OCCUPATIONAL HEALTH AND SAFETY OF THE

INFORMAL WORKERS IN THE TRANSPORT SECTOR

IN THE PHILIPPINES

Anna Priscilla B. Cadiz, RN, MOH

Romeo R. Quizon, MSc, Eng’g

Aileen A. Benitez-Timbang, MD, DFM

Department of Environmental and Occupational Health,

College of Public Health, University of the Philippines Manila

INTRODUCTION

• Workers in all types of occupations are entitled to a

healthy and safe workplace.

• All workers are exposed to a variety of hazards.

• Informal sectors are the unregistered workers, described

as the invisible components of the labor force.

• The limited access to occupational health and safety

(OHS) information, resources, and services further

compound the risks in the informal sectors.

INTRODUCTION

TRANSPORTATION INDUSTRY

• Road safety issues

• Health hazards such as airborne chemicals, particulate

matter, whole-body vibration, inappropriately designed

vehicles, extreme heat, biological agents, and noise

BACKGROUND 2013

DOH in coordination with the OH task force

of the IACEH developed A.O. 2013-0018 for health policy of informal mining, transport, and

agriculture sectors

2015

The proposed implementing rules and guidelines for

the A.O. was developed during

NOHSP 1

2016

The proposed 5-year roadmap for

the informal workers in the

transport sector was developed

4

BACKGROUND

• IACEH

• Established through the Executive order No. 489 in

November 22, 1991

• Sub-sector on Occupational Health shall serve as the

main coordinating body for the implementation of an

integrated and multi-sectoral program for the informal

sector.

Background of the Study IACEH Sub-sector on Occupational Health:

• DOH

• DOLE

• MGB-DENR

• LTO-DOTC

• DA

• DILG

• LGU

• SSS

• PhilHealth

Administrative Order No. 2013-0018

National Occupational Health Policy for the Informal Mining,

Transport and Agricultural Sectors Objectives:

1. To provide a comprehensive policy direction in the development of an occupational health program relevant to workers in the informal sectors (mining, transport and agricultural groups

2. Create an enabling environment for strengthening the capacity of health systems, collaborate with key partners in supporting the delivery of appropriate health services for the informal workers including recommended surveillance systems

3. Develop a mechanism to ensure enrollment of the informal workers in the National Health Insurance system

Administrative Order No. 2013-0018

National Occupational Health Policy for the Informal Mining,

Transport and Agricultural Sectors

Informal Sector

• Sector consisting of units engaged in the production of

goods and services with the preliminary objective of

generating employment and incomes to the persons

concerned, particularly unincorporated enterprises that

are market and non-market producers of goods as well as

market producers of services.

Informal Transport Group

• Drivers of taxis, jeepneys, tricycles, pedicabs who do not

have employers; usually involved in small driver-operator

relationships engaging in profit-sharing or ― “boundary

system”; or the driver is the owner of the vehicle

Development of a 5-year roadmap

Rationale

• Shall outline specific strategies and activities that are

needed to attain the medium-term (five-year) goals set

through a consensus of the tripartite parties.

• To gather the perspectives and commitment of the

different stakeholders involved with these sectors

including supporting agencies and workers’ groups and

associations.

Limitations of the Study

1. Choice of site

2. External validity

3. Designation and function of respondents

Objectives of the Study

1. To conduct a situational analysis of the occupational

health of workers in the informal transport sectors

a. To determine if there are new or updated laws, rules, and

regulations.

b. To identify hazards, existing control measure, and risk

communication activities

c. To determine availability of resources dedicated to the delivery

of OH services

d. To identify communication/information gaps among the agencies

and/or workers

e. To identify priority areas/issues on OHS

Objectives of the Study

2. To develop a logical framework that addresses the

OHS priority areas/issues

a. To establish problem statement, goal, and objectives for a five-

year plan

b. To recommend strategic approaches and programs

c. To identify opportunities for collaboration, including possible

public-private partnership(s)

d. To identify resource requirements for the implementation of the

programs and strategic approaches

e. To identify areas for monitoring and evaluation

INFORMAL

TRANSPORT SECTOR Methodology

Results

Quadrant Analysis

Methodology

• Key Informant Interviews

• Focus Group Discussions

• Walkthrough Surveys

• Review Of Related Literature

Quadrant Analysis

• The matrix consists of 4 quadrants:

• 1st quadrant (survival): areas

to be addressed among the workers’ and their external environment are analyzed and formulated into concerns or issues.

