VI. MARCO TEÓRICO
6.3 Amebas patógenas
6.3.1 Entamoeba histolytica
Abstract
A
round 60.0% of Asia’s working-age population works in the informal economy. The majority of the informal economy workforce is unable to access social protection. A comprehensive national social protection system is an essential component of a successful, sustainable market economy. This chapter examines the impact of political economy on the development of social protection for workers in the informal economy. It uses an analytical approach known as the adopted political settlement that refers to the balance of distribution of power between contending social groups and political classes on which the state is based. It discusses how political economy and relations of power have influenced the nature of social protection for informal economy workers across Asia.As democracy strengthens, some countries are investing in higher-quality inclusive life cycle schemes, such as universal old-age pensions and child benefits, which include the majority of workers in the informal economy and their families. To build political commitment for expansion of social protection for informal economy workers, there is a need to present evidence that social protection is an essential component of the market economy, and that markets will function much more effectively if a comprehensive social protection system is in place. Development partners can play a key role in supporting this process by generating and offering evidence on the social, economic, and political benefits of comprehensive, inclusive national social protection systems.
Introduction
Social protection is a core component of a market economy, contending that the state should establish systems that protect citizens from the effects of profit maximization in unfettered markets. Without social protection, there could be no market economy since it would not be sustainable in the face of societal opposition (Polanyi 1944).
In recent decades, the importance of establishing social protection in developing countries as part of a market economy has been increasingly recognized. For example, many countries agreed to the ideal of creating national social protection floors (ILO 2012). In addition, there is growing international understanding in the post-2015 development agenda that, if the Sustainable Development Goals are to be reached, countries must establish effective national social protection systems.
As countries in Asia have become more integrated into the global market economy, much of their populations work in the informal economy. A range of challenges have accompanied their economic growth, which, to be addressed effectively, require states to invest in social protection. Countries are becoming more urbanized, and growing rural–urban migration is weakening social ties and traditional forms of informal social protection. Further, there is a demographic transition under way, with many countries rapidly aging. Already, 11.6% of the population of the region is aged over 60 years, and by 2030, this demographic will reach 17.0%—24.0% by 2050 (UNDESA 2015). Inequality is also increasing in many countries, resulting in social tensions and waning social cohesion. Despite the growth of market economies, many continue to live in poverty facing challenges in providing for their families.
Only a few countries in Asia offer the informal economy workforce adequate access to social protection. A range of factors has influenced the size and nature of national social protection systems across Asia, with many shaped by the political economy within countries.
This chapter will examine the impact of political economy on the development of social protection for informal economy workers in Asia. It uses an analytical approach known as adapted political settlement, based on the framework outlined in Lavers and Hickey (2015). As Di John and Putzel (2009) explained, a political settlement refers to the balance or distribution of power between contending social groups and social classes on which the state is based. While this concept has mainly been applied to the politics of economic growth, Lavers and Hickey (2015) argued that it can also be applied to social protection, since similar factors are at play. Relations of power between elites—that
is, those regarded as rich and powerful in any society, as well as their allies in government—and other social and economic groups can explain how resources are distributed through social protection schemes and can influence the quality of their provision. In effect, elites control national resources, and the nature of their political settlements with other groups determines how resources are shared across society. A market economy, and the social tensions that it can generate if left uncontrolled, creates the motivation for elites to share resources to maintain their power and wealth, as well as broader social stability.
The World Bank (1990), Sen (1995), Mkandawire (2005), Pritchett (2005), and Kidd (2015) have implicitly used the political settlement approach when explaining the political economy of targeting of social protection.43 They argued
that, in a well-functioning democracy, alliances across social and economic classes influence levels of investment in social protection and the quality of social protection schemes. Since the poor have limited political influence, programs targeted at those living in poverty are likely to have low budgets and low transfers, as well as low quality. Sen (1995) noted that benefits for the poor often end up being poor benefits, and Kidd and Hossain (2015) argued that the term “the poor” is, in reality, often shorthand for the most socially excluded members of society who lack power.
