Using the sanitation safety planning tool to improve the occupational health and safety of de-sludging operators in Uganda: a protocol for a controlled before and after study

BackgroundDe-sludging operators play a critical role in ensuring access to safe sanitation services. De-sludging activities, however, increase the operators’ risk of exposure to physical, chemical, ergonomic, psychological, and biological hazards, which eventually affect their health-related quality of life (HRQoL). Despite immense exposure to occupational hazards, only a few evidence-based interventions have been implemented to improve the occupational health and safety (OHS) of de-sludging operators.ObjectiveThe proposed study intends to utilise the sanitation safety planning (SSP) tool to improve the OHS of de-sludging operators in Uganda. The study aims to generate evidence of the prevalence of exposure to occupational hazards and the associated health outcomes, knowledge, attitude and uptake of OHS measures, as well as the HRQoL of de-sludging operators. The facilitators and barriers to the promotion of OHS shall also be explored.MethodsA mixed-methods study will be conducted among 356 desludging operators in the Greater Kampala Metropolitan Area. A structured questionnaire pre-loaded on the KoboCollect mobile data collection application will be used to obtain information on socio-demographic characteristics, history of work-related accidents and diseases, uptake of safety measures, and health-related quality of life. A total of 10 focus group discussions (FGDs) will be conducted among desludging operators, to understand how they cope with associated occupational hazards. In addition, 25 in-depth interviews (IDIs) will be conducted among purposively selected employers to understand the barriers and facilitators of provision and implementation of safety measures among desludging operators. Quantitative data will be analyzed using STATA version 15 while qualitative data will be transcribed verbatim and the analysis aided by the NVIVO software.Expected outcomesThe study will generate evidence of the occupational health and safety of desludging operators and the effectiveness of the SSP tool. These findings will be critical in informing the design and implementation of occupational health and safety programmes among desludging operators.