Provision Health Services for Working Little Girls in Small Scale Enterprises of Denizli


Summary Outline for Action Programme on Child Labour

Working title: Provision of health services for working little girls in small scale enterprises of Denizli

Location: Denizli, Turkey

Responsible Institution: FISEK Institute on Health Services and Research

Duration: 12 months

Preparation date: 07.11.95


Summary Outline for Action Programme on Child Labour


1.Working title: Provision Health Services for Working Little Girls in Small Scale Enterprises of Denizli

2.Location: Denizli, Turkey

3.Background and justification:

In Turkey, today, the exclusion of child labour from the working force is a serious problem. There inclusion, however, creates further problems. Viewed from the standpoint of the political, economical, social and cultural structure of Turkey, the solution to this problem becomes more complex and much more long-term.

The data reveal the significance and determining effect of economic factors in the employment of child labour. But that is not all. It should be kept in mind that economic factors constitute, alongside political, social and cultural ones, an integrated whole. For example, such problems as tenure, security, employment guarantee as well as employment policies, inadequacies in education and instruction are all directly related to political solutions.

On the other hand, there is an established view, dating back to the thirteenth century that the best way to obtain basic training and a profession are through the relationship between craftsmen-apprentices. This further bolstered by cultural tradition. Our survey reveals that the roots of child labour is directly related to employment, forms of work and non-employment.

The orientation of children to work is directly related to class origins. Rural-rooted children are more inclined to child labour (apprenticeship).

It is not legally compulsory to employ an occupational physician in the workplaces where children are employed in full-time basis. Although employment of a nurse in such places is an obligation, it is not applied practically.

One day of the week the child workers should also attend to the apprenticeship school and the other days they work long hours in the workplace. If child workers who are covered by the apprenticeship training programme, become ill or injured, they can avail themselves of the services in the hospitals of the Social Insurance Association (SSK). These services are far from being adequate. The average time allocated by physicians to patients does not exceed 1 to 2 minutes. Child labour, excluding apprenticeship system, does not even benefit from such services.

As far as social welfare services are concerned, these services are supplies by Kizilay, the Turkish Red Crescent, in the form of soup-houses, located close to the apprentice training centers, which provide noon meals free of charge, only one day of the week.

As known, the action programme on ‘Health Services for children working in small scale enterprises in Ankara & Istanbul’ was to improve the working environment of children, the health and social welfare service network from which they benefit. Successful results have been obtained from the studies carried in Ankara&Istanbul with the help of ILO/IPEC. At the end of three year’s experience, the following advantages were obtained:

  • The number of children taking the service has increased from 20-30 (12-15 years of age) to 1000.
  • Quality and variety of the service have been raised by using Mobile Unit and Exhibition House.
  • The interest and support of the workers and the employers have been raised, their horizontal link has been expanded, and they became more sensitive to the issue,

The workers and working children in the region relied on and directed towards the service.

  • Strong ties have been developed with relevant General Directorate of the Ministry of Education, especially with the Apprenticeship Training Center in Ostim(Ankara)&Eastern (Ýstanbul) Industrial Regions.
  • Data obtained from the area is qualitatively and quantitatively superior compared to those obtained in Turkey until now.
  • The most important thing is that obtained data give clues about next programmes of action.

Environmental measurement studies which had been made by few holdings only, have reached small enterprises by using the opportunities of the programme. Such a high level of occupational health and safety service has not been given to small enterprises in our country until now. Environmental measurements and evaluation of the working environment revealed the necessity of collective efforts aimed at the environment as well as the individual efforts aimed at the children.

The most effective method of providing health and social welfare services to child workers is to operate at workplace level. The reason is simple. Child workers spend more time at workplaces than at home or in school. As a consequence, health hazards are prevalent in workplace.

‘Provision health services for children working in small scale enterprises’ programme includes the mobilization of the service given to small enterprises by improved medical equipment and the activation of this service with health personnel and social worker.

