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Introduction In Bangladesh, 85% of the workforce is employed in the informal sector, characterised by unsafe working conditions, low wages, and a lack of social and labour protections. Evidence on the health and occupational injuries faced by informal sector workers is limited. This study assessed the health status of informal sector workers in Dhaka’s Kamrangirchar area, where Médecins Sans Frontières (MSF) has provided occupational health (OH) services and provides evidence to inform policy. Methods We conducted a retrospective analysis using OH data from two MSF clinics, covering patients aged ≥ 18 years from February 2014 to December 2023. We performed a descriptive analysis, stratified by sex, using chi-squared tests to identify differences in health status by key characteristics, including patient demographics such as age and sex, factory type, work-related morbidity, injuries, nutritional status, and mental health. The analysis was limited to new consultations. Results Between 2014 and 2023, 64,467 OH consultations occurred among adults aged ≥ 18 years, of which 23,874 were new consultations with sex data available (self-reported); 38.6% were women. Women were more likely to work in plastics (35.7% vs. 24.4%) and garment (28.8% vs. 18.9%) factories, whereas men were predominated in leather factories (17.5% vs. 7.8%). Machinery operation was reported by 92.8% of men and 91.5% of women. Work-related conditions accounted for 90.5% of all visits. The most common diagnoses for both sexes were musculoskeletal disorders (30.3%) and gastrointestinal conditions (22.7%). Injuries represented 4.3% of new consultations, with a higher proportion in men (6.0% vs. 1.8%), and 60% of injuries occurred in metal factories. Malnutrition affected 16.7% of men and 12.5% of women. Among 561 patients with mental health outcomes, mood disorders were more frequent in women (92% vs. 84%). Conclusions This study highlights the significant work-related health burden faced by urban informal sector workers operating in hazardous environments, with gender-based differences. Urgent gender-sensitive workspace safety, social and mental health, and nutritional initiatives are needed. Ratifying the International Labour Organization Conventions C189 and C190, which aim to provide informal workers with the same protection as those in the formal sector, would be a crucial step toward safeguarding workers’ rights and well-being.

Background Enrolment of informal sector workers in Ghana’s National Health Insurance Scheme (NHIS) is critical to achieving increased risk-pooling and attainment of Universal Health Coverage. However, the NHIS has struggled over the years to improve enrolment of this subpopulation. This study analysed effect of social capital on enrolment of informal sector workers in the NHIS. Methods A cross-sectional survey was conducted among 528 members of hairdressers and beauticians, farmers, and commercial road transport drivers’ groups. Descriptive statistics, principal component analysis, and multinomial logit regression model were used to analyse the data. Results Social capital including membership in occupational group, trust, and collective action were significantly associated with enrolment in the NHIS, overall. Other factors such as household size, education, ethnicity, and usual source of health care were, however, correlated with both enrolment and dropout. Notwithstanding these factors, the chance of enrolling in the NHIS and staying active was 44.6% higher for the hairdressers and beauticians; the probability of dropping out of the scheme was 62.9% higher for the farmers; and the chance of never enrolling in the scheme was 22.3% higher for the commercial road transport drivers. Conclusions Social capital particularly collective action and predominantly female occupational groups are key determinants of informal sector workers’ participation in the NHIS. Policy interventions to improve enrolment of this subpopulation should consider group enrolment, targeting female dominated informal sector occupational groups. Further studies should consider inclusion of mediating and moderating variables to provide a clearer picture of the relationship between occupational group social capital and enrolment in health insurance schemes.

Research background: Retirement planning is viewed as one of the cornerstones of long-term household financial security. The responsibility of retirement planning has now been shifted to the individual and is no longer the responsibility of the employer. Purpose: This paper examines the link between financial literacy and retirement planning among informal sector traders in the Randburg area of Johannesburg, South Africa. Research methodology: A questionnaire approach was used to collect data from 269 randomly selected informal sector respondents. The data was analysed using ordinal regression. Robustness tests were executed using the Wald test. Results: Findings reveal that financial literacy is linked to retirement planning, and especially with reference to informal sector workers. Additionally, education, income and the informal business sector were observed to have a positive and significant influence on retirement planning. Novelty: The paper contributes to both theoretical and practical discourses on retirement planning for informal sector entrepreneurs which has not received much attention. These results are important for policy makers in retirement planning as well as curriculum development.

