Work–family conflict, financial issues and their association with self-reported health complaints among ready-made garment workers in Bangladesh: a cross-sectional study

Our study is the first to provide insights into RMG workers’ financial situation. Whereas previous studies have highlighted a burden of financial constraints and obligations, no studies have provided specific numbers on, e.g., savings, debt, and the amount of money handed over to family members so far. Our study, furthermore, adds to the scare research on WFC among RMG workers by providing data collected during the COVID-19 pandemic for the first time. Lastly, this is also the first study to analyze possible associations of both concepts, WFC and financial issues, with health outcomes. We found rather low levels of WFC, high levels of financial obligations toward either one’s spouse and children or other relatives and moderate levels of financial support when needed. While only slightly more than 20% of workers had savings, over 40% reported to be indebted. Work–family conflict was positively associated with poor health, but there was no consistent relationship with specific symptoms. Financial support was negatively and being indebted was weakly positively associated with poor health.

Results from descriptive analyses

Our results suggest relatively low levels of WFC among RMG workers (i.e., 14.8% agreed that their family life had disturbed their job, 12.5% agreed that they faced problems in their family due to their job). This is in contrast with findings by Chowdhury et al. (2015), who found not only much higher WFC levels among RMG workers in Bangladesh but also a different direction of conflict: they found that workers were more likely to face problems in their family due to their job (71.9%) than vice versa (26.5%). Both our study and the study by Chowdhury et al. (2015) were conducted among garment workers in Bangladesh using the same questionnaire items, albeit with a simplified answer scale in our study. We surveyed a random sample of garment workers in labor colonies, whereas Chowdhury et al. (2015) surveyed a convenience sample of workers in factories. Nevertheless, it is unlikely that these differences in methodology fully explain the large differences in WFC observed.

A possible explanation for the low degree of WFC in this study may be that 40% of the participants did not have children and, therefore, had no childcare obligations. Likewise, 34% of the participants in our sample were not married and, therefore, likely did not experience additional demands from their spouse and in-laws. The information on marital status and on whether workers had children was not provided in the study by Chowdhury et al. (2015). A second potential explanation for the differing findings is that our study was conducted more recently than the study by Chowdhury et al. (2015), that is, during the COVID-19 pandemic at a time after garment factories had reopened after large lockdown-related shutdowns. This may have altered workers’ attitudes toward their jobs to that effect that they might have seen work more positively out of relief of just being employed again. However, a study by Islam et al. (2022) reported increased financial pressure on female RMG workers from their husbands who lost their jobs during the COVID-19 pandemic (Islam et al. 2022). This in turn could have increased WFC levels.

Only about 23% of workers reported to have savings, leaving 77% of workers without any savings. This number is almost twice as high as previously found in a study conducted by (Naved et al. 2018), who only found that 40% of RMG workers did not have any savings. The mean saving amount in our study was 8244 taka (roughly 96$ or 91€), which corresponds to about one month of minimum income (the legal minimum wage of garment workers in Bangladesh was set to 8000 taka per month in 2018 (United News of Bangladesh 2018)). In their study, Naved et al. (2018) found that over 38% of RMG workers reported savings of 20,000 taka or more. In our study, however, only half as many workers (15.1%) had savings of 20,000 or above. Our study was conducted during the COVID-19 pandemic, which may have greatly contributed to the lower amounts of savings observed.

Literature describes, for example, severe pay cuts for Bangladeshi workers in general (HRB and Chowdhury Center for Bangladesh studies at UC Berkeley 2021) or complete loss of income for RMG workers (HRB and Chowdhury Center for Bangladesh studies at UC Berkeley 2021; LeBaron et al. 2021; Glover 2020; The Daily Star 2020) due to the pandemic. These emanated from the global supply chain as international retailers broke binding contracts with garment factories and refused to pay for produced garments laying in ports or stores (Siddiqi 2022, 2020). Garment factories, in turn, had to pay for all arising expenses until shipment of garments (including workers’ salaries) and suddenly could no longer pay salaries, which led to immediate dismissals and labor law violations (Siddiqi 2020).

In line with this, Munim et al. (2022) report that maintaining employees’ salaries as before COVID-19 was the least frequently implemented measure among all measures implemented by RMG industry experts in Bangladesh during the COVID-19 pandemic (Munim et al. 2022). The abovementioned pay cuts may have led to fewer possibilities of saving money and were paralleled by a sudden inflation of food and transportation costs during the pandemic (Rahman and Matin 2022, 2021) and the consequent need to spend savings to cover living costs. Likewise, the number of RMG workers without any savings rose by 25% in the course of the pandemic (LeBaron et al. 2021).

