Perceptions of COVID-19 related risks by platform-based couriers: An analysis of user comment threads on Reddit.

BACKGROUND: The COVID-19 pandemic increased demand for app-based platform-based couriers, creating job opportunities for individuals who have lost income because of COVID-19. Through various stages of lockdown, courier workers (e.g., delivering for Uber Eats, Amazon Flex, and Lyft) provide an essential service. At the same time, this form of work poses risks for exposure to the SARS-CoV-2 virus as these workers are highly mobile and in contact with many individuals. OBJECTIVE: To explore how platform-based couriers discuss risks associated with their work during periods of high (first wave, second wave, third wave/rise in concerns regarding variants) and low risk during the COVID-19 pandemic, 2020-2021. METHODS: We provide a narrative analysis of user posts (n = 2,866) on Reddit during periods of interest. RESULTS: Our analysis resulted in three central findings. First, we identified changing patterns in discourse as the pandemic went on. Second, we found that the theme of risk prevailed largely in the first wave, with dialogue dominated by tips and asking for advice about how to manage risk. Third, our findings reveal a growing polarization among users during the latter phases of the study. CONCLUSION: Polarization largely focused on acceptance (or not) of public health measures and the nature of their work as independent contractors and the role/responsibility of courier companies to offer protection. Our study is the first to document risks, from the perspectives of anonymous couriers who may be unwilling to share their honest opinions and thoughts through primary data collection where anonymity is not guaranteed.

Managing the unknown or the art of preventing SARS-CoV-2 infection in workplaces in a context of evolving science, precarious employment, and communication barriers. A qualitative situational analysis in Quebec and Ontario.

Introduction: The issue of communications in the public space, and in particular, in the workplace, became critical in the early stages of the SARS-CoV-2 pandemic and was exacerbated by the stress of the drastic transformation of the organization of work, the speed with which new information was being made available, and the constant fear of being infected or developing a more severe or even fatal form of the disease. Although effective communication is the key to fighting a pandemic, some business sectors were more vulnerable and affected than others, and the individuals in particular socio-demographic and economic categories were proportionately more affected by the number of infections and hospitalizations, and by the number of deaths. Therefore, the aim of this article is to present data related to issues faced by essential workers interacting with the public and their employers to mitigate the contagion of SARS-CoV-2 (COVID-19) at work. Methods: Following the constructivist paradigm, an interpretative qualitative design was used to conduct one-on-one interviews with precarious/low-wage, public-contact workers (N = 40), managers (N = 16), and key informants (N = 16) on topics related to their work environments in the context of COVID-19 prevention. Results: This article has highlighted some aspects of communication in the workplace essential to preventing COVID-19 outbreaks (e.g., access to information in a context of fast-changing instructions, language proficiency, transparency and confidentiality in the workplace, access to clear guidelines). The impact of poor pre-pandemic working relations on crisis management in the workplace also emerged. Discussion: This study reminds us of the need to develop targeted, tailored messages that, while not providing all the answers, maintain dialog and transparency in workplaces.

Perceived COVID-19 health and job risks faced by digital platform drivers and measures in place to protect them: A qualitative study.

INTRODUCTION: As they deliver food, packages, and people across cities, digital platform drivers (gig workers) are in a key position to become infected with COVID-19 and transmit it to many others. The aim of this study is to identify perceived COVID-19 exposure and job risks faced by workers and document the measures in place to protect their health, and how workers responded to these measures. METHODS: In 2020-2021, in-depth interviews were conducted in Ontario, Canada, with 33 digital platform drivers and managers across nine platforms that delivered food, packages, or people. Interviews focused on perceived COVID-19 risks and mitigation strategies. Audio recordings were transcribed verbatim and uploaded to NVivo software for coding by varied dual pairs of researchers. A Stakeholder Advisory Committee played an instrumental role in the study. RESULTS: As self-employed workers were without the protection of employment and occupational health standards, platform workers absorbed most of the occupational risks related to COVID-19. Despite safety measures (e.g., contactless delivery) and financial support for COVID-19 illnesses introduced by platform companies, perceived COVID-19 risks remained high because of platform-related work pressures, including rating systems. We identify five key COVID-19 related risks faced by the digital platform drivers. CONCLUSION: We situate platform drivers within the broad context of precarious employment and recommend organizational- and government-level interventions to prevent digital platform worker COVID-19 risks and to assist workers ill with COVID-19. Measures to protect the health of platform workers would benefit public health aims by reducing transmission by drivers to families, customers, and consequently, the greater population.

Provider Perspectives on Sexual Health Services Used by Bangladeshi Women with mHealth Digital Approach: A Qualitative Study.

Cases of sexually transmitted infections (STIs) are underreported in Bangladesh. Women in general suffer from poor sexual health outcomes due to a lack of access to sexual health services. mHealth, a digital approach to STI services, is an easier and cheaper way to disseminate health information in Bangladesh. However, women have less autonomy in accessing STI services and it is important to learn if, how and/or why women use mHealth. A qualitative study was conducted with 26 medical doctors to explore their perceptions of the mHealth STI services used by Bangladeshi women. Themes were grouped under four categories: (1) provider perceptions of mHealth for sexual healthcare; (2) the health literacy of women clients; (3) cost and maintaining timeliness in providing mHealth services; (4) mHealth service accessibility. Data suggest that mHealth can play a significant role in improving the awareness and utilization of STI services in Bangladeshi women. Successful opportunities for STI service expansion using mHealth were identified, depending on the quality and type of service delivery options, awareness of challenges related to health literacy framework, cost, accessibility to information and availability of culturally competent health experts to disseminate health information. We identify the need to increase access and use of mHealth services for sexual health, as it provides an innovative platform to bridge the health communication gaps in sexual health for Bangladeshi women.

