A two-pronged approach to understanding reciprocity and mental health relationship in developing countries: evidence from young informal construction workers in Nigeria.

BACKGROUND: Mental health problems disproportionately affect young people in developing countries. However, there is limited research on help-seeking behaviours and the social support systems that improve mental wellbeing among vulnerable youth populations. OBJECTIVE: This mixed-methods study aimed to examine the relationship between social support reciprocity and mental health among young informal construction workers in Nigeria, a population at high-risk for occupational and socioeconomic stressors. METHODS: A cross-sectional survey was administered to 686 informal workers to measure reciprocity, mental health-related quality of life, and covariates. In-depth interviews with 32 participants provided qualitative context. RESULTS: Quantitative analyses showed 25% of participants reported poor mental health. Reciprocity positively predicted mental health after controlling for covariates. Qualitative findings revealed reciprocity occurs directly between individuals as well as indirectly through trade unions and religious groups. Indirect exchanges through groups helped address limitations of direct support due to limited resources. CONCLUSIONS: This study fills important gaps in understanding how social relationships impact mental health in developing country contexts. Findings emphasize the role of collective action and community-based support systems in promoting mental wellbeing among vulnerable populations. Insights can inform culturally relevant, systems-level mental health interventions.

Effect of social capital on enrolment of informal sector occupational groups in the national health insurance scheme in Ghana: a cross-sectional survey.

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.

Impacts of unconditional cash transfers on health care utilisation in informal sector households in Togo.

BACKGROUND: Most Togolese population earns their income from informal sector, and they are very often exposed to health outcomes. Cash transfers impact healthcare utilization by improving household's social capital, socio-economic status, lifestyle choice, and physical health. The aim of this paper was to analyse the impact of unconditional cash transfers on health care utilisation in informal sector households. METHODS: We used the propensity-score method to compare health care utilisation by households that received cash transfers from nonbeneficiary households and simulated a potential confounder to assess the robustness of the impacts of the estimated treatment (i.e., cash transfer). Data were obtained from a national survey that covered 1405 households. RESULTS: The results show that women benefited the most from cash transfers (73.1%). Our estimates indicate that health care utilisation increased by 28.3% among workers in the informal sectors who benefited from unconditional cash transfers compared to nonbeneficiaries. The greatest impact was found on agriculture households with an increase by 31.3% in the health care utilisation. In general, cash transfer beneficiaries are more likely to use public health centres; there was an increase in public health facility attendance of 21.3%. CONCLUSIONS: Cash transfers are a valuable social protection instrument that improve health care utilisation of populations in the informal sector. Policymakers could use cash transfer as the infusion of income and/or assets that may impact health outcomes. Cash transfers are an opportunity to alleviate barriers of access to health care by older people. Future research must examine impact of cash transfer on health of vulnerable groups such as older people, children, and people with disabilities.

Opportunities and challenges for circular economy in the Maldives: A stakeholder analysis of informal E-waste management in the Greater Malé Region.

In the Maldives, the contribution of the informal sector to e-waste management is significant as a formal e-waste management system is not yet established. The opportunities for advancing the circular economy in the Maldives' e-waste sector rely on the possibility of its formalization. This study aimed to examine the current and anticipated situations of e-waste management in the Greater Malé Region of the Maldives, with a specific focus on formalizing the informal sector. Interviews and questionnaire-based surveys were conducted followed by statistical analysis of the data. The t-test performed for the consumer survey data (n = 202) suggests that formalization encourages consumers to engage with the informal sector, resulting in increased resource recovery. Thematic analysis of interviews conducted with both formal and informal sector stakeholders (n = 17) revealed that the informal sector plays a substantial role in managing e-waste. It also underscored the need for government assistance to enhance safety and productivity in this sector. Various opportunities and challenges for establishing a circular economy in the country were identified, such as the rise in e-waste generation, the presence of an active informal workforce, the lack of sufficient government support, and prevailing stereotypes among consumers regarding informal workers. These findings provide a fresh perspective on the solutions for waste management in the Maldives and open the door to further explore the significance of the informal sector and feasible formalization initiatives. This study could contribute to the literature on the role of the informal sector in waste management in the Maldives and other small island developing states.

The informal economy as a provider of assistive technology: lessons from Indonesia and Sierra Leone.

