3 million women working in the garment sector in Bangladesh face myriad health issues and other men workers face related health problems that negatively impact their well-being in addition to their productive potential
The ready-made garment (RMG) industry is Bangladesh’s greatest contributor to GDP growth and has played a significant role in the country’s improved performance against world development indicators. The industry represents 75% of Bangladesh’s exports and employs up to 4 million people, 80% of whom are women.
However, the RMG industry has grown rapidly in Bangladesh within the context of the limited social or physical infrastructure to support it. Also, the high cost of medical care is a critical issue in Bangladesh. 40% of the country’s ready-made garment (RMG) industry’s workers, out of 42 lakhs, are deprived of medical treatment due to the high cost of healthcare. This makes them unhealthy and less productive which affects the overall economy.
Health is critical to the wellbeing of a person, and it is a basic human right. It also makes an important contribution to economic progress, as healthy populations live longer, are more productive, and save more.
However, within the RMG industry, 87 percent of women employees suffer from ailments and diseases including malnutrition and anemia, poor hygiene, inadequate pre and post-natal care, and exposure to infections and illness.
The existing healthcare systems cannot provide full protection to RMG workers because there is a large-scale shortage of qualified healthcare providers in Bangladesh. For instance, the nurse to population ratio is 1:7788 and the doctor to population ratio is 1:46457.
It would be nearly impossible to produce a sufficient number of public- and private-sector healthcare providers in the short term. The long working hours of many workers also constrain them from availing external health services during normal operating hours.
It is seen that enormous potential to better leverage factory-based nurses and on-site clinics to bridge some of these gaps and efficiently link RMG sector workers, especially women, to the health products and services that they need. Right now, that potential is not being realized.
High cost of health care in Bangladesh
The high cost of medical care is a big issue in Bangladesh. Out of 42 lakhs, 40% of the country’s RMG industry’s workers, are deprived of medical treatment due to the high cost of healthcare. The Institute of Health Economics of Dhaka University (DU) revealed the information at a coordination meeting called, “Policy Framework for Health Insurance Model in RMG Sector of Bangladesh” on Friday.
The institute recommended the formation of a special Insurance Fund Management Organization to ensure the healthcare of these sick RMG workers.
Professor Dr. Syed Abdul Hamid of the institute said that 43% of garment workers fall ill at some point in the year. The type of their illness depends on the labor and work environment. They do not get proper treatment due to the excessive cost of healthcare services. Even at government hospitals, they face various difficulties to get treatment.”
Response of BGMEA and BKMEA towards health care issue
Md Hanifur Rahman Lotus, Chairman at Standing Committee on Health Centre of the Bangladesh Garment Manufacturers and Exporters Association (BGMEA), thinks if Tk1 is invested by each worker in health insurance, it will give Tk15 in return. In this way, the sector’s additional contribution to the country’s economy will be $10 billion.
He advocated for collaboration among the government, factory owners and workers during a talk on financing mechanisms.
At present, there are 45 lakh, RMG workers, in the country. For example, only if they pay Tk1 each daily, it will be possible to raise a big fund. When the contribution of the government and the owners will be added to it, the fund will be enough to meet the health expenses of the workers, Hanifur pointed out.
Fazlee Ehsan Shamim, a Director of the BKMEA told that they have already invested in their workers’ healthcare facilities. So, spending more in the form of health insurance will come as another burden for them.
Pilot health insurance scheme needed to be permanent
According to Abdul Hamid, “There is no alternative to introducing health insurance for this large population, although about half a crore people of the country work in this sector, only about 1% of the workers have health insurance coverage.”
According to the DU professor, no significant effort is apparent which can bring the remaining RMG workers under health coverage. But they are hopeful that if everyone can work with a combination of government and non-governmental organizations, their standards of living will change.
Workers have to take unpaid leave for an average of four more days per month outside of the scheduled sick leaves that affect them financially.
Most of the insurance benefits that are now available to workers are pilot projects. The pilot health insurance scheme has ended in 2021. He recommended the government create structures that make the projects permanent.
He also called upon all organizations – including public and private hospitals as well as the BGMEA and Bangladesh Knitwear Manufacturers and Exporters Association (BKMEA) – to work together to fulfill the basic rights of these marginalized workers.
Benefits RMG sector will gain by bringing under health insurance
Nasreen Sultana, Director of the Institute of Health Economics said a vast portion of the income of garment workers is spent on treatment and production is disrupted. She said if the health of the workers of the country is brought under a health insurance facility, such workers will benefit and Bangladesh’s production capacity will increase, strengthening the economy of the country as a whole.
Usually, per month on average, 10% of workers shift to other factories for better opportunities and up to 8% remain absent for illness. The introduction of health insurance in all apparel factories will boost workers’ productivity and reduce absenteeism in workplaces by improving their health and safety conditions. At least $10 billion will also be added to the country’s economy annually if all workers are brought under insurance coverage.
So, BGMEA and BKMEA along with the government can come together to provide permanent health insurance for workers to make them more productive and increase the production capacity of the country.
It might not be possible to bring workers of 42 sectors at the same time under the health insurance coverage. It can be begun with RMG. Gradually, all will come under it and benefit the economy of Bangladesh.