In contrast, when social protection programs are inclusive in their design—that is, incorporating not only the poor but also those with more political power, such as those in the middle of the income spectrum, taxpayers, and the wealthy— levels of investment in social protection schemes increase, as do the value of transfers and quality of program delivery. Governments mostly respond to the demands of the more powerful.
When examining the influence of political economy on social protection, it is important to develop criteria that can be used to assess the level of government commitment to particular schemes. This chapter thus assesses commitment by the size of a state’s investment in a scheme, most easily measured as a percentage of national gross domestic product (GDP), and the quality of a program. Quality is more challenging to measure, of course, but it broadly refers to the value of transfers offered to beneficiaries and the extent to which the right people receive the right amount of money and the ease with which they receive it.44
43 See also Kidd and Hossain (2015).
44 The extent to which people receive the right amount of money at the right time is dependent on the
To understand the impact of political economy on the development of social protection for the informal economy, it is necessary to understand the nature of the informal economy as well as the shape of national social protection systems and how they differ among countries. Thus, the chapter begins by describing the characteristics of the informal economy in Asia and then details the shape of social protection systems across Asia. The next section examines how politics and relations of power have influenced the nature of social protection for informal economy workers across the region, and it concludes by outlining how political economy can be influenced to extend social protection to the informal economy workforce.
In this chapter, social protection—sometimes known as social security—is defined as schemes that provide individuals, families, and households with regular, predictable income transfers.45 Generally, there are two main types of
social protection transfers: those that are financed from general government revenues, which can be referred to as social transfers; and those financed by contributions from employees and employers, often known as social insurance.
The Informal Economy in Asia
There are many definitions of the informal economy, but, in general, the term refers to workers not registered with the state who do not pay income taxes or receive protection from labor legislation (Evers and Seale 2015).46 The
International Labour Organization (ILO), which has increasingly referred to informal economy employment as vulnerable employment, estimated that it encompasses around 60.0% of workers in Asia (ILO 2011).47 The proportion
is highest in South Asia at 77.0%, encompassing over 80.0% of the workforce in Bangladesh (World Bank 2008). In many middle-income countries in Southeast Asia, the proportion is 40.0%–65.0%, although in the Lao People’s Democratic Republic (Lao PDR), it reaches over 80.0%. East Asia has around 50.0% of its workforce in the informal economy, while in Central Asia, the size of the informal economy has grown dramatically since the fall of the Soviet Union and may still be expanding. Only in the wealthier countries of Asia, such as Japan, the Republic of Korea, and Malaysia, do those in vulnerable employment number less than 30.0% of the overall workforce (Cichon and Cichon 2015).
45 This chapter does not examine other aspects of social protection such as health financing or access to
a broader range of social services.
46 OECD (2009, 1) defined informal economy employment as “jobs or activities in the production and
commercialisation of legal goods and services that are not registered or protected by the state and, accordingly, are not covered by the social security system.”
47 See Cichon and Cichon (2015) for a more comprehensive discussion on the size of the workforce in the
The nature of informal economy employment varies among countries and areas in Asia. In most, a high proportion of those in the informal economy are in the agriculture sector, either as owners of small plots of land or unskilled laborers (or both). In Bangladesh, for example, nearly 50.0% of the labor force is in the agriculture sector (World Bank 2008). Informal economy workers outside of agriculture engage in a range of employment arrangements and activities either as employer-owners of informal firms, own-account workers (i.e., self-employment with no employees), informal employees of both formal and informal firms, subcontracted workers and wage workers for households (i.e., domestic workers), casual day workers, and unpaid family members. Common activities include street traders; home-based, piece-rate workers in the garment industry; transport workers; rubbish collectors; domestic servants; and shoe cleaners.
