非正规就业者与医疗保健服务：对老挝人民民主共和国啤酒促销员获得医疗保健服务的促进因素和障碍的定性研究
Informal workers and access to healthcare: a qualitative study of facilitators and barriers to accessing healthcare for beer promoters in the Lao People's Democratic Republic.
作者信息
Sychareun Vanphanom, Vongxay Viengnakhone, Thammavongsa Vassana, Thongmyxay Souksamone, Phummavongsa Phouthong, Durham Jo
机构信息
University of Health Sciences, Faculty of Postgraduate Studies, Vientiane, Lao PDR.
University of Queensland, Faculty of Medicine & Biomedical Sciences, School of Public Health, Herston, Brisbane, Australia.
出版信息
Int J Equity Health. 2016 Apr 18;15:66. doi: 10.1186/s12939-016-0352-6.
BACKGROUND
Informal 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.
METHODS
In-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.
RESULTS
Most 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.
CONCLUSIONS
Drawing 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.
背景
非正规就业者由于其工作和就业条件，往往面临相当大的风险和脆弱性。本研究旨在以老挝人民民主共和国非正规经济部门受雇的女性啤酒促销员为例，探讨非正规工作经历与获得医疗保健之间的相互作用。
方法
对万象市啤酒商店、餐馆和娱乐场所工作的24名女性啤酒促销员进行了深入访谈。采用了滚雪球抽样的招募策略。访谈探讨了啤酒促销员的工作组织经历、感知到的医疗保健需求、获得医疗保健和保险的情况以及寻求医疗保健的做法。对数据进行了主题分析，随后运用布迪厄的惯习、资本和场域概念进行分析。
结果
纳入研究的大多数啤酒促销员年龄为18岁，单身，从事啤酒促销员工作一年以上，略超过半数的人工作是为了支持自己接受高等教育。啤酒促销员对健康持整体看法，也将良好健康视为有助于美丽——这是她们工作中的一个重要特质。许多人报告说，她们的工作条件，包括嘈杂的环境、接触二手烟、长时间站立和性骚扰，对她们的身心健康产生了负面影响。只有四名参与者拥有任何形式的医疗保险，获得医疗保健受到个人特征、卫生系统因素以及非正规就业条件的限制。
结论
借鉴布迪厄的研究成果，本研究表明就业和疾病如何与日常实践中体现的惯习、获得资本的机会以及女性啤酒促销员在就业领域社会等级制度中的地位相关联。
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