Includes bibliographical references and appendices

The safety, health, and dignity of sanitation workers, despite being critical to global
sanitation efforts, have long been neglected. This study addressed this issue by conducting
a comprehensive analysis of the occupational safety, health, and dignity of sanitation
workers in Mukuru kwa Reuben slums, Nairobi, Kenya. The research objectives included
assessing occupational hazards, examining factors associated with the current state of
occupational safety, health, and dignity, and evaluating existing measures for worker
protection. The study adopted a mixed-methods approach, combining qualitative and
quantitative data to provide a holistic understanding of the issues. The findings, n=40,
revealed significant occupational hazards faced by sanitation workers, with chemical
hazards being the most prevalent (40.0%), followed by psychosocial (27.5%), physical
(22.5%), and biological hazards (10.0%). A staggering 85.0% of workers reported a lack
of access to personal protective equipment (PPE). Socioeconomic factors strongly
influenced workers' conditions, with significant correlations found between the state of
occupational safety and health (OSH) and various factors: availability of PPE (r = 0.574,
p = 0.002), income (r = 0.613, p = 0.000), poverty (r = -0.491, p = 0.000), and training (r
= 0.516, p = 0.004). Environmental factors also showed strong correlations, with
occupational hazards negatively impacting OSH (r = -0.725, p = 0.000) and working
conditions positively influencing OSH (r = 0.672, p = 0.000). The study uncovered
significant deficiencies in occupational safety measures, with 77.5% of workers reporting
a lack of standard operating procedures, 87.5% lacking access to welfare facilities, and
72.5% not receiving any training on sanitation work. Social stigma and discrimination
affected 67.5% of workers, negatively impacting their dignity. Additionally, 82.5% of
workers lacked formal employment contracts, and 85.0% were unaware of any
government policies recognizing their work. Based on these findings, the study
recommends enhancing training and awareness programs, providing access to PPE,
improving working conditions, strengthening legal protections, establishing supportive
networks, and conducting regular monitoring and evaluation. This research highlights the
urgent need to prioritize the well-being of sanitation workers, recognizing their crucial role
in sanitation services and addressing the multifaceted challenges they face.