October 2000, at an international meeting in Pretoria, South Africa, chaired by the World Health Organization (WHO), 45 delegates from Sub-Saharan Africa, Europe, and the United States discussed the results of the Healthy City project in the region and the possibilities for incorporating occupational safety, health, and hygiene items into the project. Working conditions play only a minor role in current Healthy City projects. This is partly the result of a low profile of occupational safety, health, and hygiene on political agendas, and partly a result of a lack of convincing demonstration projects. To tackle these points WHO will start two initiatives. First, a document for decision makers will be issued, to highlight the subject and bring it to the attention of local, national, and international bodies. Second, demonstration projects will be started, making use of the methods developed in the Work Improvement In Small Enterprises (WISE) projects and the experience of the Prevention and Control Exchange (PACE) project.

Accidents, Occupational↗

PubMed1992

Urban planning in metropolitan areas of Asia: the challenge of accomodating the informal sector.

One paradox in the recent pattern of urbanization in Asia is 'metropolisation' and 'informalization'. This is paradoxical since growth and development of a metropolis is expected to reduce its traditional or informal sector. From available evidence, this paper shows that metropolisation in Asia, instead of reducing the size of informal sector, is rather providing new impetus to its growth. After revealing the nature and content of these growth patterns, the paper argues the case for making changes in the urban planning paradigms for accommodation of the informal sector in metropolitan development. The concurrent expansion of a metropolis and the informal sector within it will not appear paradoxical, the author believes, once the traditional urban planning paradigms of land use, zoning, and standards, mostly evolved from the Western experience of urban-industrial development, are modified in light of the socio-economic realities of the Asian metropolises. The huge population base of the respective countries relative to capital and other material resources, and vast qualitative change in the production structure of urban metropolitan economies have made the presence of the informal sector rather functionally relevant in the very heart of their metropolises. The paper provides some directions, citing examples from several cities, as to how to make the necessary accommodation. The paper further contends that mere physical accommodation by legal acceptance and provisions will not be enough. The other major direction of change in urban planning ought to be for integrating the physical, economic, and social dimensions of planning for ensuring better quality of life for all instead of a small proportion of people.

Adolescent↗

PubMed2000

Quality of sexually transmitted disease treatments in the formal and informal sectors of Bangui, Central African Republic.

BACKGROUND: Interventions for upgrading sexually transmitted disease (STD) management in sub-Saharan Africa have focused on the public sector, and to a much lower extent on private medical practitioners and pharmacies. However, in most African cities there is a large informal sector that provides care to many patients with STD symptoms. GOAL: To compare the quality of treatments offered to patients with major STD syndromes in the public sector, pharmacies, and the informal sector of the same city. STUDY DESIGN: Healthcare providers in health centers, pharmacies, private laboratories, and market drug peddlers in Bangui, Central African Republic, were asked to complete a short form for every patient consulting them with genital complaints. The treatments they ordered were evaluated for their potential efficacy against the major etiologic agents of the syndrome for which the patient consulted. RESULTS: The majority of male patients with STDs preferred to seek care in pharmacies and in the informal sector. The STD treatments offered to patients with urethral discharge or genital ulcers in pharmacies and in the informal sector tended to focus on a single etiologic agent. The quality of STD treatments offered by drug peddlers and private laboratories was poor, apart from adequate coverage of syphilis in patients with genital ulcers and of candidiasis in women with vaginal discharge. For instance, 41% and 34% of patients with urethral discharge managed by drug peddlers and private laboratories did not receive a drug active against either Neisseria gonorrhoeae or Chlamydia trachomatis, whereas this proportion was 22% in pharmacies and 14% in health centers. For patients with genital ulcers, the proportion offered a drug active against Haemophilus ducreyi was 2% if seen by drug peddlers, 0% in laboratories, 10% in pharmacies, and 25% in health centers. For each syndrome and each category of provider, between one fourth and two thirds of patients had already received another ineffective treatment elsewhere. CONCLUSION: National STD and HIV control programs will have to improve STD management in pharmacies and in the informal sector if they are to have any impact on the dynamics of HIV infection in urban centers.

Ambulatory Care↗

PubMed1991

The informal sector of welfare: a crisis in caring?

The informal sector is the major provider of informal care for dependent people and everyday care for able-bodied people in Britain. A large and complex sector of care, it has come to occupy a central place in British government policies for health and welfare. Through the 1980s, the informal sector was increasingly identified as a solution to problems in the formal systems of care. The paper reviews the concept of informal care and the welfare philosophies which informed the development of these policies, arguing for a broader and more critical perspective which locates informal care within the context of the wider caring work that goes on in households. Seen in this context, structural features of caring that are celebrated as strengths (its base in kinship relations where carers are unpaid, for example), can be experienced as problematic by those involved in caring. As a case study, the paper focuses on the experiences of mothers caring for children on low incomes for insights into some of the contradictions of caring.

Delivery of Health Care↗

PubMed1993

Rural-urban migration, informal sector and development policies: a theoretical analysis.

"A theoretical model of rural-urban migration has been developed with special reference to the informal sector. The wage rate and employment in the informal sector are determined endogenously. The paper shows the simultaneous existence of open unemployment and informal sector in the urban area in migration equilibrium. The effects of alternative subsidy policies on unemployment and welfare of the workers are studied." The model is intended primarily for use in analyzing trends and policies in developing countries.

Asia↗

PubMed1991

Informal sector shops and AIDS prevention. An exploratory social marketing investigation.

