Health Services for Marginalized Groups: A Sociological Study on Construction Workers in Paccerakkang, Makassar City
Abstract
Introduction: This study aims to gain an in-depth understanding of the experiences of construction workers in accessing health services in Paccerakkang Subdistrict, Biringkanaya District, Makassar City. As part of the informal sector workforce, construction workers face various health risks as well as structural limitations in obtaining adequate health services. This study adopts a health sociology perspective to examine how social, economic, and public policy factors influence access to health services among informal workers.
Methods: This study employed a qualitative approach with a phenomenological design. The research participants consisted of six construction workers selected purposively based on the criteria of being aged 18–60 years, actively working as construction workers, and having experience in accessing health services within the past year. Data were collected through in-depth interviews, participant observation in the workers’ work and residential environments, and documentation to strengthen the empirical context of the study. Data analysis was conducted using thematic analysis through processes of data reduction, categorisation, and meaning-making to identify patterns of experience and the participants’ interpretations of access to health services.
Results: The findings indicate that construction workers perceive health services not only as a means of medical treatment but also as a form of social protection that helps maintain work productivity and family well-being. The main barriers to accessing health services include economic constraints, unstable income, long working hours, and the lack of occupational safety facilities. Some participants also highlighted complicated administrative procedures and high treatment costs, although in general they did not experience discrimination from health professionals. To overcome these barriers, construction workers developed adaptive strategies such as utilising formal health services and traditional treatment, maintaining health through healthy lifestyles, and relying on social support from family members and co-workers.
Conclusion: This study concludes that the experiences of construction workers in accessing health services are shaped by the interaction of economic, social, occupational, and health policy factors. Therefore, stronger synergy between government institutions, health service providers, and worker communities is required to create a health service system that is more equitable, inclusive, and responsive to the needs of informal sector workers in urban settings.
Downloads
References
- Firori FA, Wisana IDGK. The Effect of Participation in JKN on Unmet Needs for Healthcare Services. Indones J Heal Adm (Jurnal Adm Kesehat Indones. 2023;11(2). https://doi.org/10.20473/jaki.v11i2.2023.186-195
- Satriawan D, Pitoyo AJ, Giyarsih SR. Cakupan Kesehatan Universal (UHC) pekerja sektor informal di Indonesia. Tata Loka. 2020;22(4):556–72. https://doi.org/10.14710/tataloka.22.4.556-572
- Rosidah LK, Asdary RN. National Health Insurance Membership and Economic Status As Determinants of Accessibility of Antenatal Care service. J Matern Child Heal. 2021;6(4). https://doi.org/10.26911/thejmch.2021.06.04.02
- Istiqomah A, Jayanti IP, Wijayanti R, Hidayatullah F, Oktadewi FD. Telaah Artikel: Implementasi Sistem Pembayaran Kapitasi pada Jaminan Kesehatan Nasional sebagai Strategi dalam Mengatasi Kesenjangan Pelayanan Kesehatan. STOMATOGNATIC-Jurnal Kedokt Gigi. 2023;20(1):24–31. https://doi.org/10.19184/stoma.v20i1.38864
- Ningrum EP, Sumarno M, Nursyamsi SE, Siregar N. Faktor Terkait Kesenjangan Ekonomi dan Kesejahteraan. PRIVE J Ris Akunt dan Keuang. 2024;7(2):116–26. https://doi.org/10.36815/prive.v7i2.3480
- Nugraheni H, Wiyatini T, Wiradona I-M. Kesehatan Masyarakat dalam Determinan Sosial Budaya. Deepublish; 2018.
- WHO. Closing the Gap in A Generation: Health Equity Through Action on the Social Determinants of Health. World Health Organization; 2008.
- Pahutar AA, Siregar D, Firdaus K, Kamal T, Hakim R, Hanafi AH. Studi Islam dengan Pendekatan Fenomenologis. Dakwatul Islam. 2024;8(2):156–73. https://doi.org/10.46781/dakwatulislam.v8i2.686
- Braun V, Clarke V. Using Thematic Analysis in Psychology. Qual Res Psychol. 2006;3(2):77–101. https://doi.org/10.1191/1478088706qp063oa
- Nowell LS, Norris JM, White DE, Moules NJ. Thematic Analysis: Striving to Meet the Trustworthiness Criteria. Int J Qual Methods. 2017;16(1):1609406917733847. https://doi.org/10.1177/1609406917733847
- Bush T. Authenticity in Research: Reliability, Validity and Triangulation. Res Methods Educ Leadersh Manag. 2012;6(19):75–89.
- Sulianta F. Research Ethics: Panduan Praktis untuk Peneliti. Feri Sulianta; 2025.