Our results, furthermore, suggest that over 40% of workers are indebted. The mean debt amount was 16,641 taka (roughly 193$ or 184€), which is equivalent to about two months of minimum income. Incurring debts was a prominent coping strategy for Bangladesh’s general population during the COVID-19 crisis as cost for necessities rose (Rahman et al. 2020), especially for female garment workers whose husbands lost their jobs in the informal sector during the crisis (Islam et al. 2022). A report among garment workers in Ethiopia, Myanmar, India, and Honduras suggests that during the COVID-19 pandemic debt levels increased by an average of 16% and workers were having difficulties paying back their loans (LeBaron et al. 2021) (also see Hewamanne and Yadav 2022). Unfortunately, published numbers on garment workers’ household debt before the pandemic were not available for comparison.

The majority of workers agreed they had to keep their job to financially support their spouse, children, or other relatives. This is in accordance with reports from ethnographic and qualitative studies among RMG workers (Akhter et al. 2017b; Chand 2006; Naved et al. 2018). Roughly, one-third of RMG workers could call on someone to support them if they lost their job. This degree of financial support is much lower than compared to studies conducted in the USA (Fingerman et al. 2009) or Sweden (Fritzell and Lennartsson 2005). Possibly, relatives and friends of RMG workers suffered from financial strains themselves and, therefore, may not have been able to lend money. Financial support is, however, of special interest considering many garment workers have lost their jobs during the COVID-19 pandemic (LeBaron et al. 2021).

With respect to stratified analyses according to sex, men more frequently had to financially support relatives other than their children or spouse, gave a larger absolute share of their money to their families and more people depended on their wages. However, with respect to the overall salary, men and women handed out similar percentages of their earnings to family members (about 61%). Male workers’ monthly salary was about 30% higher than female workers’ mean salary. This discrepancy is likely partially explained by the different types of jobs performed by male and female workers within a factory. While female workers typically do manual labor (e.g., sewing machine operators), male workers more frequently work in management or supervisor positions.

With respect to stratification according to age, younger workers more frequently reported being able to call on someone in case financial support is needed than older workers. Accordingly, older workers reported much more debt than younger workers did. Possibly, this may be explained by the fact that older workers were more likely to have children compared to younger workers (90% vs. 34%), resulting in increased financial obligations.

Results from association analyses

The results from our association analyses suggest WFC of RMG workers to be associated with poor health. Here, family-to-work conflict was more strongly and significantly associated with poor health than work-to-family conflict. It is conceivable that the double burden of family and work obligations leads to physical exhaustion and mental stress among garment workers, which both in turn may have a negative effect on health. Several international studies from, e.g., the US.A, Taiwan, Switzerland, and Norway have shed light on the association between WFC and poor overall employee health (Tsukerman et al. 2020; Pien et al. 2020; Hämmig and Bauer 2014), burnout (Pien et al. 2020), shorter sleep duration (Berkman et al. 2015), insomnia (Lee et al. 2019; Vedaa et al. 2016), musculoskeletal disorders (Hämmig and Bauer 2014), and metabolic syndrome indicators (Versey and Tan 2020). In their study among employees in Switzerland Hämmig and Bauer (2014) report that work–life conflict was the psychosocial working condition that was strongest linked to adverse health (compared to, e.g., low social support, low job autonomy).

We found that having savings was associated with better health, albeit not significantly. As discussed earlier, mean savings in our study sample were as much as a month’s salary. This amount may be quickly used up, e.g., in case of dismissal and might, therefore, not be a significant relief for workers. During the COVID-19 pandemic, research, furthermore, suggested many Bangladeshis to have relied on their savings to compensate rising food costs (Rahman et al. 2020). However, savings may not only be viewed as a relief but also as a burden for garment workers. Research among female RMG workers in Bangladesh suggested that having savings beyond a certain threshold increased the likelihood of workers to experience violence at home (Naved et al. 2018). The authors of the study explained this by a likely increase in arguments over access to the saved money and over how to spend it.

