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Occupational Health and the Informal sector Prof. Folashade Omokhodion Department of Community Medicine University of Ibadan and University College Hospital, Ibadan Definition The informal sector or informal economy • that part of an economy that is not taxed, or monitored by any form of government. • All economic activities; in all sectors of the economy that are operated outside the purview of government regulation • Describes the activities of the working poor. Definition • The formal sector on the other hand is : A group of people, usually employees, that includes recognized income sources for paying income taxes based on all 40-hour, regular wage jobs. • The formal sector has companies registered with the government and hence, it offers job security, paid holidays, pensions, health, fixed working hours, extra pay for overtime work, medical and other allowances, gratuity and various other benefits Informal sector • According to SIDA, the key drivers for the growth of the informal economy in the twenty-first century include: ▫ limited absorption of labour, particularly in countries with high rates of population or urbanization; ▫ excessive cost and regulatory barriers of entry into the formal economy, often motivated by corruption; ▫ weak institutions, limiting education and training opportunities as well as infrastructure development; ▫ increasing demand for low-cost goods and services; ▫ migration motivated by economic hardship and poverty; ▫ difficulties faced by women in gaining formal employment Informal sector • The ILO/ICFTU international symposium on the informal sector in 1999 proposed that the informal sector workforce can be categorized into three broad groups: • (a) owner-employers of micro enterprises, which employ a few paid workers, with or without apprentices; • (b) own-account workers, who own and operate one-person business, who work alone or with the help of unpaid workers, generally family members and apprentices; • (c) dependent workers, paid or unpaid, including wage workers in micro enterprises, unpaid family workers, apprentices, contract labor, homeworkers and paid domestic workers. Characteristics of the Informal sector • The concept of the informal sector was introduced into international usage in 1972 by the International Labor Organization (ILO) which defined informality as a -way of doing things characterized by • ease of entry; • reliance on indigenous resources; • family ownership; • small scale operations; • labor intensive and adaptive technology; • skills acquired outside of the formal sector; • unregulated and competitive markets. Characteristics of the Informal sector • • • • • • • • Unprotected by legislation Unrecognized, Unorganized Limited capital Lack of access to credit facilities Low wages Insecure income Evasion of taxes Informal sector in Nigeria • Nigeria has the largest informal sector in Africa- by sheer numbers, high unemployment rate and rising levels of poverty. • It accounts for nearly 70% of the workforce • Current unemployment rates in Nigeria -23.9 % ( National Bureau of Statistics 2012) • 54% of youths (15-35years) unemployed- denominator 64million (2012 National Baseline Youth Survey Report) • Women and children constitute a major proportion of workers in this sector- women have difficulty attaining formal employment because of low education – they work at home and on the streets. Children provide cheap labour Informal sector in Nigeria • Poverty has risen in Nigeria, with almost 100 million people living on less than a $1 a day, despite economic growth, statistics have shown. The National Bureau of Statistics said 60.9% of Nigerians in 2010 were living in "absolute poverty" • Poverty drives people to seek some form of livelihood. Informal sector in Nigeria • Thus , the informal sector has grown within the last decade especially with the advent of mass unemployment, government and NGO driven poverty alleviation schemes. • Accounts for 57.9% of Nigeria’s Gross Domestic product(GDP) • This growth has taken place without regulation or supervision by the competent authorities. Informal sector in Nigeria • The media has applauded small scale entrepreneurs without taking cognizance of health hazards they are exposed to; e.g women who work in the quarry in northern Nigeria, a young man making aluminum pots from scrap metal etc. • They are displayed as success stories of those who have emerged from the pains of poverty and become successful business men and women. • While its true that they are making money, it is at the expense of good health; many of the hazards of such workplaces may not produce immediate illnesses but could result in major illnesses in the long term such as cancers and chronic poisoning. Informal sector in Nigeria • The plethora of poverty alleviation programmes which dovetail into cottage industries producing