In the last few years the world economy has transformed radically as a result of increasing shift of production processes from developed to developing countries. Bangladesh is no exception to this trend. Readymade garment (RMG) industry of Bangladesh is one of the major industries that developed as a result of global shift of production where manufactures compete on price and quality. Here the factory owners reduce the cost of production in various ways and earn maximum benefit from the workers. This situation obliges workers to work more, which in turn affect the health of the workers. On the other hand, the competitiveness of the garment industry in the world market was seriously affected by ill health of the workers, since ill health decreases the labour productivity to a great extent (Majumdar 2003). Recent estimate suggests that there are about 35 lakh garment workers working in 4,500 factories across the country (The Daily Star 2009) of whom almost 80% are women (Mridula and Khan 2009). The emergence of garment industries brought about a change in the traditional scenario as women were viewed within a narrow perspective of their child bearing and reproductive role. Employment in the garment industry has increased the average age of marriage and improved financial situation of women, but many significant challenges remain to their health (BSR 2010). Many studies have been done on garment workers occupational safety and security (Akhter et al. 2010), gender (Khan 2001) and harassment (Begum et al. 2010), physical and mental health (Majumdar 2003), breast feeding knowledge (Afrose et al. 2012), livelihood pattern (Ali et al. 2008) and socioeconomic condition (Chowdhury and Ullah 2010), health related quality of life (Islam et al. 2011) etc. There is limited evidence about female garment workers (FGW) reproductive health. Drinking and toilet habit and nature of job apparently found to have reproductive morbidities (Begum et al. 2006). Among the pregnant workers the rate of miscarriage is very high and most of them experience abortions more than once (Majumdar 1996). Mridula and Khan (2009) showed that the working environments were not friendly and secured enough to keep FGWs reproductive health rights. The FGWs have failed to realise properly the gravity and importance of their reproductive health issues, and hence they have failed to raise their voice against their employers. FGWs’ reproductive health rights are not given due attention internationally and are treated as a less important issue (BSR 2010). It was revealed that the owners of the garment industries and Bangladesh Garment Manufacturers and Exporters Association initiated few steps to improve reproductive health of the FGWs. However, more information was needed about their well-being and reproductive health status. This study aimed to gain this information from FGWs using focused ethnographic approach.
Majority of the participants were 14-30 years old. Among them, 79 were married, 40 unmarried, two separated, five widows and six divorced. Twenty-seven respondents have never been to school, 41 have completed some primary education (Grade 1-4), 28 have completed all primary education, 32 have completed some secondary education (Grade 6-10) and four have completed all secondary education or higher education. Most of them were Muslim. The majority of women were married at <18 years of age. Age at marriage for most of the respondents was between 12 to 19 years. The occupation pattern shows that majority of the respondents were operator (n=68) while 49 were helper and 10 were quality controller. Others were involved in various sectors such as folding, finishing and packaging. The monthly average income of the respondents was 7,424 BDT (range: 3,500–12,000 BDT). Thirty-one respondents were involved with any NGO. The majority of the respondents entered into the garment factories for their financial crisis. And these financial crises were related with other factors including father or husband’s sickness, needed to support their own family or inlaws, marriage, and influence of relatives. Findings revealed that FGWs had limited access to safe drinking water and toilet facilities. They did not have access to filtered water in each floor even in the factory. They mostly used piped water for drinking. In few factories, safe drinking water is only available for managers and other higher level employees, there was no designated area for drinking water supply and is only available inside the toilet. They have separate toilet facilities for the female employees. But there was lacking of hygiene materials such as toilet tissues, waste paper basket, soap, etc. To ascertain the status of behavioural change activities of the factory, they were asked whether they were participated in any training, workshop, viewing BCC materials at their workplace. Usually FGWs got training on fire protection quarterly or monthly. None of the participants got training on reproductive health/behaviour, hygiene and cleanliness, or basic health education. The findings revealed that in spite of doctor’s availability at the factory, 24 hours female doctor is a major concerned to the respondents. Very limited medicines were available at the factory such as, vitamins, oral saline, paracetamol, pain-killer for headache, fever, gastric, needle punch and hand injury. The majority of the workers were not aware of the term ‘health insurance.’ They were also not aware of any health insurance facility available in the workplace. It was found that most of the factories had the provision of maternity leave, but majority of FGWs were deprived from the right of maternity benefits in several ways. Few factories giving female workers with infants extra flexibility in work hours to breastfeed their baby at day care centre run by the factory.