Debt in our study was, in contrast, significantly associated with poor health. The link between financial strain and poor health is well-established in the international literature (Artazcoz et al. 2021; Prentice et al. 2017; Steptoe et al. 2020). Several hypotheses have been put forward to explain this link: lower financial resources may decrease access to healthcare, utilization of healthcare services and treatment adherence (Grafova 2018b). Financial strain may also result in a feeling of uncertainty about financial resources leading to elevated stress levels, which then result in poorer health (Grafova 2018a). This is in line with a longitudinal study that suggests only a small contribution of health-related behaviors to the association between financial strain and health. Instead, it suggests biological pathways to explain the association (Prentice et al. 2017).

Being indebted was weakly positively associated with poor health. Incurring debt was a prominent coping strategy for Bangladeshis during the COVID-19 pandemic (Rahman et al. 2020). Considering RMG workers’ low salaries, however, it may be impossible for workers to pay back their debt (Islam et al. 2022), which may result in a high stress level and possibly poor health. International research across different populations also suggests that being indebted is associated with several health complaints, such as sleep problems (Hall et al. 2008; Warth et al. 2019), back pain (Ochsmann et al. 2009), and chronic disease (Blomgren et al. 2016).

No other meaningful associations between financial matters and the health of RMG workers were observed in our data. Given the high levels of agreement with financial obligations, however, it is conceivable that the number of individuals who did not have financial obligations was too small to identify significant associations.

Strengths and limitations

Our study has several strengths. First, the questionnaire was developed by an interdisciplinary research group and was translated, back-translated, and profoundly piloted, which greatly enhanced face validity and likely comprehensibility of the instrument. Second, we performed random sampling of garment workers, which reduced the likelihood of selection bias and increased the representativeness of the study population compared to the total population of RMG workers. Selection bias was additionally reduced by the fact that interviews were conducted in the evenings and on weekends outside working hours. We were able to recruit a large number of participants who most likely came from various factories and, therefore, had a great variety of working conditions and likely varying degrees of WFC and financial matters.

Nevertheless, some limitations need mentioning. We inquired about psychosocial working conditions and found weak to moderate associations with health outcomes. It is possible that physical working conditions play a greater role for workers’ health in the RMG setting. Due to the cross-sectional design of the study, the detected associations cannot necessarily be interpreted as causal. The exact response rate on the individual level cannot be determined and may be lower than the response rate on the household level (69.1%). Selection bias cannot be ruled out, as it is possible that workers with better working conditions were more likely to participate in the study. Furthermore, WFC and financial matters may have changed during the COVID-19 pandemic and may have not been representative compared to pre-pandemic times (i.e., we might have found higher values for, e.g., increase of financial demands or increased WFC (Islam et al. 2022)).

Our study is specific to Dhaka urban settings in one of the oldest export garment factory hubs (i.e., Mirpur). However, our data may not be representative of the entire RMG workforce in Bangladesh, including other large garment factory hubs, such as in Chittagong. Future research would be useful to understand how workers’ lives and health outcomes are unfolding in the newly developing export garment factory hubs outside Dhaka and in the export processing zones.

Implications

Psychosocial working conditions have largely been absent in public and policy discourses in Bangladesh. The long and allegedly inherent persistence of adverse psychosocial working conditions may have brought about that they are perceived as an ‘assimilated phenomenon’ and thus attract less attention. Our study is an attempt to address this gap. The results of this study offer no immediate benefit to the participants. However, if confirmed by prospective studies, they may indirectly contribute to better working conditions in the long term. The insights into workers’ health help identify target areas for specific health-related interventions (e.g., against headache or back pain).

Our results suggest increasing workers’ salaries as a measure to potentially improve workers’ health. However, solely increasing salaries has been demonstrated counterproductive for workers’ health and consequently a profound change in working conditions is needed so that factory owners do not offset the increase in workers’ salaries by, e.g., shortening their breaks or increasing production targets (Kabir et al. 2022). Global labor platforms and national EU and North-American governments who are in bi-lateral trade and policy relations with Bangladesh can benefit from the findings of this work as industry stakeholders. The results of the present study are also interesting for factory owners, who should also have an interest in a healthy workforce, because healthy employees are generally more productive. Healthy employees may also stay longer with the company and as a results expertise or skills are not lost.

In terms of future research, the interrelationships between physical and psychological working conditions should be disentangled as physical conditions may be more relevant than psychosocial conditions with respect to RMG workers’ health. Such research would preferably rely on prospective studies.

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