Services provided to child workers, however, should not be to the exclusion of older, trained workers. Since they work together, occupational diseases may be infectious. Furthermore, occupational diseases when diagnosed among the adult workers can alert protective measures to prevent spreading to child workers. As a consequence, the model for provision of necessary health and social welfare services, should be a comprehensive and all-embracing whole. Anyway, a service provided only to child workers and excluding the grown-ups, would cause reactions and may be even cause obstructions from the latter group.

From now on, it has been expected that the workers and employers who have positive impressions will increase their contribution to this service.

Studies carried out by our Instìtute with the support of ILO/IPEC in Ankara and Istanbul has shown that the model, that have been proposed to improve the working conditions of child workers in industry, has worked in the short run. Verifying the estimations about self-financing, studies in Ankara have been going on as before, despite the fact that ILO/IPEC support had ceased.

It can be seen that boys held a dominant place in studies performed up to now. Different approaches and solutions should be brought out for girls, who have a different place in society and show different types of behaviour.

Girls have different reasons than boys in entering working life. The reason is totally economic in cases of early employment. They give what they earn to their families. Families use this money either for buying some requirements or for preparing dowry for the girl. After being forced to marry at 18 at the latest, girls immediately give up working.

Thus they do not have the opportunity of learning a job, making career or guaranteeing their future life. Lack of choice and means drive girls into a dense network of exploitation. Their timid and helpless status also causes them to encounter with sexual harrassment.

Intervention studies should primarily aim at changing the present and future status of working girls. To reach this target, it is essential for them to perceive their independent personality and to communicate with a reliable social focus in solidarity, beyond the inadequate support of family. Those efforts require a special and specific action programme giving more importance to ‘social psychology’, in addition to the previous studies in FISEK/Ankara and FISEK/Istanbul.

First of all, a particular service channel should be opened for working girls and qualified personnel should work in this field. Those efforts are limited with the role expected fron women in the society and in working life. The project will not be able to overcome these limits in the short run. What should be done is 1)To build a connection with working girls and to provide the social solidarity support that they need 2)To build a connection with the enterprises employing girls, to motivate and help them with improving health and safety conditions in the workplace.

Denizli has completed many stages of industrialization although it is not a metropolitan city. It has not reached ‘greater city’ position yet, but it is confronted with dense migration. Textile industry is important in the region and more investments are made in this city compared to the other cities of the same size. There are two main communication roads linking Aegean region to the rest of the country and one of those roads passes through Denizli. The city has also an airport and a developing university.

Aegean region, involving Denizli, has very productive lands and is one of the wealthiest regions of the country. These conditions promote migration from inner parts of Turkey. Rapid industrialization and agricultural mechanization lead people to make the comparison of ‘living the great industrial revolution’ for Denizli.

As of 1981, there were 29 private firms employing more than 50 workers. This figure rose to 102 in 1995, The number of workplaces employing more than 100 workers, at present, is 52. According to the statistics of the Denizli Chamber of Commerce, there are 3.000 workplaces on a small- and medium-size basis. Of these, 53% are exporting their products. And, the total share of the textile sector, in total exports, is 75%. Of the total exports, 70% goes to the members of the European Community (EC).

Among the top 500 firms in Turkey, 9 are from Denizli. Of these 9 firms, all of them are tops in their own fields in Turkey. Foreigh investments are around 2%, and Denizli’s contribution to Turkey’s G.N.P. is l.4. Value added rates are 31% industry, 55% in services, and 14% in agricultare.

Analyses based on the census results show that Denizli province has confronted extensive internal migration from the other provinces since 1980’s. In the period of 1980-85, 3 out of one thousand people living in Denizli, had come from another province. This figure has increased to 15 out of one thousand between 1985-90 .

According to the analyses regarding 1980-85 period, Denizli province had received migrants either from the neighbouring provinces like Afyon, Burdur and Manisa or from mostly Eastern-Southeastern provinces like Erzurum, Agrì, Kars, Mus, Siirt, Van and Zonguldak.