Within Asia, women are more likely to be in informal employment than men; in South Asia, for example, 84.5% of women are in vulnerable employment, compared with 74.8% of men (ADB and ILO 2011).48 As Figure 3.1 indicates,
nonpaid work in family businesses is dominated by women, while men make up the own-account and employer statuses. In fact, only 1.0% of all female workers in Asia run their own businesses with paid employees. Gender differentials in income in the informal economy surpass those in the formal sector, and, among women, there is a stronger correlation between poverty and informal economy labor. As the Asian Development Bank (ADB) and ILO (2011, 14) noted, “Informal women workers are the ‘working poor,’ struggling in survivalist activities, working arduous and long hours but not earning enough to support themselves or their families.”
For many workers in the informal economy, underemployment is endemic, meaning that workers are unable to maximize their incomes. In Bangladesh, around 25.0% of the labor force is either unemployed or underemployed, with 9.0% of those employed working less than 20 hours per week. In Indonesia, ADB estimated that those who are underemployed work an average of only 28 hours per week (World Bank 2008, Sugiyarto 2007).49
The challenges are greater for young people, as they experience much higher rates of unemployment or underemployment. In Bangladesh, 2.7 million young people enter the labor market each year, but only 0.7 million are able to find employment (Islam 2012). In Viet Nam, ILO estimated that around 53.0% of those under the age of 25 years have obtained vulnerable employment (Thanh Nien News 2013), and, in 2012, around 40.0% of young people remained out of education, training, or work, a situation that has hardly improved with most
48 The main exceptions are the Mongolia and Philippines.
of those with limited schooling ending up in low-paid jobs in the informal economy (World Bank 2013b).
Although some workers in the informal economy generate good incomes, in general, employment in the informal economy is associated with low, insecure wages (Huitfeldt and Jutting 2009). However, the understanding of the relationship between informal economy employment and poverty is distorted by unrealistically low poverty lines in many countries. The use of the $1.25 purchasing power parity (PPP) per day poverty line as the international standard for poverty has ignored the reality that survival on such a sum is extremely challenging and that it should be more accurately regarded as indicating extreme poverty.50
More in-depth analyses of national household surveys have indicated that a high proportion of the population in most countries in Asia should be regarded as living on low incomes, with a $2.00 PPP per day poverty line a better indicator of deep poverty. In some countries, the figures are stark; in Bangladesh in 2008,
50 ILO (2011) noted that 422 million workers in Asia and the Pacific live on less than $1.25 PPP per day.
Figure 3.1: Distribution of Total Employment in Asia, by Status in Employment and Sex
Source: Asian Development Bank (ADB) and International Labour Organization. 2011. Women and Labour Markets in Asia: Rebalancing for Gender Equality. Manila: ADB.
Share in total employment (%)
Salaried
worker Employer Own-accountworker 60 50 40 30 20 10 0 Contributing family worker Male Female
while 43.0% of the population lived on under $1.25 PPP per day, 84.0% had per capita consumption of less than $2.00 PPP per day (World Bank 2012a). Other low-income countries, such as India, Nepal, and Pakistan, have 50.0%–60.0% of their populations living on less than $2.00 PPP per day. In the middle-income countries of the Philippines and Indonesia, the rates are 41.7% and 43.3%, respectively.51 The People’s Republic of China (PRC) and Viet Nam perform
better, with 18.6% and 12.5% of their populations living on less than $2.00 PPP per day, respectively. However, overall, it must be emphasized that over 868 million workers in Asia and the Pacific survive on less than $2.00 PPP per day (ILO 2011).
Even in middle-income countries, few people can be regarded as middle class, since the majority survives on relatively low incomes. With no adjustment for PPP, only around 20.0% of the population in Viet Nam lives on more than $4.60 per day; in Indonesia, only 18.0% live on more than $2.60 per day; and, in Georgia, only 32.0% live on more than $4.70 per day. Therefore, most families, including most of those engaged in the informal economy, do not have sufficient income to invest in the well-being of their families or to save for the future. In Indonesia, many in this group have been characterized the “scooter class,” which could also apply to other middle-income countries in Asia, such as Viet Nam (Schlogl and Sumner 2014, Kidd et al. 2015).52 Consequently, even in middle-income countries, the
majority of the population can be regarded as either living in poverty or vulnerable to it, obliged to sell their labor in uncertain and informal labor markets.