Promoting the use of assistive technology (AT) is crucial for the health and well-being of users, but there is a huge global problem of unmet need for AT. In this context informal (unregulated) providers of AT play a significant role of meeting AT user need, particularly in less-resourced settings. This study draws on research into formal and informal AT provision in low-income urban communities in Indonesia and Sierra Leone to explore the potential of informal providers in addressing unmet need. Specifically, it looks at the different performance of formal and informal providers regarding the availability and the adequacy of AT that they provide. The study concludes by proposing further research into the scope for coproduction of AT between formal and informal providers.

Assistive technology (AT) (e.g. wheelchairs, hearing aids, or products for people with visual impairments) are crucial for the wellbeing of users, but there is huge and growing unmet need for AT globally. In low-income settings many users access AT from the informal (unregulated) economy, which tends to provide AT in under-served communities, and at lower cost, helping to address this gap. However, AT from informal providers often fails to meet minimum product standards and/or lacks associated services such as assessment, fitting, user training, maintenance and repairs. On the other hand, many users of AT from informal sources value, in addition to low cost, some other features, such as their ability to customize assistive products and innovate in product development. This study therefore proposes exploring ways in which formal and informal providers of AT could work together to improve access at the same time as ensuring the safety and quality of AT for low-income users.

Workplace concentrations of particulate matter and noise levels among stone quarry and soil brick-making workers in Tanzania.

This study was conducted in 15 artisanal stone quarries (SQ) and 22 soil brick-making (SBM) sites. Specific objectives were to: (i) quantify ambient concentrations of suspended particulate matter (PM) and gaseous pollutants and noise levels at SQ and SBM workplaces; (ii) critically evaluate the potential workplace hazards, and risk factors; and (iii) analyze potential health risks to workers. Gaseous pollutants, PM, and noise levels were measured by using portable digital devices. Social demographic information of 150 workers across the study sites was collected using a questionnaire. Quantitative data were summarized and exploratorily analyzed using Stata software. This study revealed that fuel burning in the SBM releases SPM up to 10-fold and CO gas up to 14-fold above the WHO-recommended time-weighted average exposure concentrations of 16.6 µg/m3 and 0.3 mg/m3, respectively. On average hitting with a pickax in SQ areas released noise levels of about 81.01 ± 6.8 dB[A]. Overall, the SQ and SBM workers were exposed to low concentrations of PM and noise levels when the measurements were taken. Long working hours for repetitive activities in hot-sunny (27.1 ± 2.3 °C) and low outdoor humidity 23 ± 1.5%, potentially increase epidemiological risks to vulnerable individuals and enhance worker exposures to inhalable PMs. Although workplace noise exposure below the regulatory threshold of 85 dB[A] may not cause immediate hearing damage, it can have a significant impact on workers' hearing health, cognitive performance, psychological well-being, and overall productivity. This study provides an overview of workplace conditions rather than an accurate representation of the actual worker exposure levels because personal breathing zone sampling devices were not used. This study provides baseline information for further research and can be used for evidence-based decision-making and policy formulation to safeguard worker safety and health in SQ and SBM sites in Tanzania.

Formal and informal solid waste management in Kutaisi, Georgia: A status quo report based on material flow analysis.

The goal of this study is a qualitative and quantitative evaluation of processes and flows within the solid waste management (WM) system in Kutaisi, Georgia, and the wider Imereti region. The applied methodology based upon data collected through customized questionnaires enabled both the formal and informal sectors (IS) to be characterized. Moreover, waste composition studies in the region's rural and semi-urban areas revealed that the share of recyclables is higher in urban areas and commercial centres. A material flow analysis was used to transparently consolidate the collected data, showing that dumping and landfilling still play a major role within the Georgian WM system. The total amount of waste landfilled on 'Nikea' landfill in 2019 equals 58,000 tonnes year-1, from where around 55,500 tonnes year-1 is formally collected municipal solid waste, and 2,503 tonnes year-1 is commercial and industrial waste. According to the findings, the size of the IS in Kutaisi is 0.07-0.15% of the city's population, whose supposed cumulative income is estimated GEL 0.57-1.13 million (EUR 180-360 thousand) in 2019. Informally collected recyclables are estimated 870-1,750 tonnes year-1, comprising 6-11% of recyclables landfilled in Kutaisi in 2019. The study provides a basis for decision-makers. Replicating the applied methodologies and approaches to create this sound database could support the WM system across whole Georgia. The study further reveals the importance of the need to stop neglecting the IS and recognizes the importance of its role in the WM system of Kutaisi and the wider Imereti region, respectively.