This research aimed to assess the perceptions of air quality and health symptoms caused by low urban air quality among vulnerable socio-economic groups in the world of work in Bangkok, Thailand through a questionnaire survey of 400 workers of both formal and informal sectors in the five districts with different socio-economic characteristics and levels of air pollution. The findings showed symmetry between air quality-monitoring data and health symptoms of different socio-economic groups but asymmetry between air quality-monitoring data and people’s perceptions of air quality in their areas. It also showed inequalities of low air quality-related health impacts on socio-economic groups in the world of work. People working near the streets, highways, and industrial zones tended to have more health symptoms related to low air quality, and informal sector workers faced more health risks than formal sector workers. The study appeals for effective air pollution communication to enhance the public and informal sector worker population’s literacy of air pollution, the sources of air pollution and its critical health impacts, and the available and sufficient primary care organizations and community health care centers to address work-related health needs to reach the informal sector worker population.

Background In recent years, the Chinese government has been trying to improve informal-sector workers’ and farmers’ access to healthcare and reduce their financial burdens by introducing a plan of cost-sharing reduction, but the effect on outpatient care utilization remains unknown. Furthermore, scarce evidence has been provided to help understand the impact of cost-sharing reduction on healthcare use in low- and middle-income countries. The policy change of the coinsurance reduction for outpatient care from 75 to 55% for the enrollees of the Urban and Rural Residents Basic Medical Insurance in Taizhou, China in 2015 provides us a good quasi-experimental setting to explore such an impact. Methods We do a quasi-experimental study to explore the impact of coinsurance reduction on outpatient care use among the informal-sector workers and farmers aged 45 and above by estimating a fixed-effects negative binomial model with the difference-in-differences approach and the matching method. Heterogeneous effects in primary care clinics and for the older people aged 60 and above are also examined. Our data is from the China Health and Retirement Longitudinal Study 2013 and 2015. Results We find neither statistically significant impact of coinsurance reduction on outpatient care utilization in all health facilities for informal-sector workers and farmers aged 45 and above, nor heterogeneous effects in primary care clinics and for older people aged 60 and above. Conclusions We conclude that the coinsurance reduction cannot effectively improve the informal-sector workers’ and farmers’ utilization of healthcare if the cost-sharing undertaken by patients remains high even after the reduction. Besides, improving healthcare quality in primary care clinics may play a more important role than merely introducing a cost-sharing reduction plan in enhancing the role of primary care clinics as gatekeepers. We propose that only a substantial coinsurance reduction may help influence the utilization of healthcare for informal-sector workers and farmers, and enhancing the healthcare quality in primary care clinics should be given priority in low- and middle-income countries.

Voluntary social insurance (VSI) is critical to extending social protection coverage to informal sector workers in developing countries like Vietnam, yet participation rates remain low. This study investigates the behavioral, social, and structural determinants influencing VSI participation, integrating the theory of planned behavior (TPB) and rational choice theory (RCT) into a comprehensive framework. Data were collected through a structured survey of 448 informal workers and analyzed using structural equation modeling (SEM). Results demonstrate that positive attitudes, supportive subjective norms, respected community figures, and community cohesion drive VSI participation, whereas financial incentives and flexible payment options alone do not. The study highlights the dominant role of internal motivations and social trust over purely economic considerations. Practical implications emphasize the need for communication strategies fostering positive perceptions, leveraging community leadership, and reinforcing institutional credibility. These findings provide valuable insights for policymakers aiming to design more inclusive, resilient social protection systems tailored to transitional economies like Vietnam. Plain Language Summary • Internal motivations and social trust outweigh financial incentives in driving participation in Vietnam’s voluntary social insurance (VSI). • Positive attitudes, supportive norms, and respected community figures significantly influence informal workers’ decision to enroll in VSI. • Flexible payment schemes and government subsidies alone are insufficient to boost VSI enrollment without addressing trust and awareness. • Policy strategies must prioritize trust-building, community engagement, and reshaping public perceptions to expand social protection coverage.