The growing availability of panel datasets, which track households over time, indicates that the simplistic dichotomy of poor and nonpoor, which is often used in social analysis and policy development, is an imaginary construct.53
Household consumption and incomes are highly volatile, as people respond to opportunities and are hit by shocks. For example, in Georgia, around 60.0% of households in the poorest quintile of the population in 2013 were not in that quintile in 2011; therefore, they can be regarded as having fallen into poverty (Baum, Mshvidobadze, and Tsuruoka 2015). In Viet Nam, the proportion falling into the poorest quintile between 2010 and 2012 was nearly 40.0% (Kidd et al. 2015). Further, among the majority in the second, third, and fourth consumption quintiles (where many people in the informal economy can be found), the movement between quintiles was significant, indicating a high level of insecurity. Indeed, in Georgia, over 50.0% of those in the richest quintile in 2011 experienced a relative fall in living standards by 2013, with some having fallen completely into extreme poverty.
51 World Bank. Poverty Headcount Ratio at $3.10 a Day (2011 PPP). http://data.worldbank.org/indicator/
SI.POV.2DAY
52 The term “scooter class” refers to those in the middle of income distribution, with sufficient income to
purchase cheap scooters but, generally, with low incomes and insecure employment.
The insecurity faced by most people in the informal economy is linked to the risks that they face across their life cycles, which are exacerbated by low incomes. Life cycle risks begin in early childhood, with undernutrition particularly important.54 While stunting rates are, as expected, high in low-income
countries,55 they are also high in the middle-income countries of Southeast
Asia. In 2011, in Viet Nam, 22.0% of children under 5 years of age were stunted (General Statistics Office 2011), and, in Indonesia, 35.6% were stunted in 2010 (UNICEF 2013). Undernutrition impacts negatively on children’s cognitive development, subsequently hindering their ability to perform well at school and reducing their productivity and earning potential as adults, enhancing the likelihood that they will remain in vulnerable employment. Undernutrition also increases the likelihood of being overweight or obese in later life, with the associated heightened risks of cardiovascular disease, diabetes, and other noncommunicable diseases, which, in the long term, will increase the risks faced by workers in the informal economy.56
Children of school age risk not being able to access a good education. Again, this threatens their long-term well-being and their chances of gaining formal sector employment. For example, in Indonesia, only 25.0% of the labor force has completed senior secondary education, and there are concerns that secondary schools, including vocational schools, are not providing children with adequate skills for the labor market (Alatas and Newhouse 2010). Further, across Asia, many children face the risk of being employed in the informal economy at a young age, particularly in low-income countries. In South Asia, 13.0% of boys and 12.0% of girls are involved in child labor, while in East Asia, the figures are 10.0% and 7.0% (UNICEF 2015).
People of working age in the informal economy face significant risks. Many are in insecure jobs and/or underemployed and, as a result of low educational attainment, find it difficult to gain decent work. Women in the informal economy face particular risks, since they are often in more vulnerable employment, are unable to access adequate child care, and, as a result, cannot return to work after giving birth. If they do, they may experience a fall in their productivity. Ill health and disability are further risks to workers in the informal economy, which can undermine standards of living. In Bangladesh, one study found that around 87.0% of working-age people who became disabled left employment within 1 year (Chowdhury and Foley 2006).57 In Viet Nam, people aged 25–29,
54 It can be argued that risks begin when children are still in the womb, since risks faced by their mothers
(e.g., poor nutrition) will impact their offspring.
55 In Bangladesh, 41.0% of children are stunted (NIPRT, Mitra and Associates, ICF International 2013). 56 The impact of undernutrition can be seen in estimates that its prevalence in Asia reduces overall gross
national product by 11.0% (IFPRI 2014).
living with a disability, have poverty rates that are more than double those of people without a disability (Kidd and Abu-el-Haj 2015).
Migrants are a category of workers in the informal economy at particular risk.