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      Programa de promoción de la salud en un lugar de trabajo informal en Corabastos, Bogotá: una perspectiva participativa Translated title: Health promotion program in an informal workplace in Corabastos, Bogotá: a participatory perspective Translated title: Programa de promoção da saúde em um local de trabalho informal em Corabastos, Bogotá: uma perspectiva participativa

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          Abstract

          Resumen Objetivo: La investigación tuvo como objetivo construir de manera participativa un programa de promoción de la salud en un lugar de trabajo informal en Corabastos, Bogotá, durante 2016 y 2017. Metodología: Se desarrolló en cuatro etapas: 1) movilizar, que se fundamentó en lograr el compromiso de las principales partes interesadas; 2) organizar, con el fin de establecer un grupo dedicado a la transformación y el mejoramiento de las condiciones de salud y trabajo; 3) construir, donde se elaboró un plan de salud como una hoja de ruta para actuar y transformar la las condiciones del trabajo informal; y 4) actuar, o sea, contribuir a la promoción de la salud en lugares de trabajo informal. Resultados: se conformó un grupo de diez trabajadores informales y un investigador externo; se impulsó la participación colectiva y la validación consensuada de todo el proceso. Se identificaron y priorizaron problemáticas, y se construyó el plan de salud, con los objetivos de hacer un manejo adecuado de las basuras, defender los lugares de trabajo informal de las acciones represivas de la fuerza pública, mejorar la calidad de los productos a vender, fortalecer la asistencia a los servicios de salud y establecer alternativas económicas de trabajo. El estudio permitió el diálogo y la participación colectiva de los trabajadores en todas las etapas y la apropiación de la investigación por parte de la comunidad. La metodología brindó herramientas para empoderar a los trabajadores involucrados, al reconocer sus propias capacidades y posibilitar su acción para obtener trasformaciones locales.

          Translated abstract

          Abstract Objective: The objective of the research was to create a participatory health promotion program in an informal workplace in Corabastos, Bogotá, during 2016 and 2017. Methodology: It was developed in four stages: 1) mobilizing, which involved achieving the commitment of the main stakeholders; 2) organizing, in order to establish a group devoted to the transformation and improvement of health and working conditions; 3) building, which involved creating a health plan as a roadmap to act upon and transform informal working conditions; and 4) acting, that is, contributing to the promotion of health in informal workplaces. Results: a group of ten informal workers and an external researcher was created; collective participation and consensual validation of the entire process was promoted. Problems were identified and prioritized and the health plan was built considering the objectives of achieving an adequate waste management, defending informal workplaces from the repressive actions of the public force, improving the quality of the products to be sold, strengthening access to health services and establishing economic work alternatives. The study enabled dialogue and collective participation of workers in all stages as well as the community's appropriation of the research. The methodology provided tools to empower workers by recognizing their own capabilities and enabling them to put them into action in order to obtain local transformations.

          Translated abstract

          Resumo Objetivo: A pesquisa teve como objetivo construir de forma participativa um programa de promoção da saúde no local de trabalho informal em Corabastos, Bogotá, durante 2016 e 2017. Metodologia: Foi desenvolvida em quatro etapas: 1) mobilizar, que foi baseado em alcançar o comprometimento das principais partes interessadas; 2) organizar, a fim de estabelecer um grupo dedicado à transformação e melhoria das condições de saúde e trabalho; 3) construir, onde um plano de saúde foi desenvolvido como um roteiro para atuar e transformar as condições do trabalho informal; e 4) agir, isto é, contribuir para a promoção da saúde em locais de trabalho informais. Resultados: foi formado um grupo de dez trabalhadores informais e um pesquisador externo; foi promovida a participação coletiva e a validação consensual de todo o processo. Os problemas foram identificados e priorizados, e o plano de saúde foi construído, com os objetivos de fazer uma gestão adequada do lixo, defender locais de trabalho informais a partir das ações repressivas da força pública, melhorar a qualidade dos produtos a serem vendidos, fortalecer a assistência aos serviços de saúde e estabelecer alternativas econômicas de trabalho. O estudo permitiu o diálogo e a participação coletiva dos trabalhadores em todas as etapas e a apropriação da pesquisa pela comunidade. A metodologia forneceu ferramentas para capacitar os trabalhadores envolvidos, reconhecendo suas próprias capacidades e possibilitando sua ação para obter transformações locais.

