The Bangladesh readymade garment (RMG) sector commenced in the 1980s and is now ranked second in clothing supply for international brands globally. This sector has created employment opportunities for more than four million workers, mainly female, with little or no education or previous skill. The sector is also considered a significant economic industry for Bangladesh accounting for 83 percent of the country’s total export earnings. Despite creating huge job opportunities and making enormous contributions to the national economy, the Bangladesh RMG sector is marred by poor working conditions, employees’ health and safety concerns, and workplace rights-related issues. One key example of the poor working conditions is frequent disasters, such as the physical collapse of Rana Plaza in 2013, killing more than 1130 workers, and the fire in Tazreen Fashion in 2012, where more than 112 garment workers died. Many thousands have sustained injuries from these disasters and regular workplace injuries continue to be reported. Further, workers’ daily working conditions remain unsafe and pose continuing hazards for the workforce.

Since Bangladesh RMG sector continues to expand to meet international clothing demands, it is timely to explore in what conditions the global fashions are made along with the impacts of those conditions on workers’ health and wellbeing. This thesis provides empirical data which examined why and how the currently employed RMG workers were vulnerable to different types of physical and psychological health issues. In addition, the research explores the impacts of a catastrophic event, structural changes in relation to wages, and the COVID-19 pandemic on RMG workers. A mixed-method approach, with multiple methods of inquiry, which drew on the principles of pragmatism, was used across five separate yet interconnected studies.

Study 1 presents findings from three focus groups (female: 21; male: 16) that aimed to explore the current working conditions, with a further focus on differences experienced by male and female RMG workers. The study found that RMG working conditions comprise a lack of available workplace facilities and safety measures, which eventually impact workers’ health and safety. Study 2 comprising a cross-sectional survey of 411 RMG workers (mean age=26.24 years, SD=6.40, female=80%) based in both Dhaka and Chattogram, the two largest cities with the highest density of RMG factories, examined the prevalence and risk factors of physical and psychological health. Results demonstrated that stress, anxiety, and boredom were prevalent among nearly two-thirds of the respondents, while headaches and colds were prevalent among more than half of the respondents. Overall, working conditions, workplace environments, the nature of RMG work, demographic characteristics, and geographical locations were significant risk factors for workers’ health illnesses. Three additional studies were undertaken to determine how sudden changes impacted RMG workers’ health and wellbeing. In-depth interviews, in Study 3, were conducted with Rana Plaza survivors to examine the long-term impacts of this disaster on them. The study found that Rana Plaza collapse resulted in significant physical (bone injuries/fractures and amputation, severe headache, kidney problems, and functional difficulties) and emotional trauma, depression, and suicidal ideation for those who survived this catastrophic event. In-depth interviews in Study 4 were undertaken to understand the impact of a newly implemented minimum wage structure on the currently employed RMG workers. The study found that working hours, production targets, work pressure, and workplace abuses have been increased alongside the new wage structure. Finally, Study 5 investigated the impact of COVID-19 finding the pandemic will have long-lasting effects on the RMG workers, especially related to their health issues, financial hardship, and inability to pay for essentials such as food, and future employment opportunities.

This multi-method, multi-study research contributes to an overall understanding of Bangladeshi RMG workers’ vulnerability to physical and psychological health illnesses. Specifically, identification of high prevalence rates of both physical and psychological health illnesses and modifiable risk factors, various health risks and safety concerns in relation to factory location (Dhaka vs Chattogram) and factory type (Export Processing Zone (EPZ) vs non-EPZ), add new knowledge to the existing literature. The findings of this research provide a holistic view of the challenges of RMG workers and can inform future policy development to ensure their health and safety at work. However, utilising the Marxist notion of ‘accumulation of capital’, the findings are also understood within the cultural conditions of Bangladesh, which severely impede any likely improvement in workplace safety for RMG workers within Bangladesh. Advocacy for such changes will be required through international pressure via clothing supply chains. This research will assist in informing the global evidence base to assist in such efforts.

Objective. Poor health outcomes of Bangladeshi readymade garment (RMG) workers tend to be associated with a variety of occupational factors. This study aimed to investigate the prevalence of, and risk factors associated with, the physical and psychological health outcomes of Bangladeshi RMG workers. Methods. Responses to a cross-sectional survey from a convenience sample of 411 adult Bangladeshi RMG workers (mean age = 26.24 years; SD 6.40 years; female = 80%) were analysed using bivariate and multivariate (logistic regression models) analyses. Results. More than half of the participants reported headaches (61.6%) and colds/flu (51.3%), followed by fever (37.2%), diarrhoea (32.8%), bodily pain (29.9%) and respiratory infections (20.9%). For psychological health, stress (69.1%), anxiety (66.2%) and boredom (64.5%) were most prevalent, followed by sleeplessness (51.3%), depression (48.2%) and fear (34.3%). RMG workers from the factories located in Chattogram (a peripheral region compared to Dhaka) reported poorer physical and psychological health outcomes than those working in factories in Dhaka (the capital city of Bangladesh). Overall, compared to males, female RMG workers were more likely to be vulnerable to both physical and psychological health outcomes. Conclusion. Improvement in workplace conditions and safety programmes is needed to safeguard the overall health outcomes of Bangladeshi RMG workers.