P-333 Health related economic burden among unorganized sector workers: a systematic review and meta-analysis

Introduction

Unorganized sector constitutes around 87% working population in India (Periodic Labor Force Survey, 2017 – 18) and 60% working population around the world (ILO Report 2018). Aim of the current study is to find the proportion of the income spent on Health among unorganized sector workers around the world.

Materials and Methods

A systematic search was conducted for published studies in English till December 2022. Independent two electroic searches were carried out in PubMed, EMBASE and Web of Science using key words ‘economic burden/financial burden/monetary/cost of illness/Health care cost’ AND ‘unorganized sector/informal sector/blue-collar job/agricultural laborer/construction workers/migrant workers/leather workers/artisans/beedi workers/fishermen/barbers/newspaper vendors/vegetable vendors/fruit vendors/casual laborer/mill workers.’ We have included articles reporting total income of the worker, health related cost. References of the selected articles were also traced. Meta-analysis was performed to calculate pooled estimate using random effects model. Quality of studies was assessed using Newcastle Ottawa Scale adapted for cross-sectional studies.

Results

We have got 321 records from all searched data bases. Of which, 16 records were included for full text review after screening abstract and removing duplicates. Finally, five records were included for meta-analysis. All the variables were first converted from the local currency to USD of that particular year and then to USD of 2022 after adjusting for inflation. Proportion of income was spent on Health was 15.9% (95% CI: 10.9 – 21.7) of the total income earned among the workers belonging to unorganized sector. Significant amount of heterogeneity (I2 = 92.34%) existed among studies.

Conclusion

A significant proportion of total income of unorganized sector workers is being utilized for Health. There is thus an urgent need for devising means of publicly funded healthcare services for the unorganized sector workers.