Conference Agenda

The impact of globalization and industrialization in the last decade has been characterized by a persistence of informality and an increase in precarious jobs increasing workers’ exposure to occupational health risks. Technological advances and the COVID-19 pandemic have also accelerated participation in the gig and platform economy, giving rise to new forms of employment for which neither national social health protection (SHP) systems nor occupational health services (OHS) are adequately adapted. In many LMICs but also high-income countries, OHS remain bound by the employer-employee relationship, often leaving workers engaged in the informal, platform and gig economies without access to OHS. Similarly, this group remains disproportionately excluded from SHP coverage. Recent evidence has also shown the tendency for national SHP systems and workers to absorb the financial burden of occupational disease, despite the existence of workers’ compensation mechanisms. This signals a preponderance of curative care over preventative care with important financial ramifications for national SHP systems but also for workers who face the financial and health risks of preventable diseases and accidents. The extension of SHP and OHS coverage to workers in all forms of employment is thus a joint priority for both OHS and SHP systems. In this paper, we argue that the establishment of robust interinstitutional linkages can strengthen both systems and extend coverage of both SHP and OHS. Limited evidence of such interinstitutional linkages in countries such as Canada and Finland supports this argument. However, limited evidence exists elsewhere, particularly in LMICs.

This scoping review aims to document existing institutional linkages between SHP and OHS systems globally. To do so, it asks: 1) In which countries can we identify interinstitutional linkages? and 2) What is the nature of such linkages?

This study is based on the scoping methodology of Arksey and O’Malley. Relevant databases and grey literature will be searched using a search strategy developed by a librarian at Université de Laval. A double-blind selection of papers will be conducted based on defined inclusion and exclusion criteria. Finally, deductive thematic synthesis is used to present the results and a typology of linkages is developed.

To the best of our knowledge, this study is the first to provide a systematic mapping of interinstitutional linkages between OHS and SHP systems globally. A better understanding of such linkages will allow for the documentation of best practices that can guide the strengthening of both systems in the face of current global crises.

Ensuring decent work for all, and expanding social protection, are essential goals. But what do these look like in the context of persistently high unemployment, and a crisis of social reproduction caused by widespread joblessness, and low wages? The South African experience of high unemployment, and rural areas disarticulated from key sites of production, is instructive for a global conversation about social protection. Drawing on a mixed-methods study of households in Agincourt, in rural South Africa, I investigate how the highly gendered distribution of paid and unpaid work should inform thinking about social protection and decent work. Following the end of Apartheid, the legal barriers preventing women from working in the main economy were dismantled, and female labour force participation rose rapidly. But this legal equality has not translated into substantive equality, and women in rural areas continue to be significantly worse off in economic terms than men. Furthermore, despite a well-developed literature on South Africa’s political economy, we know little about the productive and socially reproductive lives of rural women in contemporary South Africa. I argue that households in this part of rural South Africa are responding in complex and contradictory ways to the manner in which capitalism in South Africa has changed in the post-Apartheid period. It illuminates the important links between paid work, labour force participation, unpaid work, and livelihood strategies. The research finds large and persistent gendered differences in employment, income and the socioeconomic wellbeing of households. With unemployment for women more than double that for men, this raises important questions of how to design and implement social policy to address these pervasive inequalities. I argue that the scarcity of employment in this rural economy points to the limits of supply-side employment and decent work policies, and reaffirms the central role of social policy as economic policy. Indeed, it is clear that South Africa’s social protection system, particularly in rural areas such as Agincourt, is central to the reproduction of life and labour. The research adds to our knowledge about an area of South Africa which is both important in its own right, and one which is emblematic of the conceptual and methodological challenges of thinking about rural areas and their relationship with the economic heartlands of urban South Africa in a way that does not marginalise the economic lives of women, and highlights the role social protection should play in addressing widespread inequalities.