Learning from the past to plan for the future: An historical review of the evolution of waste and resource management 1970-2020 and reflections on priorities 2020-2030 - The perspective of an involved witness.

Improving waste and resource management (WaRM) around the world can halve the weight of plastics entering the oceans, significantly mitigate global heating and contribute directly to 12 of 17 sustainable development goals (SDGs). Achieving such results demands understanding and learning from historical evolution of WaRM. The baseline is 1970, prior to environmental legislation. Early steps in the Global North focused on the 'technical fix' within strictly enforced legal frameworks, first bringing hazardous wastes and municipal solid wastes (MSW) under control, then gradually ramping up environmental standards. Using modern technologies to the Global South often failed due to institutional and financial constraints. From 1990, focus switched to integrating technical and governance aspects: local institutional coherence, financial sustainability, provider inclusivity, user inclusivity, national legislative and policy framework. The Global North rediscovered recycling, using policy measures to promote segregation at source; this relied on new markets in emerging economies, which had largely disappeared by 2020. The Global South is making progress on bringing wastes under control, but around 2.7 billion people lack access to waste collection, while ~40% of collected MSW is open dumped or burned - a continuing global waste emergency. So, much remains to be done to move further towards a circular economy. Three policy priorities are critical for all countries: access to sustainable financing, rethinking sustainable recycling and worldwide extended producer responsibility with teeth. Extending services to unserved communities (SDG11.6.1) requires a people-centred approach, working with communities to provide both quality services and decent livelihoods for collection and recycling workers.

Impact of COVID-19 restrictive measures on income and health service utilization of tuberculosis patients in India.

BACKGROUND: The nationwide lockdown (March 25 to June 8, 2020) to curb the spread of coronavirus infection had significant health and economic impacts on the Indian economy. There is limited empirical evidence on how COVID-19 restrictive measures may impact the economic welfare of specific groups of patients, e.g., tuberculosis patients. We provide the first such evidence for India. METHODS: A total of 291 tuberculosis patients from the general population and from a high-risk group, patients from tea garden areas, were interviewed at different time points to understand household income loss during the complete lockdown, three and eight months after the complete lockdown was lifted. Income loss was estimated by comparing net monthly household income during and after lockdown with prelockdown income. Tuberculosis service utilization patterns before and during the lockdown period also were examined. Household income loss, travel and other expenses related to tuberculosis drug pickup were presented in 2020 US dollars (1 US$ = INR 74.132). RESULTS: 26% of households with tuberculosis patients in tea garden areas and 51% of households in the general population had zero monthly income during the complete lockdown months (April-May 2020). Overall income loss slowly recovered during July-August compared to April-May 2020. Approximately 7% of patients in the general population and 4% in tea garden areas discontinued their tuberculosis medicines because of the complete lockdown. CONCLUSION: Discontinuation of medicine will have an additional burden on the tuberculosis elimination program in terms of additional cases, including multidrug resistant tuberculosis cases. Income loss for households and poor restoration of income after the lockdown will likely have an impact on the nutrition of tuberculosis patients and families. Tuberculosis patients working in the informal sector were the worst affected group during the nationwide lockdown. This emphasizes that a policy priority must continue to protect those working in informal sectors from the economic consequences of such restrictive measures, including paid sick leave, additional food support, and direct benefit transfers. Alongside ensuring widespread access to COVID-19 vaccines, these policy actions remain pivotal in ensuring the well-being of those who are unfortunate enough to be living with tuberculosis.

Estimating the costs for implementing a maternity leave cash transfer program for women employed in the informal sector in Brazil and Ghana.