• 3rd quadrant (Internal fix-it) aims to maximize the workers’ strengths and minimize the concerns/issues in the working environment.

SECTOR Positive

findings

(workers)

Areas to be

addressed

(workers)

Areas to be

addressed

(agencies)

3rd quadrant

Internal Fix it

1st quadrant

Survival

Quadrant Analysis • 2nd quadrant (External fix-it)

looks into the positive findings in the external environment which could be opportunities to address the issues of the workers.

• 4th quadrant (future or opportunistic) identifies opportunities that will lead to the improvement of the OHS of the sector.

• For the roadmap, the 1st and 2nd quadrants were prioritized in the development of strategies.

SECTOR Positive

findings

(workers)

Areas to be

addressed

(workers)

Positive

findings

(agencies)

4th quadrant

Future

2nd quadrant

External Fix-it

Methodology OBJECTIVES SOURCE OF DATA DATA COLLECTION

SITES

METHOD OF DATA

COLLECTION

DATA

ANALYSIS

1. To conduct a situational analysis of the occupational health of workers in

informal transport sector

a. To

determine if

there are new

or updated

laws, rules,

and regulations

DOH-DPCB

DOLE (BWC,

OSHC, ECC)

PhilHealth

SSS

DILG

LGUs

DOTC-LTO

Selected regions in

Luzon, Visayas,

Mindanao

Review of Related

Literature

Key Informant

Interview

Quadrant

Analysis

Methodology OBJECTIVES SOURCE OF DATA DATA COLLECTION

SITES

METHOD OF DATA

COLLECTION

DATA

ANALYSIS

1. To conduct a situational analysis of the occupational health of workers in

informal transport sector

b. To identify

hazards,

existing control

measure, and

risk

communication

activities

Project

Management

Team (PMT) and

representatives

from workplaces

surveyed

Selected regions in

Luzon, Visayas,

Mindanao

Focus Group

Discussion Quadrant

Analysis

Methodology OBJECTIVES SOURCE OF DATA DATA COLLECTION

SITES

METHOD OF DATA

COLLECTION

DATA

ANALYSIS

1. To conduct a situational analysis of the occupational health of workers in

informal transport sector

c. To

determine

availabilit

y of

resources

dedicated

to the

delivery of

OH

services

DOH-DPCB

DOLE (BWC, OSHC,

ECC)

PhilHealth

SSS

DILG

DOTC-LTO

Selected regions

in Luzon, Visayas,

Mindanao

Key Informant

Interview (KII)/Self-

Administered

Questionnaire (SAQ)

Quadrant

Analysis

Workers

representatives

Focus Group

Discussion (FGD)

Methodology OBJECTIVES SOURCE OF DATA DATA

COLLECTION

SITES

METHOD OF

DATA

COLLECTION

DATA

ANALYSIS

1. To conduct a situational analysis of the occupational health of workers in

informal transport sector

d. To identify

communicatio

n/information

gaps among

the agencies

and/or workers

DOH-DPCB

DOLE (BWC, OSHC, ECC)

PhilHealth

SSS

DILG

LGUs

DOTC-LTO

Selected regions in

Luzon, Visayas,

Mindanao

Key Informant

Interview

(KII)/Self-

Administered

Questionnaire

(SAQ)

Quadrant

Analysis

Workers representatives Focus Group

Discussion

(FGD)

Methodology ACTIVITIES SOURCE OF DATA METHOD OF DATA

COLLECTION

2. To develop a logical framework that addresses the OHS priority areas/issues

Development of the draft roadmap PMT

Technical advisers

PMT meeting

Consultation with the technical

working group (TWG) DOH-DPCB

DOLE (BWC, OSHC, ECC)

