Informal workers and access to healthcare: a qualitative study of facilitators and barriers to accessing healthcare for beer promoters in the Lao People's Democratic Republic.
BACKGROUND
Informal workers often face considerable risks and vulnerabilities as a consequence of their work and employment conditions. The purpose of this study was to examine the interplay between the experience of informal work and access to health, using as an example, female beer promoters employed in the informal economy, in the Lao People's Democratic Republic.


METHODS
In-depth interviews were undertaken with 24 female beer promoters working in beer shops, restaurants and entertainment venues in Vientiane City. The recruitment strategy of snowball sampling was used. Interviews explored the beer promoter's experience of the organization of work, perceived healthcare needs, access to healthcare and insurance, and health seeking practices. The data was analysed thematically and subsequently using Bourdieu's concepts of habitus, capital and field.


RESULTS
Most of the beer promoters included in the study were 18 years of age, single, had worked as beer promoters for more than one year and just over half were working to support their higher education. The beer promoters demonstrated a holistic view of health, also viewing good health as contributing to being beautiful - an important attribute in their work. Many reported that their work conditions, including the noisy environment, exposure to second-hand tobacco smoke, long hours on their feet and sexual harassment negatively affected their physical and mental health. Only four participants had any form of health insurance with access to healthcare constrained by individual characteristics, health system factors and the conditions of their informal employment.


CONCLUSIONS
Drawing on the work of Bourdieu, the study shows how both employment and illness are linked to habitus embodied in everyday practices, access to capital and the position the female beer promoters hold in the social hierarchy in the field of employment.
University of Health Sciences, Faculty of Postgraduate Studies, Vientiane, Lao PDR. vsychareun@gmail.com.
Vanphanom
V
Sychareun
University of Health Sciences, Faculty of Postgraduate Studies, Vientiane, Lao PDR.
Viengnakhone
V
Vongxay
University of Health Sciences, Faculty of Postgraduate Studies, Vientiane, Lao PDR.
Vassana
V
Thammavongsa
University of Health Sciences, Faculty of Postgraduate Studies, Vientiane, Lao PDR.
Souksamone
S
Thongmyxay
University of Health Sciences, Faculty of Postgraduate Studies, Vientiane, Lao PDR.
Phouthong
P
Phummavongsa
University of Queensland, Faculty of Medicine & Biomedical Sciences, School of Public Health, Herston, Brisbane, Australia.
Jo
J
Durham
D004651:Employment / Q000379:methods*; D005260:Female; D006297:Health Services Accessibility / Q000592:standards*; D006801:Humans; D000070100:Informal Sector; D007812:Laos; D008297:Male; D036301:Qualitative Research; D055815:Young Adult
Beer promoters, access to healthcare; Bourdieu; Habitus; Informal sector; Informal workers; Lao PDR