BACKGROUND: Maternity leave policies are designed to protect gender equality and the health of mothers in the workforce and their children. However, maternity leave schemes are often linked to jobs in the formal sector economy. In low- and middle-income countries a large share of women work in the informal sector, and are not eligible to such benefit. This is worrisome from a social justice and a policy perspective and suggests the need for intervening. Costing the implementation of potential interventions is needed for facilitating informed decisions by policy makers. METHODS: We developed and applied a costing methodology to assess the cost of a maternity leave cash transfer to be operated in the informal sector of the economy in Brazil and Ghana, two countries with very different employment structures and socioeconomic contexts. We conducted sensitivity analysis by modeling different numbers of weeks covered. RESULTS: In Brazil, the cost of the maternity cash transfer would be between 0.004% and 0.02% of the GDP, while in Ghana it would range between 0.076% and 0.28% of the GDP. The relative cost of rolling out a maternity intervention in Brazil is between 2.2 to 3.2 times the cost in Ghana depending on the benchmark used to assess the welfare measure. The differences in costs between countries was related to differences in labor market structure as well as demographic characteristics. CONCLUSIONS: Findings show how a standard methodology that relies on routinely available information is feasible and could assist policymakers in estimating the costs of supporting a maternity cash transfer for women employed in the informal sector, such intervention is expected to contribute to social justice, gender equity, and health trajectories.

Does coinsurance reduction influence informer-sector workers' and farmers' utilization of outpatient care? A quasi-experimental study in China.

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.

Exploring heterogeneity of national health insurance scheme enrolment among persons in the informal sector.

The Ghanaian government began implementing the National Health Insurance Scheme (NHIS) in 2005, anchored on the universal health coverage principle. However, informal sector workers contribute to the low enrolment into the scheme. This paper examines the factors that influence enrolment status in Ghana's NHIS among individuals in the informal sector. The study employed the fixed-effects logit model, using the Ghana Socioeconomic Panel Survey datasets. The findings revealed that gender, age, education, marital status, household size, physical activity, income, savings and subjective social welfare determine enrolment decisions of persons in the informal sector. Drivers of NHIS enrolment for male and female household heads were secondary education and household size. Heterogeneously, age, Junior High School education, married, physical activity, subjective social welfare and savings influenced only male-headed households' enrolment status. The study shows differences in enrolment status among rural and urban residents, as age, education, marital status, household size, and physical activity influenced rural residents, while for urban inhabitants', savings determined their NHIS enrolment decisions. However, gender, obesity, income and subjective social welfare predicted enrolment decisions for rural and urban residents. Finally, two variables, gender (male) and physical activity predicted the NHIS enrolment decision among the poor, whereas subjective social welfare and savings influenced the wealthiest enrolment decisions. For Ghana to achieve the Sustainable Development Goals of universal health coverage, the study recommends enhanced public education on NHIS benefits among informal workers to promote enrolment.

Source separation in municipal solid waste management: Practical means to its success in Asian cities.

Source separation plays a pivotal role in sustainable and integrated Municipal Solid Waste Management (MSWM) and in achieving a circular economy in Asia. However, it is still not an official practice, and many cities continue to utilise open dumping, involving receiving mixed waste without pre-treatment. This paper, therefore, examines the advantages of source separation of MSW and explores the main factors for success in the planning and implementation of official source separation programmes in cities in Asia. Analysis of the results for two case studies in India and Japan could be used to strengthen capacities of policymakers in designing and implementing official source separation systems to facilitate material recovery and achieve sustainable development in Asia.

Application of a 'Recycling Exchange' instrument to compensate waste pickers in Brazil via a first payment for urban environmental services programme.

This article presents an approach to compensate waste pickers in the informal sector of Minas Gerais state, Brazil, via a Payment for Urban Environmental Services (PUES) instrument, called 'Recycling Exchange'. The aim is to evaluate the effects of this instrument on the amount of waste diverted from landfill and reintroduced into the production chain, and to increase recognition of waste pickers' contributions to the state's economy. It was found that the 'Recycling Exchange' met the fundamental objectives of a PUES: the double social and economic benefits of the social inclusion of waste pickers in the execution of the public policy for solid waste management, and inducing (in the case of glass), ensuring and stabilising (plastic and paper) continuity of the activity of selling recyclables in times of wide price fluctuations for these recyclables. The instrument enhanced the provision of this environmental service and the positive externalities associated with recycling.

The financing need of equitable provision of paid maternal leave in the informal sector in Indonesia: a comparison of estimation methods.

