Intersecting Systems of Power Shaping Health and Wellbeing of Urban Waste Workers in the Context of COVID-19 in Vijayawada and Guntur, Andhra Pradesh, India.

Background: Waste work in India is an undervalued role relegated to historically marginalised communities. The informal nature of their work coupled with lack of state regulation keeps waste workers trapped in poverty. This study aims to understand how intersecting systems and relations of power impact the agency of waste workers to shape their health and wellbeing. Methods: We used in-depth interviews, key informant interviews, and focus group discussions to collect primary data from waste worker communities in Vijayawada and Guntur in India. Thematic analysis was used to analyse data using conceptual frameworks relating to wellbeing and power. Results: Inter-generational poverty and lack of access to social determinants of health keeps waste workers trapped in a cycle of debt and poverty. They experience negative wellbeing owing to material and relational deprivations that are sustained by a nexus of power relations, explained using the themes of "power over", "power to", "power with", and "power-within". Conclusions: The ability of communities to exercise agency is constrained by the power exercised on their lives by the state and society. NGOs play a supportive role for the realisation of rights, but the ability of waste workers to organize and effect change is limited to coping strategies. [ABSTRACT FROM AUTHOR]

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