December 12 is Universal Health Coverage Day. But what does UHC mean for the majority of the world's workers who are informally employed — and how can policymakers ensure UHC reaches them?
Around the world, 61% of workers are informal. In some countries, the percentage is higher than 90%. They are street vendors, waste pickers, domestic workers, and industrial outworkers, among others. Their incomes are essential for their families, and their work contributes significantly to local and national economies. But to earn, they must be able to work.
Accessible universal health coverage (UHC) is crucial for these individuals, their families and communities, and the larger society.
Here are some ways to ensure informal workers can access UHC.
Plan with informal workers
It is important to consider the specific needs, risks and barriers of informal workers. Informal workers know their own needs. They must be included in discussions as health policy is formulated. Laura Alfers, Director of WIEGO's Social Protection Programme, has written extensively on this. Read:
- Beyond Health Insurance: What Does Extending Universal Health Coverage To Informal Workers Really Mean?
- Universal Health Coverage: An Informal Worker Perspective
Keep capital linked to coverage
Financing for health requires new thinking and multiple players. "Delinking" social protection from employer-based schemes could have devastating consequences for informal workers. But progressive financing is possible. WIEGO believes there are ways to effectively reconfigure linkages between workers and capital.
Consider innovative / good practice examples
Across India, the Self-Employed Women's Association (SEWA) health cooperative has established an innovative programme that delivers invaluable benefits to informal women workers and their families. In addition to providing preventative health information, community health workers help people connect to government programmes and access health benefits. Meet some of the workers in these stories:
- How Universal Health Coverage Reaches the World’s Poorest: Community Health Workers - a new WIEGO blog profiles Pushpa Rathod, a community health worker for 18 years
- Bridges to Better Lives: SEWA's Community Health Workers offers an intimate look at the community health workers, the wide range of services they provide in a challenging policy environment—and what they gain in return.
In Southeast Asia, where informal employment makes up almost 80% of total employment, governments are taking some important steps towards extending UHC to informal workers. WIEGO has been working with HomeNet South East Asia, a network of home-based workers who are particularly vulnerable due to low earnings and isolation. Read Towards Universal Health Coverage for Home-Based Workers in Southeast Asia.
This report from WIEGO and partners looks at innovative approaches to address the health needs and constraints of informal workers. Informal worker organizations are demonstrating, in practical terms, how UHC for informal workers can look. Health policymakers can learn from this.
Here are a few more good practice examples:
WIEGO is leading the Cuidar Project in Brazil in concert with cooperatives. The project has mapped waste pickers health risks and is working toward solutions.
- This 10-minute video will help you understand the difficulties poor informal workers face in accessing health services in places like India, South Africa and Thailand—and show you some solutions.
About Universal Health Coverage Day
December 12th is the anniversary of the United Nations’ historic and unanimous endorsement of universal health coverage in 2012. Universal Health Coverage Day is an annual rallying point for the growing movement for health for all.