Department of Community Health Medicine, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa.
National Health Laboratory Services, National Institute for Occupational Health, Johannesburg, South Africa.
PLoS One. 2020 Jul 1;15(7):e0235173. doi: 10.1371/journal.pone.0235173. eCollection 2020.
Informal waste recyclers contribute significantly to waste removal in South Africa. Waste recyclers face health hazards which are associated with handling and disposal of waste, a lack of personal protective wear and inaccessibility to occupational health care services. Consequently, accessing health care within the public health care sector is important for health outcomes in this population. This study assesses health care access of informal waste recyclers in South Africa to establish baseline information for health planning for potential inclusion of informal waste recyclers into occupational health services.
A cross-sectional study of informal waste recyclers in two landfill sites in Johannesburg was conducted from March 2018. A standardized structured questionnaire was used to collect information on sociodemographic details, health care utilization, barriers to access and acceptability and affordability of health care. Factors associated with health care utilization were assessed using logistic regression.
A total of 363 informal waste recyclers were included in the study. Less than half of informal waste recyclers (41.0%) used health care facilities in the last 12 months. Those who accessed services chose to use facilities close to where they live (87.0%). Barriers to accessing health care services included long waiting periods (36.6%), being unable to take time off work (26.3%) and transport problems (13%). In the univariate analysis, factors such as gender and being treated well at the clinic and location of the health care facility were associated with health care utilization (OR: 1.97, p = 0.05, OR: 1.94, p = 0.02, OR: 0.65, p = 0.04 respectively).
Informal waste recyclers face numerous challenges to accessing health care. Specific to their informal trade, barriers to health care utilization are related to financial repercussions due to the informal nature of their work.
在南非，非正规废物回收者对废物清除做出了重大贡献。废物回收者面临着健康危害，这些危害与废物的处理和处置、缺乏个人防护装备以及无法获得职业保健服务有关。因此，在公共保健部门获得保健服务对于这一人群的健康结果非常重要。本研究评估了南非非正规废物回收者获得保健服务的情况，为潜在将非正规废物回收者纳入职业保健服务进行卫生规划提供基线信息。
2018 年 3 月，在约翰内斯堡的两个垃圾填埋场进行了一项非正规废物回收者的横断面研究。使用标准化的结构化问卷收集社会人口统计学细节、保健服务利用、获得保健服务的障碍以及保健服务的可及性和可负担性方面的信息。使用逻辑回归评估与保健服务利用相关的因素。
共有 363 名非正规废物回收者纳入研究。在过去 12 个月中，不到一半的非正规废物回收者（41.0%）使用了保健设施。那些获得服务的人选择使用靠近他们居住地的设施（87.0%）。获得保健服务的障碍包括等待时间长（36.6%）、无法请假（26.3%）和交通问题（13%）。在单变量分析中，性别以及在诊所受到良好对待和保健设施位置等因素与保健服务利用相关（OR：1.97，p=0.05；OR：1.94，p=0.02；OR：0.65，p=0.04）。
非正规废物回收者在获得保健服务方面面临诸多挑战。具体来说，由于他们的非正式贸易性质，他们在利用保健服务方面的障碍与由于工作的非正式性质而产生的经济后果有关。
