Sanitation Workers in an Urban Public Space: Understanding Lived Experiences through the Social Determinants Framework

Abstract

Sanitation workers remain marginalized and disregarded, trapped in a vicious cycle of poverty and struggle despite the legislative efforts and advocacy from various organizations promoting social justice, equity, and inclusiveness. This study delves into the complexities faced by sanitation workers in Tamil Nadu through a qualitative analysis grounded in the Social Determinants of Health framework (SDH) and situational assessments. Drawing from data triangulation, including in-depth interviews, field observations, and policy reviews, the analysis explores the extent of these challenges through the lens of lived experiences. It identifies gaps in social welfare policy, existing and re-emerging barriers that threaten sanitation workers’ social and economic protection. Further, the scope of the study highlights measures that can strengthen socio-economic welfare policies and promote inclusivity by improving the quality of life of the workers by addressing deeply rooted systemic marginalization and bridging gaps in existing interventions, such as the NAMASTE Scheme (National Action for Mechanized Sanitation Ecosystem, 2023-26) and Tamil Nadu’s Sanitation Workers Welfare Development Scheme (2022), and contributes valuable knowledge for social work professionals and policymakers to facilitate effective implementation. The findings underscore the importance of sanitation workers and the urgent need for rights-based, inclusive frameworks that recognize them as integral to the urban ecosystem. Key recommendations include formalizing contract labour, regular medical screenings, mental health support, participatory policymaking, and structural changes such as worker-designed Personal Protective Equipment (PPE), digital grievance redressal mechanisms, and community-led waste-to-resource conversion initiatives. Combined, these measures are instrumental in achieving Global Sanitation Standards and advancing Sustainable Development Goals: SDG 3 (Good Health and Well-being), SDG 6 (Clean Water and Sanitation), SDG 8 (Decent Work and Economic Growth), SDG 10 (Reduced Inequalities), SDG 11 (Sustainable Cities and Communities), and SDG 16 (Peace, Justice and Strong Institutions).