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          Willingness-to-Pay for Community-Based Health Insurance among Informal Workers in Urban Bangladesh

          Introduction Reliance on out-of-pocket payment for healthcare may lead poor households to undertake catastrophic health expenditure, and risk-pooling mechanisms have been recommended to mitigate such burdens for households in Bangladesh. About 88% of the population of Bangladesh depends on work in the informal sector. We aimed to estimate willingness-to-pay (WTP) for CBHI and identify its determinants among three categories of urban informal workers rickshaw-pullers, shopkeepers and restaurant workers. Methods The bidding game version of contingent valuation method was used to estimate weekly WTP. In three urban locations 557 workers were interviewed using a structured questionnaire during 2010 and 2011. Multiple-regression analysis was used to predict WTP by demographic and household characteristics, occupation, education level and past illness. Results WTP for a CBHI scheme was expressed by 86.7% of informal workers. Weekly average WTP was 22.8 BDT [Bangladeshi Taka; 95% confidence interval (CI) 20.9–24.8] or 0.32 USD and varied significantly across occupational groups (p = 0.000) and locations (p = 0.003). WTP was highest among rickshaw-pullers (28.2 BDT or 0.40 USD; 95% CI: 24.7–31.7), followed by restaurant workers (20.4 BDT 0.29 USD; 95% CI: 17.0–23.8) and shopkeepers (19.2 BDT or 0.27 USD; 95% CI: 16.1–22.4). Multiple regression analysis identified monthly income, occupation, geographical location and educational level as the key determinants of WTP. WTP increased 0.196% with each 1% increase in monthly income, and was 26.9% lower among workers with up to a primary level of education versus those with higher than primary, but less than one year of education. Conclusion Informal workers in urban areas thus are willing to pay for CBHI and socioeconomic differences explain the magnitude of WTP. The policy maker might think introducing community-based model including public-community partnership model for healthcare financing of informal workers. Decision making regarding the implementation of such schemes should consider worker location and occupation.
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            Impact of educational intervention on willingness-to-pay for health insurance: A study of informal sector workers in urban Bangladesh

            Background The reliance on out-of-pocket payments for health services leads to a catastrophic burden for many households in Bangladesh. The World Health Organization suggests that risk-pooling mechanisms should be used for financing healthcare. Like many low-income countries (LIC), a large share of employment in Bangladesh is in the informal sector (88%). Inclusion of these workers in health insurance is a big challenge. Among other barriers, the “literacy gap” for health insurance” is a reason for the low insurance uptake in Bangladesh. The aim of this study is, therefore, to assess the impact of an educational intervention on willingness-to-pay (WTP) for health insurance among informal sector workers in urban Bangladesh. Method An educational intervention on occupational solidarity and health insurance is offered to groups of informal workers. Educational sessions take place once a week (3–4 hours) during three subsequent weeks for each occupational group. For assessing the impact of the educational intervention, WTP for joining health insurance using occupational solidarity between workers in “pre- and post-treatment” periods as well as between “control and treatment” groups were compared. Multiple-regression analysis is applied for predicting WTP by educational intervention, while controlling for demographic and socioeconomic characteristics. Results The coefficient of variation (CoV) of the WTP is estimated in control and treatment groups and expected to be lower in the latter. The WTP for health insurance is higher (33.8%) among workers who joined the educational intervention in comparison with those who did not (control group). CoV of WTP is found to be generally lower in post-treatment period and in treatment group compared to pre-treatment period and control group respectively. Conclusion Educational interventions can be used for increasing demand for health insurance scheme using occupational solidarity among informal sector workers.
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              Health risks and informal employment in South Africa: does formality protect health?

              The association between work and health has not been well explored in the context of economically developing countries, largely due to inadequate data.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Journal
                rfnsp
                Revista Facultad Nacional de Salud Pública
                Rev. Fac. Nac. Salud Pública
                Universidad de Antioquia (Medellín, Antioquia, Colombia )
                0120-386X
                August 2019
                : 37
                : 2
                : 22-35
                Affiliations
                [2] Bogotá orgnameUniversidad Nacional de Colombia Colombia aimunozs@ 123456unal.edu.co
                [1] Bogotá orgnameUniversidad Nacional de Colombia Colombia tapabloe@ 123456unal.edu.co
                Article
                S0120-386X2019000200022
                10.17533/udea.rfnsp.v37n2a04
                4480806f-35ff-4731-9b99-c519a98d251b

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                : 11 March 2019
                : 04 July 2017
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 38, Pages: 14
                Product

                SciELO Colombia

                Categories
                Investigación

                Promoción de la salud,working conditions,Promoção da saúde,pesquisa ação participativa,condições de trabalho,setor informal,investigación acción participativa,condiciones de trabajo,sector informal,Health promotion,research,participatory action,informal sector

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