SOCIAL CAPITAL, POVERTY AND HEALTH: A STUDY ON HANDICRAFT WORKERS IN BANGLADESH

Abstract

This paper is an attempt to analyse the linkages between social capital, poverty and health among handicraft workers in Bangladesh. Over the past decades, the successive governments of Bangladesh have put considerable efforts for poverty reductions, improvement of health and socio-economic status of the low-income group of people. However, the roles of social capital in improving poverty and health outcomes of the deprived populations are less explored. The lack of active group membership, social network, and collective actions can contribute towards improving health for the poor. The growth of industrial sector, while effective, can remain inadequate to foster economy growth due to lower productivity of labour in our country. For increasing labour productivity, we need to focus on the social capital at the workplace or lack thereof. Because in a workplace group membership, social support, cooperation, trust, and information sharing increase the social exchange and interaction between workmate and authority, which in turn increases the capacity to serve the workers to raise labour productivity, which ultimately leads to decline poverty. Few empirical studies have examined the link between social capital, poverty, and health in Bangladesh. From this time, we need to investigate the relationship between social capital, poverty and heath within the handicraft sector in Bangladesh. The scope of the field study is based on both institutional and household level surveys of female workers within the handicraft sector in Bangladesh. This study examines the indicators of social capital at the workplace which influences workers healthcare seeking behaviour, health status as well as poverty. It further examines the contribution of handicraft sector in building social capital at individual level, which has a spell over effect on workers‟ health status. In this study it assumes the hypothesis that high value of trust, social cohesion, social support, social network, co-operation and collective action and group participation in workplace create more opportunity to build different forms of social capital which help to improve workers health status and socio-economic conditions. So, the main research question is: “whether workplace social capital improves workers healthcare seeking behaviour and health status as well as poverty”. A field survey is conducted through structured and semi-structured questionnaire from three handicraft enterprises in Bangladesh. Data has been collected from 326 workers of the AAF (Manikganj), HEED (Gazipur) and TMSS (Bogura). The data collection instrument was mostly followed by the Shortened and Adapted Social Capital Assessment Tools for Bangladesh (SASCAT B) which is adopted by the World Bank. This study is primarily a quantitative study where I have empirically analysed the data and tested the hypothesis. It reveals that the majority of workers and their household member received healthcare from professional healthcare providers and public facilities. The choice of providers and facilities by household depends on some important factors such as, distance to providers, travel time, treatment cost, easy access to care, quality of care, perception of providers, type and severity of illness, household education background, household decision of choice of providers, family economic conditions and finally the level of social capital. Workers at the production centres have high value of social capital, and they are more likely to seek treatment from professional healthcare providers than others due to illness. Hence, workers in the production-groups have better health seeking behaviour than the other because they have greater workplace social capital that increase intensity of social network, make more informal support and favours the dissemination of relevant health-related information. From empirical analysis, we find that the mean score of the indicators of workplace social capital (WSC) are statistically significant. A relatively higher proportion of workers in production-group have a higher value of social capital. There is no significant difference between the overall mean scores of indicators of the structural and cognitive form of social capital. The indicators of the bonding social capital, i.e., unity attitude, information sharing, and cooperation norms are statistically significant while trust in supervisor, mutual respect, and cooperation among workmate are significantly associated with social capital. The highest mean score elements of social capital are “cooperation among co-workers” and “trust in manager”. Unity, cooperation, interpersonal trusts are the three important elements for building social capital and the values of the social capital depend on the nature of employees. Permanent workers from the production groups have more opportunities to create social capital, which helps to increase labour productivity and efficiency, than other contractual or temporary employees. So, the permanent workers play more significant role in building social capital than the other. Moreover, there is no significant difference between mean values of the indicators of social capital in the selected three organizations. Hence, unity, understanding, workers‟ together attitude, information sharing and accepted attitude appear to have a significant effect on the constructing social capital at individual-level as well as health status of workers. A majority of workers reported that they were in good health and being energetic. A small fraction of workers had a mobility problem. However, the permanent workers often faced the vitality and psychological distress than others. In case of outpatient care, the majority of household member sought treatments from formal healthcare providers. In case of maternal healthcare, the majority of pregnant women received ANC care three times from the public health facilities, received T.T doses and ultrasound test during their pregnancy period and delivered at hospital, which indicates they have good health seeking behaviour. Greater number of workers reported having good health and being energetic. A small fraction of workers has mobility problem. However, the permanent workers often faced the vitality and psychological distress than others. In case of outpatient care, the majority of household member sought treatments from formal healthcare providers. In case of maternal healthcare, the majority of pregnant women received ANC care three times from the public health facilities, received T.T doses and ultrasound test during their pregnancy period and delivered at hospital, which indicates they have good health seeking behaviour. We applied the ordered probit model to examine the relationship between social capital and health, where the dependent variable is self-reported health (using a 5- point Likert scale from 1=excellent to 5=poor). The estimated model of self-reported health (SRH) and social capital illustrated association between workers, social network, information sharing, cooperation, trust in supervisor, active membership in organizations, participation in a training programs, obedience to organizations, savings, monthly income, and households endowments play a significant role to build social capital at workplace and these indicators has a significant effect on worker‟s health status. The estimated parameter of the social capital shows the pattern of employments and break or leave rules are significantly associated with self-reported health of workers. Mental stress for skill requirement, residence quality and food expenditure per week, time constraint to finished a task, and active memberships are statistically correlated with health status of workers. In addition, residence quality and food expenditure per week of household are statistically correlated with tiredness of workers, while the time constraint to finish task and active association are also significantly correlated with health problem. The estimated model of the psychological distress and workplace social capital (WSC) shows that group membership, age of workers, skill, and skill requirement for organizations, mental pressure to finish a task, demanding workloads, and long working hours has a stronger effect on workers psychological distress. Moreover, the indicators of unity, understanding, information sharing, aggregate concepts, and trust on co-workers have a negative coefficient on workers mental health. The correction between workplace social capital and poverty score is statistically significant. Workers in poor groups more frequently participated in the decision-making process than rich groups of workers. The poor groups of workers have more informal relationship than the richest groups of workers, and the effect of social capital on health according to poverty score is statistically significant. The distribution of social capital, health and demographic variables according to poverty scores shows that most of the workers in the poorer groups are more likely to have high level of understanding between them than the richest groups of workers which indicate poor groups of workers have high value of social capital than the richest quintile. The results also show that the workers of the poorer groups have high value of the workplace social capital than the richer workers, suggesting the workers of poor groups might have more opportunities to improve their individual level social capital and health status than the other. The probit regression model of asset score and 8-item workplace social capital shows that there is positive significant correlation present in workplace social capital (WSC) and assert of households in the handicraft sector. Mutual understanding between co-workers, sharing work related information with workmate, and aggregated idea of workers are significantly associated with household asset score. Hence, high value of the socio-economic status (SES) makes it possible to improve poverty situation and increases the value of workplace social capital (WSC) of workers. Based on the findings of this study, I made some recommendations that could assist the concerned institutions to formulate suitable policy and strategy. It also helps to build a conceptual framework in the hope for increasing the stock of social capital at workplace which may improve health status, income per capita, and reduce poverty of the workers in handicraft sector. Finally, the results of this study suggest us to design and implement the appropriate strategies for increasing the stock of social capital and physical capital in the handicraft sector which can enhance better health status of the poor and disadvantaged workers as well as poverty.