Objective Informal sector workers are exposed to occupational hazards which could escalate their healthcare expenditures. Thus, enrollment in a health protection scheme among informal sector workers is useful for reducing their catastrophic healthcare expenditures. However, there is scant information on factors predicting their enrollment in the National Health Insurance Scheme (NHIS) in Ghana, a gap this quantitative study aims to fill. A sample of 350 informal sector workers was involved in a cross-sectional survey. Results Approximately 17% of the participants were enrolled in NHIS. Respondents who had worked between 5 and 7 years were significantly more likely to enroll in NHIS compared with those who had worked below 2 years ( AOR = 13.159, CI 1.135–152.596, p = 0.039). The study further found that apprentices (AOR = 0.72, CI 0.353–1.056, p = 0.005) were less likely to enroll in NHIS compared with their masters. Participants who were exposed to electrical hazards (AOR = 2.93, CI 1.56–5.10, p = 0.013) and suffered from occupational diseases (AOR = 2.75, CI 1.743–5.17, p = 0.001) were significantly more likely to enroll in NHIS. Also, respondents who were non-Christians were significantly less likely to enroll in NHIS compared with their respective counterparts (AOR = 0.726, CI 0.067–2.503, p = 0.011). The findings are useful for increasing the NHIS enrollment rate among informal sector workers in Ghana.

The primary purpose of this study is to systematically review the effect of different hazardous work environment among workers in the informal sector across of India, with a particular emphasis on respiratory health risks. The research question focuses on identifying the types of occupational exposures that threaten respiratory health and assessing the efficacy of current health policies and interventions for these workers. This systematic review critically analyzes literature from 2013 to 2023, focusing on studies that investigate occupational exposures on respiratory health among informal sector workers in India and different intervention strategies to control the problems. Of these, 17 studies focused on respiratory health impacts, while 11 examined intervention strategies. Databases such as PubMed, Scopus, and Google Scholar etc. were searched using a structured strategy, adhering to PRISMA guidelines. Only peer-reviewed English-language studies were included, which may introduce language bias and limit the generalizability of findings. Common occupational exposures identified include dust and chemical vapours, which were significantly associated with conditions such as asthma and chronic respiratory diseases. Quantitative insights revealed that workers exposed to high dust levels had a threefold increased risk of chronic bronchitis, while intervention studies highlighted improvements in respiratory health through measures like enhanced ventilation systems and use of personal protective equipment. The study highlights gaps in implementing effective health policies, emphasizing the severe respiratory risks faced by informal sector workers in India and the urgent need for comprehensive occupational health measures. The conclusions emphasize the need for targeted interventions, including stronger policies, better workplace practices, and enhanced worker education, to reduce occupational hazards and improve health outcomes.

PurposeThis paper uses the Social Identity Model of Collective Action (SIMCA) framework of Zomeren et al. (2008) to explain the organising experiences of the informal sector workers engaged in large number in the world's largest shipbreaking industry located in the western Indian town of Alang.Design/methodology/approachA single case study approach was adopted to understand the participation of shipbreaking workers in their trade union and factors that influence their participation.FindingsSense of cohesive collective identity and injustice alongside efficacy considerations have shaped the organising experiences and affected the participation of informal sector workers in their union. The trade union was able to overcome the scourge of invisibility that has been one of the dominant features of informal sector employment.Research limitations/implicationsThis paper treated union participation as unidimensional. Besides, the subjective conceptualization of strengths of perceptions of injustice, identities and efficacy considerations could be a limitation. The paper does acknowledge the gendered nature of shipbreaking but have not actively pursued it as a part of our research.Practical implicationsThe findings of our study are an exemplar for those who intend to organise informal sector workers, especially precarious workers. The empirical findings allude to the role of trade unions in combating the invisibility, which is one of the defining features of informal sector workers through a distinctive, cohesive identity inculcated in those workers.Originality/valueThis paper has borrowed the SIMCA framework to explore union participation. Organising experiences of precarious workers from the developing world provides a contextual and an empirical novelty to our study.

Record-breaking summer heat events are increasing in frequency in Zimbabwe and 2016 was a particularly hot year with the country experiencing its worst heat wave event in decades. Currently, Zimbabwe has no coordinated public health response to deal with heat wave events and no specific data on heat-related morbidity and mortality. The country has no legislation for protecting workers against environmental heat exposure, particularly those most vulnerable who are employed in the informal sector. These workers are also at risk due to their outdoor work environments. The article outlines the state of climate and heat stresses in Zimbabwe, as benchmarked against other African countries and France. It further summarizes outdoor workers' susceptibility to heat exposure and the need for the Zimbabwean Government to develop policies to ensure the health and safety of an increasing population of outdoor workers in Zimbabwe.