soap, polish etc do not have a component of health and safety for the worker. • While work is an antedote to poverty, unsafe and unhealthy work is a recipe for disaster. This was well demonstrated in the Zamfara lead poisoning disaster. • Work done in residential premises and home based work leads to exposure of family memberse.g child’s consumption of caustic soda and ensuing oesophageal stricture. Range of Informal sector workers 4 main groups: • Manufacturing: block making, soap making, mining, pottery • Service-mechanics, welders, carpenters, painters and plumbers • Trading; petty traders • Agriculture- particularly in the rural areas Distribution of informal enterprises in Nigeria by activity category CBN/FOS/NISER Activity category No of persons Percentage% Wholesale and retail trade 36, 722 49.0 Manufacturing 22, 539 30.1 Repairs (cars, cycles and goods) 2, 406 3.2 Transportation (land and water) 2, 164 2.9 Hotels and restaurants 1, 948 2.6 Building and construction 1, 375 1.8 Health and Social work 637 0.9 Water supply 458 0.6 Real estate/renting services 300 0.4 Education 298 0.4 Informal sector and OHS • OHS services do not usually cover informal sector • Dr. El Batawi- an Egyptian occupational physician who served as CMO in the office of Occupational Health WHO, Geneva several decades ago referred to them as “the forgotten masses.” FIGURE 23.3a. The informal sector at work: Petty manufacturing. (a) Making blocks for house construction, Kano, Nigeria. Photo: Roy Maconachie. From Africa South of the Sahara, 3rd edition, by Robert Stock. Copyright 2013 by The Guilford Press. Carpentry Vulcanizer Bicycle repair Lagos! Work conditions • Premises - road side - market - residential • Workshops -no toilet facilities for toilet - poor water supply -poor lighting -poor ventilation -poor housekeeping Occupational exposures • Physical hazards Noise – mill workers Light – welders • Chemical hazards Petro chemicals – mechanics Pb – battery chargers solvents- printers, painters, sprayers Hg – gold mining Alkalis – soap Mх Occupational exposures • Biological ▫ G.I. organisms – poor food and water sources ▫ Food grains, dust ▫ Other infections in the work place e.g HIV • Mechanical ▫ ▫ ▫ ▫ ▫ Lifting , Heavy physical work Wrong postures, bending, twisting Poorly designed tools Unsafe work practices Occupational exposures • Psychological ▫ ▫ ▫ ▫ Long working hours Poor remuneration No job security Relationships with opposite sex Health problems of Informal sector workers • • • • • • Musculoskeletal disorders Low back pain Respiratory disorders Injuries Dermatitis Noise induced hearing loss Artisans • Mechanics (Omokhodion & Osungbade 1996) ▫ Hand dermatitis 25% ▫ Cuts and bruises 35% ▫ Low back pain 9% • Saw mill workers (Fatusi & Erhabor 1996) ▫ Musculoskeletal disorders 69% ▫ Conjunctivitis 41% ▫ Tinnitus 34% • Gas welders (Erhabor, Fatusi, Ndububa 1992) ▫ Chronic bronchitis 13% ▫ Eye irritation 51% Artisans • Mill workers (Omokhodion & Kolude 2005) ▫ ▫ ▫ ▫ ▫ Headaches 73% Low back pain 53% Rhinitis 63% Tinnitus 28% Hearing loss 3% • Printers (Omokhodion et al 2013) ▫ Musculoskeletal disorders 28% ▫ Low back pain 20% ▫ Respiratory symptoms 12% Occupational health and Safety needs • Database on OHS in the informal sector; exposures and health effects-short and long term; health problems and health needs • Regulatory arm of OHS establishment to oversee the sector Occupational health and safety needs • Training in identification of hazards and implementing practical solutions • Low cost personal protective equipment • Workplace improvement with low cost materials • Access to microcredit Occupational Health and Safety needs • Needs can be met within the primary health care setting. • Primary health care: • It is the first level of contact of individuals, the family and community with the national health system bringing health care as close as possible to where people live and work. • Need to train primary health care workers • Visits to workplaces Occupational health needs • Raise awareness about occupational health and safety issues • Health and safety posters, pamphlets • Waste disposal- avoiding public health nuisance • Residential waste collectors will not take industrial wastes; so informal workers engage in dumping of wastes. • Low cost solutions to ergonomic hazards A Mechanic Workshop-some practical low cost solution- appropriate technology Use of gloves to reduce contact with chemicals such as engine oil, petrol, lubricants SOEHPON • Needs to be relevant to the needs of the forgotten masses • Should continue dialogue with leaders of the various workgroups • Assist government to collate data about exposures • Provide guidelines for regulation of informal sector workers • Make definite efforts to assist government to incorporate occupational health into the primary health care system to serve the needs of these workers 35 2012 Mabayoje College lecture