Sample Research Proposal Study on Social Health Security to Workers in Informal Sector in Indonesia
Category : Healthcare Management Systems
A Study on Social Health Security to Workers in Informal Sector in Indonesia
1.0 Research Context
General access to health care providers that offers best services with the inclusion of modern facilities, medical products as pharmaceuticals and medical devices and provision for medical research. Insurance payments in the form of cost-sharing and risk management are also achieved when there is social security. Managed care which is at times extended to the members of the family is highlighted. However, in Indonesia and in other countries, healthcare is treated as a commodity; hence, competition does not provide quality or create health care value instead it adds massive administrative costs and complexity into the system. Thereby, it is not a priority particularly among the informal sector. Also, the reduced transparency of transactions and the comparability of performance and cost data undermine accountability and the capacity of the health care markets to function efficiently.
Continuous increase in insurance premium rates over the years that drives expensive new drugs, medical advances that require state-of-the-art medical equipments became the consequences as well as shifting of health costs from employers to employees and high-cost and low-cost patients balance. These are the consequences of social health inequality in general but there are also financial and economic consequences. The financial consequences include: ineligibility will leave the injured or sick with no choice but to stay at home instead of liquidating savings and income to pay for medical bills; high cost of care that could possibly lead to individual bankruptcies and health insurance coverage, amount ceiling of care paid for in catastrophic illness. On the other hand, the economic consequences are: additional costs for firms to add new workers; therefore, non-progress in job growth; health care costs suppress wage increases due to total compensation costs; more uncompensated medical care that subsequently results to higher costs and higher premiums; and, lower productivity of the uninsured workers.
There is the need therefore to determine the economic and financial consequences of social health insecurity among the informal workers in Indonesia. Remember that there are consequences may not be immediately evident among the employers but to the employees working within the informal sector. The informal sector in general is highly unstructured and we can safely assume that the occupational health and safety of the workers is not always prioritized by the employers. This brings us to the fact that in the stage that occupational health and safety is not always prioritized within the formal sector which is otherwise highly structured compared to the informal sector, how can we expect that the informal employers can contribute in the social health security of their workers. What the policies say about this should be explored aside from whether there is social health insecurity among informal workers.
1.1 Relevance of the Study
This study will be of significance to the social health literature as it will present an in-depth understanding of how the informal sector protects and promotes the social health security of the workers. The evaluation of social health security of informal workers will be relevant to identify with the social health challenges, risks and threats faced by the informal workers and what can be done to improve the current situation. Social health security among informal workers has had been limitedly explored particularly in the Indonesian setting. So as to generate data and information that the Indonesian government as well as the informal sector could use in order to come up with plans and designs that will strategically position the informal sector itself in the protection and promotion of social health security among informal workers.
1.2 Research Aims and Objectives
The main aim of this study is to investigate how the Indonesian government protects and promotes social health security of the workers working in the informal sector. In achieving this aim, the following objectives will be addressed:
· To investigate whether social health insecurity is existent within the informal sector
· To analyse how specific social health policies protect the interests of the workers within the informal sector
1.3 Research Question
The key question that the study will attempt to answer is: what is the current status of social health security as provided to the workers within the information sector in the Indonesian context? Other questions that will be answered are:
1) In what specific ways does the current social health policy protects the interests of workers within the informal sector?
2) Under what circumstances does the current social health promote the interests of workers within the informal sector?
3) How can the current social health security be improved?
2.0 Overview of Literature
Bayer et al (2007) assert that a recent argument when it comes to occupational health ethics encompasses issues of fairness and free choice. Despite the fact that some jobs/occupations are protected by various regulations relating to health, safety and welfare of workers, certain occupations are not only inherently risky but are chosen because of that risk and the tradeoffs. Since there are few real alternatives to such jobs, that is, informal works, it would be unjust to place safety in the equally along wages at the time of hiring, a justification of authorities overseeing health, safety and welfare of informal workers (Greenberg, 2003, p. 516).
This leads us to the notion of lay knowledge of occupation health, in which workers are frequently aware of the health hazards of their working environments. Lay epidemiology plays an important role in how people make sense of health risks and how they make decisions based on professional knowledge (Mclvor and Johnston, 2007). Wages should be therefore reflecting the greater risks, discomfort and effort in informal works.
Within the workplace, there are health items that require the attention of health and safety personnel. Specific health items that must be monitored and these items involve the work environment and any potential injury, hygienic or disease situation which may arise (Bohle and Quinlan, 2000). Informal workers are individuals who make a choice which results in being exposed to a certain risk, and this choice is not free. Its lack of voluntariness which stems from the fact that this person would not be given just treatment unless the risks are taken that should be considered (Merson, Black and Mills, 2006, p. 418).
There is yet another argument when discussing issues about health and safety of informal workers which is the question of voluntariness as it applies to health-related behaviours (Bayer et al, 2007). The availability of meaningful choices would be critical in here that is saying, are there alternative ways to address health-related issues. This is a matter of distributive justice that encircles health orientation of both informal workers and informal employers (Bayer et al, 2007). The difference, on the other hand, is that the second shall provide choices for the first if the former genuinely desires cultivation of healthy behaviours in the workplace.