BACKGROUND: Providing an enabling environment for breastfeeding is hampered by the inequitable implementation of paid maternity leave, primarily due to perceived or actual financial costs. To estimate the real cost of paid maternity leave requires using reliable methods. We compared methods utilized in two recent studies in Indonesia. Study A estimated the financial need of providing paid maternity leave in the formal sector with a 10-year forecast at 21% coverage of eligible mothers, while study B estimated similar costs for the informal sector at 100% coverage annually. Results are critical for guiding future application of either method to inform paid maternity leave policies. METHODS: We compared number of covered mothers working informally, total annual cost, and cost per mother. We modified some parameters used in study A (method A) to be similar to study B (method B) for comparison, namely the period of estimate (annual), coverage (100%), estimate of women potentially breastfeeding, exchange rate, female labor force participation rate, the percentage of women working in the informal sector, and adding administration cost. RESULTS: The methods differ in determining the number of mothers working in the informal sector who gave birth, the minimum wage as unit cost, and administrative cost. Both studies estimated the cost at various lengths of leave period. Method A requires more macro (e.g. national/regional) level data, while method B involves (e.g. individual) micro level data. We compared the results of method A with method B, respectively: 1) number of covered mothers working informally were 1,425,589 vs. 1,147,204; 2) total annual costs including administrative costs were US$650,230,167 vs. US$633,942,726, and; 3) cost/mother was US$456 vs US$553. CONCLUSION: Certain flexibilities can be applied to both methods, namely using parameters specific to respective regions (e.g. provincial level parameters), flexible period of analysis, and the use of administrative cost. In a setting where micro data is scarce and not easily accessible, method A provides a feasible approach, while method B will be most appropriate if suitable micro data is available. Future comparison studies in other settings are needed to provide further evidence on the strengths and weaknesses of both methods.

Opportunities and challenges in reducing personal inhalation exposure to air pollution among electronic waste recovery workers in Ghana.

BACKGROUND: Informal sector electronic waste (e-waste) recovery produces toxic emissions resulting from burning e-waste to recover valuable metals. OBJECTIVES: To identify high-risk worker groups by measuring relative levels of personal inhalation exposure to particulate matter (PM) of fine (≤2.5 µm) and coarse (2.5-10 µm) fractions (PM2.5 and PM2.5-10, respectively) across work activities among e-waste workers, and to assess how wind conditions modify levels of PM by activity and site location. METHODS: At the Agbogbloshie e-waste site, 170 partial-shift PM samples and time-activity data were collected from participants (N = 105) enrolled in the GeoHealth cohort study. Personal sampling included continuous measures of size-specific PM from the worker's breathing zone and time-activity derived from wearable cameras. Linear mixed models were used to estimate changes in personal PM2.5 and PM2.5-10 associated with activities and evaluate effect modification by wind conditions. RESULTS: Mean (±standard deviation) personal PM2.5 and PM2.5-10 concentrations were 80 (± 81) and 123 (± 139) µg m-3 , respectively. The adjusted mean PM2.5 concentration for burning e-waste was 88 µg m-3 , a 28% increase above concentrations during non-recovery activities (such as eating). Transportation-related and burning activities were associated with the highest PM2.5-10 concentrations. Frequent changes in wind direction were associated with higher PM2.5 concentrations when burning, and high wind speeds with higher PM2.5-10 concentrations when dismantling e-waste downwind of the burning zone.

Understanding abortion seeking care outside of formal health care settings in Cape Town, South Africa: a qualitative study.

BACKGROUND: Although abortion was legalized in South Africa in 1996, barriers to safe, legal abortion services remain, and women continue to seek abortions outside of the formal healthcare sector. This study explored the decision-making processes that women undertake when faced with an unintended pregnancy, the sources of information used to make their decisions and the factors that contribute to their seeking of informal sector abortion in Cape Town, South Africa. METHODS: We conducted 15 semi-structured in-depth interviews in English with women who had accessed an abortion outside of the formal health care sector. Women were recruited with the assistance of a community-based key informant. Data was analyzed using a thematic analysis approach. RESULTS: Participants were aware that abortions were legal and accessible in public clinics, however they were concerned that others would find out about their unintended pregnancy and abortion if they went to legal providers. Women were also concerned about judgment and mistreatment from providers during their care. Rather than seek care in the formal sector, women looked past concerns around the safety and effectiveness of informal sector abortions and often relied on their social networks for referrals to informal providers. CONCLUSIONS: The findings highlight the decision-making processes employed by women when seeking abortion services in a setting where abortion is legal and demonstrate the role of institutional and societal barriers to safe abortion access. Abortion service delivery models should adapt to women's needs to enhance the preferences and priorities of those seeking abortion care-including those who prefer facility-based care as well as those who might prefer self-managed medical abortions.

