ABSTRACT
Background: Waste work in India is an undervalued role relegated to historically marginalised communities. The informal nature of their work coupled with lack of state regulation keeps waste workers trapped in poverty. This study aims to understand how intersecting systems and relations of power impact the agency of waste workers to shape their health and wellbeing. Methods: We used in-depth interviews, key informant interviews, and focus group discussions to collect primary data from waste worker communities in Vijayawada and Guntur in India. Thematic analysis was used to analyse data using conceptual frameworks relating to wellbeing and power. Results: Inter-generational poverty and lack of access to social determinants of health keeps waste workers trapped in a cycle of debt and poverty. They experience negative wellbeing owing to material and relational deprivations that are sustained by a nexus of power relations, explained using the themes of 'power over';, 'power to';, 'power with';, and 'power-within';. Conclusions: The ability of communities to exercise agency is constrained by the power exercised on their lives by the state and society. NGOs play a supportive role for the realisation of rights, but the ability of waste workers to organize and effect change is limited to coping strategies.
ABSTRACT
BACKGROUND: Media coverage of road traffic collisions (RTCs) may influence preventative action. India experiences some of the highest RTC mortality and morbidity rates globally, but advocacy and effective action to mitigate this has been limited. We conducted an analysis of Indian media in English to assess whether coverage met the WHO's Reporting on Road Safety guidelines for evidence-based reporting of RTCs. METHODS: English-language articles published online between March 2018 and February 2019 were assessed against the seven recommended story angles and seven recommended key elements in the WHO guidelines. RESULTS: 458 articles were included in the analysis. The most common story angle was descriptions of single collisions, which was not a WHO-recommended story angle. These included limited key elements such as use of human story or linking to road safety risks or evidence-based solutions. However, some articles did follow the WHO-recommended story angles, with 22.1% discussing specific road safety solutions and a further 6.3% discussing vulnerable groups. Almost all articles avoided the use of technical language, but only 2.0% explicitly stated that RTCs were preventable. More than half identified at least one evidence-based solution. Very few articles discussed economic or health impacts of RTCs, including the burden they present to the public health system. CONCLUSION: Indian media in English can improve reporting by focusing on human stories and documenting experiences of those injured in RTCs. Coverage should also focus more on evidence-based solutions, emphasising the systems approach which encourages government action rather than changes to individual behaviour.