Rural occupational health in Colombia: policy–practice gaps among agricultural workers in Bolívar, Valle del Cauca

Abstract

This study examines policy–practice gaps in occupational safety and health (OSH) protection among agricultural workers in Bolívar, Valle del Cauca, Colombia. A multi-method design combined 14 semi-structured interviews and two focus groups with an adapted ILO Vision Zero Fund survey administered to 200 agricultural workers. Survey data were analyzed descriptively and through exploratory Multiple Correspondence Analysis (MCA), and qualitative and quantitative findings were integrated during interpretation. Findings showed multidimensional patterns involving occupational protection, working conditions, health-service availability, agricultural practices, and productive autonomy. These patterns coexisted with informal, seasonal, short-term, day-labor, and subsistence work, limited occupational risk coverage, discontinuous prevention and training, and fragmented institutional coordination. Qualitative findings further highlighted women’s combined productive and care roles, local and traditional knowledge, community participation, and heterogeneity across territorial settings and agricultural practices as relevant to prevention and decision-making. Conventional social protection and occupational risk arrangements centered on formal, contributory employment may not fully respond to dispersed and unstable rural work. Strengthening rural OSH requires integrated, territorially adapted, gender-sensitive strategies linking prevention, social protection, sustained training, institutional coordination, community participation, and productive autonomy. The findings support assessing differentiated and progressive protection pathways, including the feasibility of subsidized occupational risk coverage for more vulnerable workers and small productive units, combined with contributory mechanisms where work arrangements are more stable. By linking worker-level realities with institutional and policy-implementation gaps, this study provides evidence to inform more equitable rural OSH policies responsive to diverse territorial realities in Colombia.