- Neto JBF, De Moraes GLA, de Souza Aredes J, Giacomin KC, De Melo LP, Sempe L, et al. Building the Capacity of Community Health Workers to Support Health and Social Care for Dependent Older People in Latin America: A Pilot Study in Fortaleza, Brazil. BMC Geriatr. 2021;21(1):526. https://doi.org/10.1186/s12877-021-02472-8
- Andersen RM. Revisiting the Behavioral Model and Access to Medical Care: Does it Matter? J Health Soc Behav. 1995;1–10. https://doi.org/10.2307/2137284
- Penchansky R, Thomas JW. The Concept of Access: Definition and Relationship to Consumer Satisfaction. Med Care. 1981;19(2):127–40. https://doi.org/10.1097/00005650-198102000-00001
- Kustanto M, Anindita A. Reproduksi Makna Miskin dalam Surat Keterangan Tidak Mampu (SKTM) untuk Pelayanan Kesehatan Masyarakat Miskin Non Kuota di Kabupaten Sidoarjo. Bul Penelit Sist Kesehat. 2019;22(4):272–81. https://doi.org/10.22435/hsr.v22i4.2398
- Levesque J-F, Harris MF, Russell G. Patient-Centred Access to Health Care: Conceptualising Access at the Interface of Health Systems and Populations. Int J Equity Health. 2013;12(1):18. https://doi.org/10.1186/1475-9276-12-18
- Peters DH, Garg A, Bloom G, Walker DG, Brieger WR, Hafizur Rahman M. Poverty and Access to Health Care in Developing Countries. Ann N Y Acad Sci. 2008;1136(1):161–71. https://doi.org/10.1196/annals.1425.011
- Satriawan D, Pitoyo AJ, Giyarsih SR. Faktor-Faktor yang Memengaruhi Kepemilikan Jaminan Kesehatan Pekerja Sektor Informal di Indonesia. Tata Loka. 2021;23(2):263–80. https://doi.org/10.14710/tataloka.23.2.263-280
- Edo A, Yasin M. Dampak Kesenjangan Akses Pendidikan Dan Faktor Ekonomi Keluarga Terhadap Mobilitas Sosial. J Ilmu Pendidik Sos. 2024;2(3):317–26. https://doi.org/10.71382/sinova.v2i3.175
- Murayama H, Fujiwara Y, Kawachi I. Social Capital and Health: A Review of Prospective Multilevel Studies. J Epidemiol. 2012;22(3):179–87. https://doi.org/10.2188/jea.JE20110128
- Gilmer TP, Center K, Casteel D, Choi K, Innes-Gomberg D, Lansing AE. Developing Trauma Resilient Communities Through Community Capacity-Building. BMC Public Health. 2021;21(1):1681. https://doi.org/10.1186/s12889-021-11723-7
- Rambe DH, Lubis M, Ritonga N, Purba SH. Solusi Teknologi SIMRS dalam Meningkatkan Kualitas Layanan Kesehatan Publik di Indonesia. J Ris Ilmu Kesehat Umum dan Farm. 2025;3(1):33–43. https://doi.org/10.57213/jrikuf.v3i1.488
- Campbell C. Social Capital, Social Movements and Global Public Health: Fighting for Health-Enabling Contexts in Marginalised Settings. Soc Sci Med. 2020;257:112153. https://doi.org/10.1016/j.socscimed.2020.112153
- Putri NK, Laksono AD, Rohmah N. Predictors of National Health Insurance Membership Among the Poor with Different Education Levels in Indonesia. BMC Public Health. 2023;23(1):373. https://doi.org/10.1186/s12889-023-15292-9
- DeCorby-Watson K, Mensah G, Bergeron K, Abdi S, Rempel B, Manson H. Effectiveness of Capacity Building Interventions Relevant to Public Health Practice: A Systematic Review. BMC Public Health. 2018;18(1):684. https://doi.org/10.1186/s12889-018-5591-6
- Sari B, Idris H. Determinant of Independent National Health Insurance Ownership in Indonesia. Malaysian J Public Heal Med. 2019;19(2):109–15. https://doi.org/10.37268/mjphm/vol.19/no.2/art.177
- Cheng Q, Fattah RA, Susilo D, Satrya A, Haemmerli M, Kosen S, et al. Determinants of Healthcare Utilization Under the Indonesian National Health Insurance System–A Cross-Sectional Study. BMC Health Serv Res. 2025;25(1):48. https://doi.org/10.1186/s12913-024-11951-8
- Birgel V, Decker L, Roeding D, Walter U. Community Capacity for Prevention and Health Promotion: A Scoping Review on Underlying Domains and Assessment Methods. Syst Rev. 2023;12(1):147. https://doi.org/10.1186/s13643-023-02314-1
Copyright (c) 2026 Media Publikasi Promosi Kesehatan Indonesia (MPPKI)

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.