Shopkeepers at 88 informal sector shops in the black township of Khayelitsha were interviewed to explore whether such shops should be considered as venues for the dissemination of AIDS prevention information and condoms through social marketing programmes. The existence of a variety of media and interpersonal information sources on the premises, the presence of opinion leadership and the willingness of several owners to distribute posters and pamphlets and sell condoms suggests that such shops should be further investigated as avenues for AIDS prevention efforts. A relationship was found between the degree to which a shop exhibited aspects of social influence and the degree to which it was established in terms of infrastructure, income and experience of personnel. It was concluded that shopkeepers might be an important group to target early in a programme, because they might then influence others' reaction to it. Finally, it would be important for shop personnel and other township residents to be part of the design, planning and implementation of AIDS prevention programmes.

Acquired Immunodeficiency Syndrome↗

PubMed1988

Urbanization, the informal sector and migration: issues for research and cooperation.

Only recently have development studies begun to examine the complex set of relationships between urbanization, the growth of the informal sector, and internal migration in Latin America. This paper suggests that the economic crisis of the 1980s has resulted in significant changes in these phenomena and that 1 of the most important changes has been the growth of return international migration between Latin American countries. Also of importance are the continued migration flows to North America. The paper argues that the interconnectedness of these phenomena requires more multinational research efforts.

Americas↗

PubMed2001

Reinsurance of health insurance for the informal sector.

Deficient financing of health services in low-income countries and the absence of universal insurance coverage leaves most of the informal sector in medical indigence, because people cannot assume the financial consequences of illness. The role of communities in solving this problem has been recognized, and many initiatives are under way. However, community financing is rarely structured as health insurance. Communities that pool risks (or offer insurance) have been described as micro-insurance units. The sources of their financial instability and the options for stabilization are explained. Field data from Uganda and the Philippines, as well as simulated situations, are used to examine the arguments. The article focuses on risk transfer from micro-insurance units to reinsurance. The main insight of the study is that when the financial results of micro-insurance units can be estimated, they can enter reinsurance treaties and be stabilized from the first year. The second insight is that the reinsurance pool may require several years of operation before reaching cost neutrality.

Community Health Planning↗

PubMed2000

'Breaking out of the asylum': developments in the geography of mental ill-health--the influence of the informal sector.

This paper focuses on the changing role of the voluntary sector in the provision of care and support to community-based individuals with mental ill-health (MIH) in contemporary Scotland. In doing so, it reflects on the ways in which deinstitutionalisation is contributing to changing interrelationships between the formal and informal sector, the influence of the voluntary sector in the development of the locational geographies of individuals with MIH, and factors contributing to geographical variations in access and availability of voluntary sector supports. These developments are considered within the framework of the shadow state.

Community Mental Health Services↗

PubMed1997

Willingness to pay for health insurance in a developing economy. A pilot study of the informal sector of Ghana using contingent valuation.

In the midst of high cost of health care both at the macro and micro levels, health insurance becomes a viable alternative for financing health care in Ghana. It is also a way of mobilising private funds for improving health care delivery at the macro level. This study uses a contingent valuation method to assess the willingness of households in the informal sector of Ghana to join and pay premiums for a proposed National Health Insurance scheme. Focus group discussions, in-depth and structured interviews were used to collect data for the study. There was a high degree of acceptance of health insurance in all the communities surveyed. Over 90% of the respondents agreed to participate in the scheme and up to 63.6% of the respondents were willing to pay a premium of 5000 cents or $3.03 a month for a household of five persons. Using an ordered probit model, the level of premiums households were willing to pay were found to be influenced by dependency ratio, income or whether a household has difficulty in paying for health care or not, sex, health care expenditures and education. As income increases, or the proportion of unemployed household members drop, people are willing to pay higher premiums for health insurance.

Consumer Behavior↗

PubMed1992

An occupational health programme for adults and children in the carpet weaving industry, Mirzapur, India: a case study in the informal sector.

The Indo-Dutch Environmental and Sanitary Engineering Project under Ganga action Plan in Kanpur and Mirzapur is being executed within the framework of Indo-Dutch bilateral development cooperation. The project aims to integrate technological, social and health related improvements. It is expected that the development approach and methodology can be replicated in other urban settlements in India. The project is being supplemented by a training and institutional strengthening programme, which will facilitate the transfer of new technologies and improvements in operation and maintenance of these new technologies. One of the project's goals is to improve living conditions in the targeted areas by installing drinking water and drainage systems. A socio-economic unit (SEU) in the project supports these technical interventions by encouraging the community to participate in project activities. The Occupational Health Programme in Mirzapur was conceived by the SEU to improve the health and living conditions of child and adult weavers. At the start of the programme, 200 weavers and 60 non-weaver workers from Mirzapur city, matched for age and socio-economic status, were interviewed and underwent a physical examination. The mean age of the weavers is 27 years, reflecting the relatively large percentage of child labour (13.5%). Illiteracy among them is 73%, whereas 14% have had only a primary education. 64.5% of the carpet weavers are Muslims and 35.6% are Hindus. 61% own a loom or work in a family owned loom shed. 95% of the weavers have a monthly income of less than 600 Rs. Complaints of a persistent cough and cough with expectoration, backache, the common cold and joint pains occurred more often in the weaver population than in the comparison group and have been identified as 'occupational hazards'. An intervention programme has been implemented based on the results of the occupational health survey. These interventions include awareness camps, installment of plexiglass tiles for light improvement in the loom sheds, training of community health volunteers and house-to-house health education. Another essential part of the programme is the provision of functional literacy classes for child and adult labourers in the carpet weaving industry. Occupational health as an entry point proved to be a successful approach in this segment of the informal sector, where child labour plays an important role.

Adolescent↗

PubMedDate not supplied