NEDA-SDS

TWG meeting

Conduct of workshop/writeshop

among stakeholders DOH-DPCB

DOLE (BWC, OSHC, ECC)

PhilHealth

SSS

DILG, LGUs

DOTC-LTO

Workshop/writeshop

Preparation of the final draft of the

roadmap PMT PMT meeting

RESULTS: Informal Transport

• LAWS, RULES, REGULATIONS

EXISTING UPDATES

Memorandum Circular 2011-004

- 2011 REVISED TERMS AND

CONDITIONS PROVIDING

PENALTIES FOR VIOLATIONS

NONE

RA 8750 – Seatbelt Use Act of

1999 (LTO as the enforcer)

NONE

RA 10586 – Anti-Drunk and

Drugged Act of 2013

NONE

RA 8749 - Philippine Clean Air

Act of 1999

NONE

RESULTS: Informal Transport • IDENTIFIED HAZARDS and CONTROL MEASURES

HAZARDS CONTROL MEASURES

KII FGD WTS KII FGD WTS

PHYSICAL ✔ ✔ ✖ ✔

BIOLOGICAL ✖ ✖ ✖ ✖

CHEMICAL ✔ ✔ ✔ ✔

PSYCHOSOCIAL ✖ ✖ ✖ ✖

ERGONOMIC ✖ ✔ ✖ ✖

UNSAFE CONDITIONS ✖ ✖ ✔ ✔

UNSAFE ACTS ✖ ✖ ✖ ✖

LEGEND: ✔ - YES ( at least 1 mentioned/seen) ✖ - NONE

RESULTS: Informal Transport

• RISK COMMUNICATION

KII RESULT FGD RESULT

Through public hearing from city

government

Annual seminars on health and

safety through efforts of

organized transport group

Orientation and seminars being

conducted for road safety

RESULTS: Informal Transport • RESOURCES DEDICATED TO DELIVERY OF OH SERVICES

RESOURCES KII RESULT FGD RESULT

1. INFRASTRUCTURE ✔ ✔

2. PEOPLE ✖ Not mentioned

3. BUDGET ✖ Not mentioned

RESULTS: Informal Transport • COMMUNICATION / INFORMATION GAPS (transfer of technology &

knowledge, roll out of programs & services across different levels)

AREAS KII RESULT FGD RESULT

TECHNOLOGY TRANSFER Not mentioned Not mentioned

KNOWLEDGE TRANSFER ✔

✖

ROLL OUT OF PROGRAMS &

SERVICES

✖

✖

RESULTS: Informal Transport Sector

Positive findings (workers)

• Practice of using PPE to prevent dust and smoke exposure

• Drivers have access to health centers.

• Access to programs such as PhilHealth membership

Positive findings (agencies)

• Existing control measures on road safety addressing unsafe

conditions for drivers

• Adequate infrastructure for the delivery of OHS services

• Free medical services (medicines, consultations etc.) are

provided in the barangay health centers. • There are existing initiatives from PhilHealth for informal sector

RESULTS: Informal Transport Sector

Areas to be addressed (workers)

• Exposure to ergonomic, chemical and physical hazards

(extreme heat, smoke and dust)

• Lack of awareness on OHS information and related

services and programs

RESULTS: Informal Transport Sector

Areas to be addressed (Agencies)

• Lack of specific OHS programs rolled out for drivers

• No existing control measures addressing ergonomic

hazards

• Aside from road safety, no specific and active OHS

information dissemination system is provided to the

transport workers

• Inadequate personnel and budget to develop and

implement OHS programs and services for the transport workers.

