Introduction

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.

Methods

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.

Results

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).

Conclusion

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.

中文翻译：

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南非约翰内斯堡的非正式废物回收站的医疗保健服务。

介绍

非正式的废物回收商为南非的废物清除做出了重要贡献。废物回收商面临着与处理和处置废物，缺乏个人防护服以及无法获得职业保健服务相关的健康危害。因此，在公共卫生保健部门中获得卫生保健对于该人群的健康结果很重要。这项研究评估了南非非正规废物回收商的医疗保健可及性，从而为健康规划建立了基准信息，以便将非正规废物回收商纳入职业健康服务。

方法

自2018年3月起，在约翰内斯堡的两个垃圾填埋场对非正式废物回收站进行了横断面研究。使用标准化的结构化问卷收集有关社会人口统计学细节，卫生保健利用，获取和接受卫生保健的障碍以及负担能力的信息。使用逻辑回归评估与卫生保健利用率相关的因素。

结果

该研究总共包括363个非正式废物回收站。在过去的12个月中，只有不到一半的非正式废物回收商（41.0％）使用了医疗保健设施。使用服务的人选择使用居住地附近的设施（87.0％）。获得医疗保健服务的障碍包括漫长的等待时间（36.6％），无法休假（26.3％）和交通问题（13％）。在单变量分析中，性别因素以及在诊所和医疗机构所在地的良好治疗等因素与医疗保健利用率相关（OR：1.97，p = 0.05，OR：1.94，p = 0.02，OR：0.65， p = 0.04）。

结论

非正式废物回收者在获得医疗保健方面面临众多挑战。特定于其非正式贸易，由于其工作的非正式性质，利用卫生保健的障碍与财务影响有关。