Sick Leave Reminders and Worker Health in Bangladesh

Fieldwork by:
1,432 garment workers
2020 - 2021
AEA RCT registration number:
Research papers:

Women can increase their economic empowerment and overall quality of life through factory employment; however, women are often forced to leave work due to sickness or care taking responsibilities. Researchers working with a large apparel maker in Bangladesh are evaluating the impact of phone call reminders sharing information about their employer’s support for workers to use their company's paid sick leave to increase worker retention.

Policy issue

Manufacturing jobs can sometimes be women’s point of entry to formal employment. Stable employment can increase women’s economic empowerment and overall quality of life. However, turnover is high, and women are more likely than their male counterparts to be to leave their jobs due to sickness or care taking responsibilities.

To retain workers and reduce the spread of contagious disease, many employers offer paid sick leave. Yet, workers do not know about their sick leave options. Even workers who know about sick leave frequently do not take time off because they do not want to risk facing professional consequences. To convince sick workers to take paid time off, employers need to clearly communicate their sick leave policies and credibly commit to honoring them.

Can phone call reminders encourage workers to take sick leave? Could encouraging workers to take sick leave help factories retain women workers?

Context of the evaluation

In Bangladeshi garment factories, women face the common tension between needing a stable job and being expected to care for themselves and their families. In a 2017 study by the BRAC Institute for Governance and Development, an implementing partner for this study, 26 percent of women reported leaving their last factory job because of family problems or sickness. Only 12 percent of men, or proportionally less than half as many men as women, reported the same.

The Covid-19 pandemic has heightened this tension for many Bangladeshi women. When this study started in September 2020, Bangladesh had already recorded approximately 349,000 Covid-19 cases and more than 4,900 Covid-19 deaths.

This study took place in the sewing, washing, and finishing sections of two factories owned by a large, Bangladeshi apparel maker, who wanted its workers to take more paid sick leave and to retain more workers. Workers in apparel factories work close together, with the potential to infect coworkers if they came to work sick. During the study pilot, 7.6 percent of the apparel maker’s workers in the comparison group reported Covid-19 symptoms.

Also during the study pilot, spouses of a representative sample of garment workers were earning just 53 percent of their pre-pandemic income. If workers took more sick leave, it may prevent women from dropping out of the labor force. Higher retention could benefit both women and their families, while also benefitting the apparel maker by reducing recruiting and training costs.

Details of the intervention

Researchers worked with a large apparel maker to conduct a randomized evaluation of the impact of phone call reminders on workers physical and mental health and job satisfaction.

Researchers selected twelve sewing production lines per factory at five factories. Six lines were assigned to the intervention and six lines were assigned to comparison. There were non-experimental lines as buffers between these experimental intervention and comparison lines to limit spillover. From each line, the researchers selected twenty workers.

  1. One message. Workers in these intervention lines received an SMS reminder, reiterating the apparel maker’s commitment to their workers’ health and clarifying that workers will not face retribution for taking sick leave. The apparel manufacturer routinely communicates other information to its workers via text message.
  2. Two messages. Workers in these intervention lines received the same SMS reminder as the workers in the “one message” group, plus another message that workers are entitled to sick leave.
  3. Two messages and information. Workers in these intervention lines received the same SMS reminders as the workers in the “two messages” group, plus information about options for recourse if a request for sick leave is denied.
  4. Workers in comparison lines did not receive an SMS reminder.

Researchers collected data on two primary families of outcomes: worker health and worker job satisfaction. To measure worker health, the research team collected data on Covid-19 symptoms as well as depression, stress, and anxiety. To measure worker job satisfaction, the research team also collected information on workers’ trust in their employer and intention to continue working there.