Health and safety in informal workplaces begins with management’s commitment to make it happen. Health and safety must be part of any planning involving the workforce as well. Such a commitment must be evident in all levels of management to ensure that the safety policy becomes part of all the activities. Logically, the initiative must start from the top level wherein a written policy is required stating top management’s feeling toward company safety efforts and it should be displayed so that each worker will see it on a daily basis (Karmis, 2001, p. 2). This is where the effectiveness of health and safety controls could take effect. Further, depending upon requirements, the training function can be established as part of the health and safety department. It is therefore the safety personnel’s task to conduct or arrange training for the purpose of developing a strong relationship through contact with personnel (Kennedy, 1990). When performing, training must reflect a positive safety attitude that is well understood by others.
Mclvor and Johnston (2007) noted that the informal workforce is encouraged to unionize especially that informal workers are exposed to unstructured working practices. This requires safety at work, but the situation has a tendency to become more complex in relation to the longer term consequences regarding working in unhealthy work processes. It had placed too much priority on the immediacy of work safety and not enough on protecting workers’ health. In many cases also, workers are ignored or rationalized which could mean that the longer term health risks for the sake of economic factors are prioritised (Karmis, 2001). The notion of acceptance of risk then is a very important one, and that risks are perceived to be experienced and assessed individually rather than collectively. Although risks are perceived and understood, informal workers being aware of the negative health consequences of their risky behaviour, still preferring to prioritise other concerns (Lowrie, 2002).
3.0 Overview of Research Design
3.1 Research Philosophy and Approach
The research philosophy adopted for this dissertation is interpretive epistemology which simply refers to the philosophical underpinning of the research. Interpretive epistemology has a basic assumption that knowledge can only be created and understood from the point of view of the individuals who live and work in a particular culture or organisation. Therefore, every individual acts in situation and makes sense of what is happening based on experiences of the situation and the expectations people bring into it. This means that there may be different understandings and interpretations of reality and interpretive epistemology leads to accessing meanings made by others and describe how they come to make those meanings (Hatch and Cunliffe, 2006, p, 14). The choice of this philosophy is important because it guides the research design, the research approach, choice of methods, analysis of the findings, and even the presentation.
3.2 Research Methods and Strategies
A multi-method approach would be adopted, drawing on primary and secondary research. The reason for this is to be able to provide adequate discussion for the readers that will help them understand more about the issue under investigation as well as the different variables involve with it, the primary data for the study will be represented by the survey results that will be acquired from the respondents. Informal workers will be the respondents of this study.
On the other hand, the literature reviews to be presented in the second chapter of the study will represent the secondary data of the study. The secondary sources of data will come from published articles from journals, theses and related studies, books, company reports and official statistics. Sometimes, secondary research is required in the preliminary stages of research to determine what is known already and what new data are required, or to inform research design. Acquiring secondary data are more convenient to use because they are already condensed and organized. Moreover, analysis and interpretation are done more easily.
3.3 Data Analysis and Presentation
Data gathered using these instruments will be collated for analysis. Data analysis will primarily be characterized by statistical approach. The following statistical formula will be used in the quantitative analysis.
% = -------- x 100 ; n – number of responses
N N – total number of respondents
2. Weighted Mean
f1x1 + f2x2 + f3x3 + f4x4 + f5x5
x = --------------------------------------------- ;
where: f – weight given to each response
x – number of responses
xt – total number of responses
With this said, this dissertation will be presented in written format with the addition of data charts, representing study results. Some of the analysed data will be illustrating using pie charts and network charts but this may not be confirmed until survey data had been analysed.
3.4 Limitations of the Research Design
The study is limited on the elements of social health security in Indonesia. The utilization of small numbers of respondents as the basis of the survey is another limitation because of the fact that it cannot make generalisations. The study is also limited only the pieces of information that the respondents are willing to disclose. It is limited to the respondents’ capability to answer such questions.
Bayer, R., Beauchamp, D. E., Gostin, L. O., Jennings, B. & Steinbock, B. (2007). Public health ethics: theory, policy and practice, Oxford University Press, Oxford, US.
Bohle, P. & Quinlan, M. (2000). Managing occupational health and safety: a multidisciplinary approach. Palgrave McMillan.
Greenberg, M. I. (2003). Occupational, industrial, and environmental toxicology. Elsevier Health Sciences.
Hatch, M. J. & Cunliffe, A. L. (2006). Organization Theory: Modern, Symbolic, and Postmodern Perspective. Oxford: Oxford University Press.
Karmis, M. (2001). Mine health and safety management. SME.
Kennedy, B. A. (1990). Coal mining. SME.
Lowrie, R. L. (2002). Mining Reference Handbook. SME.
Mclvor, A. & Johnston, R. (2007). Miners’ lung: a history of dust disease in coal mining. Ashgate Publication Ltd.
Merson, M. H., Black, R. E. & Mills, A. (2006). International public health: diseases, programs, systems, and policies. Jones & Bartlett Learning.