Healthcare seeking behaviour among female garment workers in Koggala Free Trade Zone, Sri Lanka

Abstract

Background: In a 2011 study, the prevalence of musculoskeletal disease among a female garment worker group in Koggala Free Trade Zone (Sri Lanka) was estimated to be 15.5%. Nearly all affected women in this group felt their problems disrupted their leisure activities and household work, while only a few reported missing work as direct consequences of their discomfort. The reason why they did not seek treatment or take leave, however, was not clear. Objective: To explore the healthcare seeking behaviour and barriers that prevent female workers at Koggala Free Trade Zone from seeking care Methods: This is an exploratory mixed methods quantitative-qualitative study utilizing pre-interview questionnaires and focus group discussions. Four focus group discussions were held, each consisting of 6 female garment workers (n=24). Discussions were transcribed and processed through three levels of analysis and qualitative coding. Major themes on healthcare seeking and barriers to healthcare were identified using the resulting codebook. Results: The quantitative data showed that more than 90% of focus group participants (n=22) reported musculoskeletal pain in the month prior to the study and less than 30% sought care. Major barriers to healthcare seeking were identified: workers' perception on Western medical treatment and pain, the difficulty in accessing healthcare outside the factory, pressure from management to reach production goals, and financial and personal factors from taking time off work. Conclusions: Multiple factors play a role in healthcare seeking among Sri Lankan female garment workers. Targeted occupational health interventions should focus on alleviating these pain points for garment workers and on educating workers and factory management on the benefits of proactive healthcare seeking behaviour for Sri Lankan female garment workers.

Unheard voices: a cross-sectional study on the perception of Sri Lankan female factory workers towards the Abortion Law

“…In Sri Lanka, the EPZs have become an important source of employment for women, with over 100 000 women working in these zones as of 2019 (17). However, despite the economic benefits, FFWs often face a range of challenges related to their sexual and reproductive health (SRH) issues, including limited access to comprehensive services (13,(18)(19)(20). On the other hand, a majority of EPZs do not provide their female staff with adequate income or support; employees are forced to live in squalor, work long hours with many potentially dealing with sexual and (or) physical abuse (18)(19)(20)(21).…”

“…However, despite the economic benefits, FFWs often face a range of challenges related to their sexual and reproductive health (SRH) issues, including limited access to comprehensive services (13,(18)(19)(20). On the other hand, a majority of EPZs do not provide their female staff with adequate income or support; employees are forced to live in squalor, work long hours with many potentially dealing with sexual and (or) physical abuse (18)(19)(20)(21). Furthermore, sexual harassment has also become a significant issue for female EPZ workers.…”

“…Many women have been forced to live away from their families in low-budget accommodation where feelings of vulnerability are compounded further (19). A recent study shows that the health seeking behaviour of employees in Koggala selected EPZ was low due to various factors (20). Therefore, the EPZ workers, including garment workers, are identified as one of the most vulnerable communities for overall SRH issues specifically for those related to unintended pregnancies and induced abortions (13).…”