Understanding Access to and Utilisation of Sexual Health Services by South Asian Immigrant Men in Western Countries: A Scoping Review.

South Asian communities comprise one of the fastest growing populations in Western countries. However, the sexual health of immigrant men in particular remains vastly understudied and little is known about how and if men access these services. Four multi-disciplinary electronic databases were searched to between 1998 and 2018. The search yielded 586 articles; 407 duplicate articles were removed, and 376 did not meet the inclusion criteria. A total of 10 articles were included in this review. Herein we report the factors shaping sexual health service access and use, namely: (1) cultural and psychological factors; (2) sexual health service accessibility; (3) personal beliefs and patterns in service use; (4) social perspectives and conflicting values on sexual health. We identify the gaps in research needed for policymakers, formal healthcare providers, and South Asian community stakeholders to develop effective and inclusive sexual health programs for South Asian men in Western countries.

Utilization of mobile phones for accessing menstrual regulation services among low-income women in Bangladesh: a qualitative analysis.

BACKGROUND: As many as one-third of all pregnancies in Bangladesh are unplanned, with nearly one-half of these pregnancies ending in either menstrual regulation (MR) or illegal clandestine abortion. Although MR is provided free of charge, or at a nominal cost, through the public sector and various non-profits organizations, many women face barriers in accessing safe, affordable MR and post-MR care. Mobile health (mHealth) services present a promising platform for increasing access to MR among low-income women at risk for clandestine abortion. We sought to investigate the knowledge, attitudes and practices regarding mHealth of both MR clients and formal and informal sexual and reproductive healthcare providers in urban and rural low-income settlements in Bangladesh. METHODS: A total of 58 interviews were conducted with MR clients, formal MR providers, and informal MR providers in four low-income settlements in the Dhaka and Sylhet districts of Bangladesh. Interview data was coded and qualitatively analysed for themes using standard qualitative research practices. RESULTS: Our findings suggest that low-income MR clients in Bangladesh have an inadequate understanding of how to use their mobile phones to obtain health service information or counselling related to MR, and correspondingly low levels of formal or informal mHealth service utilization. Few were aware of any formal mHealth services in place in their communities, despite the fact that providers stated that hotlines were available. Overall, MR clients expressed positive opinions of mHealth services as a means of improving women's access to affordable and timely MR. Formal and informal MR providers believed that mobile phones had benefits with respect to information dissemination and making appointments, but emphasized the necessity of in-person consultations for effective sexual and reproductive healthcare. CONCLUSIONS: We report low utilization yet high acceptability of mHealth services among low-income MR clients in Bangladesh. Expanding formal and informal mHealth services targeted towards MR - and increasing publicity of these services in low-income communities - may help increase timely access to accurate MR information and formal providers among women at risk for clandestine abortion. While expanding formal and informal mHealth services for SRHR in Bangladesh may be useful in disseminating information about MR and connecting women with formal providers, in-person visits remain necessary for adequate treatment.

Exploring the context in which different close-to-community sexual and reproductive health service providers operate in Bangladesh: a qualitative study.

BACKGROUND: A range of formal and informal close-to-community (CTC) health service providers operate in an increasingly urbanized Bangladesh. Informal CTC health service providers play a key role in Bangladesh's pluralistic health system, yet the reasons for their popularity and their interactions with formal providers and the community are poorly understood. This paper aims to understand the factors shaping poor urban and rural women's choice of service provider for their sexual and reproductive health (SRH)-related problems and the interrelationships between these providers and communities. Building this evidence base is important, as the number and range of CTC providers continue to expand in both urban slums and rural communities in Bangladesh. This has implications for policy and future programme interventions addressing the poor women's SRH needs. METHODS: Data was generated through 24 in-depth interviews with menstrual regulation clients, 12 focus group discussions with married men and women in communities and 24 semi-structured interviews with formal and informal CTC SRH service providers. Data was collected between July and September 2013 from three urban slums and one rural site in Dhaka and Sylhet, Bangladesh. Atlas.ti software was used to manage data analysis and coding, and a thematic analysis was undertaken. RESULTS: Poor women living in urban slums and rural areas visit a diverse range of CTC providers for SRH-related problems. Key factors influencing their choice of provider include the following: availability, accessibility, expenses and perceived quality of care, the latter being shaped by notions of trust, respect and familiarity. Informal providers are usually the first point of contact even for those clients who subsequently access SRH services from formal providers. Despite existing informal interactions between both types of providers and a shared understanding that this can be beneficial for clients, there is no effective link or partnership between these providers for referral, coordination and communication regarding SRH services. CONCLUSION: Training informal CTC providers and developing strategies to enable better links and coordination between this community-embedded cadre and the formal health sector has the potential to reduce service cost and improve availability of quality SRH (and other) care at the community level.