Although abortion was legalized in South Africa in 1996, barriers to safe, legal abortion services remain, and women continue to seek abortions outside of the formal healthcare sector. This study explored the decision-making processes that women undertake when faced with an unintended pregnancy, who they discuss and seek help from, and the factors that influence their decision to seek an abortion outside of the formal health care sector. We interviewed 15 women who had obtained an abortion outside of the health care sector in Cape Town, South Africa. Women were aware that abortions were legal and available in public clinics, but they were concerned about negative and judgmental attitudes from health care providers even though some women were aware of the possible health safety issues related to seeking an abortion outside of the clinic setting. Abortion services should adapt to women's needs and offer them options of facility-based care but also self-managed medical abortions under the guidance of health care providers.

The financing need for expanding paid maternity leave to support breastfeeding in the informal sector in the Philippines.

In low- and middle-income countries, almost three-fourths of women in the labour force lack maternity protection. In the Philippines, current laws do not guarantee paid maternity leave to workers in the informal economy. A non-contributory maternity cash transfer to informal sector workers could be used to promote social equity and economic productivity and could provide health benefits by helping mothers meet their breastfeeding goals. The objective of the study is to provide a realistic cost estimate and to assess the financial feasibility of implementing a publicly financed, non-contributory maternity cash transfer programme to the informal sector in the Philippines. Using a costing framework developed in Mexico, the study estimated the annual cost of a maternity cash transfer programme. The methodology estimated the unit cost of the programme, the incremental coverage of maternity leave and expected number of enrollees. Different unit and incremental costs assumptions were used to provide a range of scenarios. Administrative costs for running the programme were included in the analysis. The annual financing need of implementing maternity cash transfer programme in the Philippines ranges from a minimum scenario of USD42 million (14-week maternity cash transfer) to a more ideal scenario of USD309 million (26-week maternity cash transfer). The latter is financially feasible as it is equivalent to less than 0.1% of the country's gross domestic product substantially lower than the share cost of not breastfeeding (0.7%). The annual cost of the programme is only 10% of the total cost of the largest conditional cash transfer programme.

Are there evidence to support the informal sector's willingness to participate and pay for statewide health insurance scheme in Nigeria?

In recent times, many states of the federation have attempted to implement a social health insurance scheme. This is with a view to achieving universal health coverage in their states. One of the main target populations of the scheme is the informal sector workers. There are still concerns about whether enough pieces of evidence were used to establish the scheme across the country. This perspective article briefly highlights some evidence to support the informal sectors willingness to participate and pay for a statewide health insurance scheme in Nigeria.

Occupational Safety and Health in a Community of Shellfish Divers: A Community-Based Participatory Approach.

In artisanal fishing communities in Chile, the access to occupational safety and health (OSH) is limited by factors such as the informality of employment. Our objective was to analyze the working and health conditions of workers in a coastal town in Southern Chile, under a community-based participatory approach. We carried out two independent social dialogue workshops within the community. The first one (N of participants = 25) was aimed to identify the strengths, weaknesses and challenges for preventing decompression sickness among divers. The second workshop (N of participants = 10) was set to identify the work processes and to map the occupational risks during seafood harvesting and processing in the community. Community members' training for handling and preventing decompression sickness among divers, and the collaboration between a local health representative, stakeholders and authorities, were identified as contributing factors in reducing fatalities and sequels among divers in the past. Technology and safety on board the vessels, training of healthcare personnel in OSH, and access to health programs, were identified as remaining challenges. Through risk mapping, the participants identified the relationship between working and health conditions in the community, reinforcing the necessity of improving access to health and social security. The community participation in identifying and analyzing working and health conditions could be the first step for a strategy to address OSH through primary health care in rural communities. Community empowerment and involvement in action plans, training on basic OSH for health care workers, and public policies are required.