Abstract
BackgroundInformal workers often face considerable risks and vulnerabilities as a consequence of their work and employment conditions. The purpose of this study was to examine the interplay between the experience of informal work and access to health, using as an example, female beer promoters employed in the informal economy, in the Lao People’s Democratic Republic.MethodsIn-depth interviews were undertaken with 24 female beer promoters working in beer shops, restaurants and entertainment venues in Vientiane City. The recruitment strategy of snowball sampling was used. Interviews explored the beer promoter’s experience of the organization of work, perceived healthcare needs, access to healthcare and insurance, and health seeking practices. The data was analysed thematically and subsequently using Bourdieu’s concepts of habitus, capital and field.ResultsMost of the beer promoters included in the study were 18 years of age, single, had worked as beer promoters for more than one year and just over half were working to support their higher education. The beer promoters demonstrated a holistic view of health, also viewing good health as contributing to being beautiful – an important attribute in their work. Many reported that their work conditions, including the noisy environment, exposure to second-hand tobacco smoke, long hours on their feet and sexual harassment negatively affected their physical and mental health. Only four participants had any form of health insurance with access to healthcare constrained by individual characteristics, health system factors and the conditions of their informal employment.ConclusionsDrawing on the work of Bourdieu, the study shows how both employment and illness are linked to habitus embodied in everyday practices, access to capital and the position the female beer promoters hold in the social hierarchy in the field of employment.
Highlights
Informal workers often face considerable risks and vulnerabilities as a consequence of their work and employment conditions
With the Millennium Development Goals (MDGs) expiring at the end of 2015, world leaders have agreed to seventeen Sustainable Development Goals (SDGs) which will guide global development policy and planning up to 2030
The informal workforce is estimated to comprise of one-half to three-quarters of nonagricultural employment in low- and middle income countries. Their lack of formal employer-employee relationships makes them a difficult population to reach and they are often the last to be enrolled into social protection and health insurance schemes [2,3,4]
Summary
Informal workers often face considerable risks and vulnerabilities as a consequence of their work and employment conditions. To advance the global health goal (Goal 3: Ensure healthy lives and promote well-being for all at all ages) further progress needs to made in ensuring universal access to affordable and appropriate healthcare [1] Achieving this requires reaching those employed in the informal sector who are largely excluded from any protections provided by national labour laws and regulations [2,3,4]. The informal workforce is estimated to comprise of one-half to three-quarters of nonagricultural employment in low- and middle income countries. Their lack of formal employer-employee relationships makes them a difficult population to reach and they are often the last to be enrolled into social protection and health insurance schemes [2,3,4]. The Lao People’s Democratic Republic (PDR) is a lower-middle income country situated in Southeast Asia and is undergoing rapid socio-economic change, including the emergence of a large, informal but uninsured, urban workforce [4, 7,8,9]
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