QUADRANT ANALYSIS: Informal Transport INFORMAL TRANSPORT

SECTOR

Positive Findings (Workers)

1. Use of PPE for dust and smoke

exposure

2. Membership to PhilHealth and SSS 3. Access to health centers

Areas to be addressed (Workers)

1. Exposure to ergonomic, chemical and

physical hazards 2. Lack of awareness to OHS information,

services or programs (including

PhilHealth)

3. Out of pocket health expenditures

Areas to be addressed

(agencies)

1. Mother policy not yet

implemented

2. Inadequate personnel

and budget for OHS 3. No particular control

measures for

ergonomic hazards 4. No specific info

dissemination system

for drivers

3rd quadrant – INTERNAL FIX IT

How can the membership to social

protection services and access to health

centers be continuously utilized given the

limited OHS information dissemination

system? (A4, W2, W3)

How can control measures be leveraged to

address exposure to other hazards of the

drivers, despite inadequate OHS policy

and resources? (A1,A2,A3,W1)

1st quadrant – SURVIVAL

In light of the deficiencies in policies,

resources and control measures for OHS,

what strategies can be implemented to

address the potential exposure to

occupational hazards and limited awareness

to OHS information? (A1,A2,A3,W1. W2)

How can direct health expenditures for drivers

be minimized in light of the limited OHS

information system?(A4, W3)

QUADRANT ANALYSIS: Informal Transport INFORMAL TRANSPORT

SECTOR

Positive Findings (Workers)

1. Use of PPE for dust and smoke

exposure 2. Membership to PhilHealth and SSS 3. Access to health centers

Areas to be addressed (workers)

1. Exposure to ergonomic, chemical and physical hazards

2. Lack of awareness to OHS information, services

or programs (including PhilHealth)

3. Out of pocket health expenditures

Positive Findings

(Agencies)

1. Existing control measures

on road safety addressing

unsafe conditions for drivers

2. Adequate infrastructure for

the delivery of OHS services

3. Free medical services

(medicines, consultations

etc.) are provided in the

barangay health centers.

4. There are existing

membership programs from PhilHealth for informal sector

4th quadrant – Future

How can the practice of control measures

be fully strengthened to address other

common occupational hazards given the

existing road safety regulations,

resources and services provided?

(A1,A2,A3, W1)

In what ways can the benefits from social

protection services and access to health

centers be maximized in light of the

existing membership programs for

informal sector provided by Philhealth?

(A4, W2, W3)

2nd quadrant – External Fix it

In what ways can the existing road safety

regulations and medical services and

infrastructure be leveraged to address the

potential exposure to occupational hazards

and improve the awareness of the drivers on

OHS information? (A1,A2,A3, W1,W2)

How can the current PhilHealth initiatives be

strengthened to address the out-of-pocket

health expenses of drivers? (A4,W4)

Significant Findings

1. Lack of legal personality that leads to lack of access to

OHS resources.

2. Absence of agency that will oversee the OHS for

informal transport sector.

3. Lack of specific OHS programs provided to informal

transport sector.

4. The major role of the LGUs has been highlighted in the

implementation of the roadmap on OHS of the informal

workers.

STRATEGIES

STRATEGIES: Informal Transport Sector

STRATEGIC

ISSUES

GOAL RECOMMEND

ED

STRATEGIES

Accountab

le

agencies

AGENCIE

S

RESPONS

IBLE

OBJECTIVEL

Y

VERIFIABLE

INDICATORS

MEANS OF

VERIFICATI

ON

SURVIVAL

In light of the

deficiencies in

policies, resources

and control

measures in OHS,

what strategies can

be implemented to

address the

potential exposure

to occupational

hazards and limited

awareness to OHS

information?

To

capacitate

the

stakeholder

s in

developing

and

delivering

OHS

services

and

programs

to informal

transport

workers

Implementation

of the policy

(AO 2013-0018)

DOH LGU

Presence of

functional

OHS

structures in

each region

for informal

sector

Presence of

OHS

coordinator

for informal

sector in LGU

Presence of

resources for

OHS services

delivery

Compliance

reports

submitted

STRATEGIES: Informal Transport Sector STRATEGIC ISSUES GOAL RECOMMENDED

STRATEGIES

AGENCIES

ACCOUNT

ABLE

AGENCIES

RESPONSIBLE

OBJECTIVELY

VERIFIABLE

INDICATORS

MEANS OF

VERIFICATION

SURVIVAL

In light of the

deficiencies in

policies and

resources for OHS,

what strategies can

be implemented to

address the potential

exposure to

occupational

hazards and improve

the knowledge and

practices of the

drivers towards their

health?

