EVERY year, as the first of May arrives with the red of workers’ flags and the sound of marches, Bangladesh pauses to honour its labour force. It is through the hands of its workers that the country has stitched its place on the global economic map. According to the 2024 Labour Force Survey by the Bangladesh Bureau of Statistics, the labour force stands at about 73.8 million, including 48.5 million men and 25.3 million women. About 62 per cent of the population is engaged in labour. Among them, 84 per cent of workers remain in the informal sector, without official contracts, protections, or representation. For women, this figure rises to 96.6 per cent. Meanwhile, the National Child Labour Survey 2022 shows that nearly 1.78 million children are engaged in labour, despite legal prohibitions.
Yet beneath the rhetoric of solidarity and the promise of reform lies a quieter, more urgent reality, where the physical and mental toll borne by millions of workers remains largely unseen and underserved.
Physical toll
WORK-RELATED hazards remain one of the most persistent public health challenges worldwide. According to a recent global report by the International Labour Organisation, more than 840,000 people die each year from health conditions linked to psychosocial risks such as long working hours, job insecurity and workplace harassment. Another International Labour Organisaion estimate suggests that over 2.3 million people die annually due to occupational accidents, more than 6,000 deaths every day.
These are not abstract statistics. They reflect the realities of construction workers exposed to unsafe conditions, factory workers breathing polluted air, and informal labourers working without basic protections. In the apparel sector, more than 500 major accidents have been recorded over the past decade. At the same time, a recent media report indicates that 68 per cent of workers in the ready-made garment industry have received no formal safety training.
In countries like Bangladesh, where a large proportion of workers remain in the informal sector, occupational safety is often weakly enforced. The result is a cycle in which economic vulnerability pushes individuals into unsafe work, and unsafe work, in turn, deepens that vulnerability.
Dual disease burden
WORKERS often live in crowded and congested areas, with poor sanitation and hygiene. Communicable diseases such as tuberculosis, respiratory infections, dengue and other infectious diseases remain prevalent in these settings. At the same time, the burden of non-communicable diseases is rising.
Research indicates that the proportion of deaths from non-communicable diseases in Bangladesh increased from 43 per cent in 2000 to nearly 70 per cent in 2019. Low-income communities are increasingly affected by hypertension, diabetes, heart disease and chronic respiratory conditions, driven by poor living environments and sustained work-related stress.
Women in the workplace
IN THE garments sector, where a large proportion of workers are women, many remain deprived of basic maternal health protections. Only 25 per cent of women workers receive maternity leave, and many are forced to return to work before completing the standard eight-week postnatal recovery period. In some instances, they are even pushed into so-called “voluntary” retirement. While some factories provide childcare facilities, these are often inadequate.
This lack of protection raises a critical concern, as the health of mothers affects not only women themselves but also the health and productivity of the future workforce.
Unspoken burden
WHILE physical risks are more visible, the mental health burden among workers remains largely unspoken, yet equally alarming.
In Bangladesh’s ready-made garment sector, where over four million workers — predominantly women — drive more than 80 per cent of the country’s export earnings, mental health remains largely overlooked. Evidence from a recent cross-sectional study conducted in Savar between 2023 and 2025 presents a concerning picture: 58.7 per cent of garment workers reported symptoms of depression, 73.6 per cent experienced anxiety and 19.9 per cent reported stress. Female workers faced nearly three times higher odds of both depression and anxiety compared to male workers.
The study also shows that older age and longer job tenure are associated with higher levels of psychological distress, indicating the cumulative impact of prolonged exposure to demanding work conditions. Higher monthly income was linked to increased odds of depression and anxiety, while stress was also associated with substance use.
These findings highlight how workplace pressures, combined with limited psychosocial support, are affecting worker well-being. Addressing this requires integrating workplace-based mental health screening, gender-sensitive interventions, stigma reduction and accessible support services.
Implementation is everything
THE 2025 amendment to the Bangladesh Labour Act expanded legal protections, introduced stricter prohibitions against forced labour and sexual harassment, simplified union registration and extended some coverage to previously excluded groups, including domestic workers and seafarers. The RMG Sustainability Council has worked to establish safety committees in factories, while international pressure — particularly from the European Union — has pushed regulatory enforcement in a more positive direction.
However, significant gaps remain. The amendment appears, in part, designed to demonstrate formal compliance with ratified ILO conventions rather than to address the everyday realities workers face, including inadequate wages, widespread casualisation, minimal accident compensation and limited social protection for the informal majority. Rights advocates continue to argue that while laws may protect workers on paper, enforcement, inspection capacity and political will determine protection in practice.
Health insurance for workers across all sectors also remains a critical need. One study suggests that 86.7 per cent of workers in the informal sector — including rickshaw pullers, restaurant workers and shopkeepers — would be willing to enrol in affordable health insurance schemes. Yet nearly 70 per cent of total healthcare expenditure is still paid out-of-pocket, leaving most workers without meaningful financial protection.
Future of work
LABOUR Day should not only be a moment of recognition but also a call to action. Ensuring a healthier future requires strengthening occupational safety, particularly for informal workers. Sustainable development depends not only on production but also on worker well-being. Dedicated budgets should be allocated for fire safety, maintenance and protective equipment in factories.
In labour-dense areas, accessible primary healthcare centres must be established. Industrial establishments can also collaborate with local government bodies to help finance and operate these services. Mental health must be integrated into workplace policies, including reasonable working hours, supportive supervision and access to care. Finally, workers’ voices must remain central, as policies designed without them often fail to reflect conditions on the ground.
As Bangladesh moves towards graduating from least-developed-country status, the health of its workers cannot remain a peripheral concern. It is, instead, foundational to the country’s future. A workforce that is physically strained, psychologically burdened and economically insecure cannot sustain the vision of a prosperous Bangladesh that policy narratives often promise.
Professor Rumana Huque is executive director of ARK Foundation.