Stakeholders/

agencies will be

capacitated in

developing and

delivering OHS

services and

programs to

informal

transport workers

To improve the

knowledge and

skills of drivers

on OHS

Delineation and

delegation of

roles and

responsibilities

among related

agencies in

terms of OHS

program

development

and services

delivery

Include OHS

orientation in

drivers’ lecture

on issuance and

renewal of

license

DOH

LGU

LTO Stakeholder roles

and

responsibilities in

OHS of informal

transport workers

have been

defined,

delineated and

delegated within a

documented

agreement

meeting and

acceptance of

roles and

responsibilities

Agreement of LTO

and DOH to

include OHS

orientation during

lectures to drivers

Signed/approved

documents of

meetings and

agreements on the

acceptance of

roles and

responsibilities

among agencies

Standard OHS

oriention module

STRATEGIES: Informal Transport Sector

STRATEGIC ISSUES GOAL RECOMMENDED

STRATEGIES

Accountabl

e agencies

AGENCIES

RESPONSIB

LE

OBJECTIVELY

VERIFIABLE

INDICATORS

MEANS OF

VERIFICATIO

N

SURVIVAL

In light of the

deficiencies in

policies, resources

and control measures

in OHS, what

strategies can be

implemented to

address the potential

exposure to

occupational hazards

and limited awareness

to OHS information?

Stakeholders/

agencies will

be

capacitated in

developing

and

delivering

OHS services

and programs

to informal

transport

workers

Communication

system to be

established

among LGUs and

transport group

representatives/le

aders specifically

for access to OHS

information and

available services

and programs

DOH LGU

Transport

groups

Number of

transport groups

who participated

in the

communication

Documented

agreements and

acceptance of

roles and

responsibilities of

transport groups

and LGUs in

OHS programs

and services

delivery

Documents of

meetings and

agreements

Mechanism of

communicatio

n system

among LGUs

and transport

groups

STRATEGIES: Informal Transport Sector STRATEGIC

ISSUES

GOAL RECOMMEND

ED

STRATEGIES

AGENCIES

ACCOUNT

ABLE

AGENCIES

RESPONSIBL

E

OBJECTIVELY

VERIFIABLE

INDICATORS

MEANS OF

VERIFICATIO

N

TIMELINE

SURVIVAL

How can

direct health

expenditures

for drivers be

minimized in

light of

limited OHS

information

system?

To improve

the utilization

of social

protection

services

among

informal

drivers

Transport

group leaders

will be

engaged in

information

dissemination

To improve

information

dissemination

of these social

insurances to

the informal

drivers

SSS

ECC

PhilHealth

GSIS

DOH

LGU

LGU

Number of

transport group

leaders who

have

underwent

orientation on

social safety

nets and of

those who are

able to impart

to members

Presence of a

mechanism on

information

dissemination

Training

accomplishm

ent reports

Document of

this

mechanism

STRATEGIES: Informal Transport Sector STRATEGIC

ISSUES

GOAL RECOMMEN

DED

STRATEGIE

S

AGENCIES

RESPONSIB

LE

AGENCIES

ACCOUNT

ABLE

OBJECTIVELY

VERIFIABLE

INDICATORS

MEANS OF

VERIFICATION

TIMELINE

EXTERNAL FIX-

IT

In what ways can

the existing road

safety regulations

and medical

services and

infrastructure be

leveraged to

address the

potential exposure

to occupational

hazards and

improve the

awareness of the

drivers on OHS

information?

To

integrate

OHS of

drivers in

the current

safety

regulations

Generation of

baseline

OHS data on

needs of

informal

transport

workers

Include OHS

orientation in

drivers’

lecture on

issuance and

renewal of

license

LGU

DOTC*

DOH

DOLE

Number of

medical

records of

transport

workers

reviewed and

filed

Agreement of

LTO and DOH

to include OHS

orientation

during lectures

to drivers

Medical

records in

health facilities

Signed

agreement

Standard OHS

oriention

module

STRATEGIES: Informal Transport Sector STRATEGIC ISSUES GOAL RECOMMENDED

STRATEGIES

AGENCIES

RESPONSI

BLE

AGENCIES

ACCOUNTAB

LE

OBJECTIVELY

VERIFIABLE

INDICATORS

MEANS OF

VERIFICATION

EXTERNAL FIX-IT

In what ways can the

existing road safety

regulations and

medical services and

infrastructure be

leveraged to address

the potential

exposure to

occupational

hazards and improve

the awareness of the

drivers on OHS

information?

To integrate

OHS of

drivers in the

current

safety

regulation

Review of the

implementation

and monitoring

of existing road

safety

regulations,

policies in

relation to OHS

needs of

transport

workers

DOTC-LTO LGU Review of policy

instruments

Identified gaps

and alternative

solutions in

implementation of

policies

Documents of

reviewed

regulations and

agreements

among

stakeholders

STRATEGIES:

Informal Transport Sector STRATEGIC

ISSUES

GOAL RECOMMENDED

STRATEGIES

AGENCIES

RESPONSIBL

E

OBJECTIVELY

VERIFIABLE

INDICATORS

MEANS OF

VERIFICATION

EXTERNAL FIX-IT

How can the current

PhilHealth initiatives

be strengthened to

address the out-of-

pocket health

expenses of drivers?

To strengthen

Philhealth

programs for

informal sectors

utilization

among informal

transport

workers

Generation of data

on the utilization of

PhilHealth services

among informal

drivers

DOH

PHIC

SSS

LGU

Generated data on

the utilization of social

protection services

among informal

drivers

Medical records

Records on

Philhealth

membership and

utlization

Monitoring reports

STRATEGIES: Informal Transport Sector STRATEGIC

ISSUES

GOAL RECOMMEND

ED

STRATEGIES

AGENCIES

ACCOUNTA

BLE

AGENCIES

RESPONSIBLE

OBJECTIVELY

VERIFIABLE

INDICATORS

MEANS OF

VERIFICATION

How can the

current

PhilHealth

initiatives be

strengthened to

address the out-

of-pocket health

expenses of

drivers?

To strengthen

Philhealth

programs

utlization

among

informal

transport

workers

Improve the

awareness of

informal drivers

on PhilHealth

programs and

services

DOH

DILG

LGU

PhilHealth

Allotted budget

in the

information

dissemination

system/commu

nication plan

Increased level

of awareness

among

transport

workers on

Philhealth

programs and

membership

Orientation/activit

ies attendance

sheets

Developed IECS

Records of IEC

dissemination

coverage

Recommendations

• Collaborations with other agencies and organizations for

institutional support on research and training

• Generate more information exploring the attitudes and

concerns of the informal sector workers and operators

themselves towards their safety and health at work.

Recommendations

• DILG should initiate in establishing OHS awareness and

reinforcement of the need for the OHS activities in the

local level.

• LGUs should be fully capacitated in order to deliver the

OHS services among other healthcare services delivered

to the informal sector within their jurisdiction.

Recommendations • Existing interagency collaboration between LGUs and

other agencies in facilitating the program implementation in terms of OHS must be reinforced.

• Identified accountability and responsibility among agencies.

• Partnerships and collaborations will be helpful if these are well-established and have effective communication system. The LGUs should enhance their communication with civil society groups (transport groups) by having focal persons or coordinators with adequate OHS awareness that will facilitate the communication

Conclusion

• An adequately capacitated LGU shall provide an enabling

environment for the workers to be well-informed and

empowered in giving attention to their occupational well-

being, their needs and the necessary measures they need

to address the risks in their workplace. With both the

workers and concerned government agencies being

adequately knowledgeable in OHS, will help in bridging

the gaps in the access of necessary OHS resources and

services.