1990 census revealed that 45% of the population lived in urban areas of Denizli. Rate of urbanization, which was 3.77% in 1980-85 period rose to 61.3% in 1985-90 period. Rural population has decreased by 2.8% in the recent years. 60.4% of the urban population has been living in the central district of Denizli. This central district (Denizli city) had a population growth rate of 3.76% in 1980-85 period which increased to 4.45% in 1985-90.

This situation shows the rapid population growth in central city, that comprises most of the urban population, and the high migration rate from rural areas. According to the estimations of State Planning Organization, population of Denizli city has been expected to be 262 489 in 1995 and 329 500 in 2000 .

One of the important features of the project ‘Health services for children working in small scale enterprises’, which we have been implementing in Ankara with the contribution of ILO/IPEC since 1992, is to ensure to stand without support, by increasing local contribution. However, for the project is yet new and in developmental stage, it is impossible to rely on merely the local resources. Moreover, the economic crisis in our country growing since January 1994.

Migration increases early employment of boys and girls. The important point is to raise the income of the family rather than to learn a job. For this reason, salaries have the priority and families are not interested in their children’s working environment at all.

According to the authorities in General Directorate of Apprenticeship and Widespread Education of the Ministry of Education, the Apprenticeship Education Centre in Denizli is one of the first examples in Turkey and has reached a certain level. Teachers are motivated. Their pleasure for the execution of this project in their school is expressed both by themselves and the authorities from the Ministry. In Denizli Apprenticeship Education Centre, a total of 3320 children take lessons one day in a week and work in enterprises during the other days. 235 of these children are girls at 15 years of age and under while 285 are girls of 16 and above. According to local authority, of 30 working children, under the age of 15, 1 is a member of an Apprenticeship Training Center. The rates are much better in Ankara and Istanbul.

Employers are cooperative and inclined to this kind of study, reflecting the cultural characteristics of local people. It has been considered that those characteristics will be quite beneficial in the self-financement of the project.

Although the university has been recently established and developing, it is not reasonable to expect the children born and grown up in Denizli to study in that university. Many of the students are coming from the other cities after giving a national board examination. Most of the people in Denizli will continue to send their children to workplaces instead of the university in the next years.

Determining the factors that lead girls to enter or withdraw from employment, developing inteventions aimed at reducing the differences between boys and girls and improving the solidarity of girls with each other and with the social organizations; are among the other objectives of the project.


4.Target group:

4.1.Working children in the small scale enterprises in Denizli at the age group of under 15.


5.Institutional Framework:

5.1.Description of the responsible institution:

Fisek Institute on Health Services and Research is a non-governmental organization promulgated in 1986 and active in the field of the provision of health services in small scale enterprises.

5.2.Collaborating Institutions: Ministry of Education

5.3.Collaborating Action Programme: ‘Health Services for children working in the small scale enterprises in Ankara and Istanbul (No: P.0908.3.442.153; P.0908.3.442.296; P.0908.3.442.295) and ‘Improving the working conditions of the children working in small scale enterprises’ (No.P.0908.3.442.402)



6.1.Development Objective: Elimination of child labour

6.2.Immediate Objective: Improve the working conditions and status of working girls by providing

6.2.1.To improve health services available to small scale workplaces both qualitatively and from the standpoint of increasing accessibility by working girls;

6.2.2.To evaluate the working environment of children and to use environmental measurement equipment in addition to the observations for this purpose;

6.2.3.To provide social advisorship services to working girls to make them aware of social opportunities, occupational options and leisure-time recreation activities;

6.2.4.To train working girls in occupational health&safety& social status thereby increasing their awareness of and demand for better health and social services, thus bringing about their increased participation for the same;

6.2.5.To include employers in the programme through face to face intercourse;

6.2.6.To keep the number of the workplaces and working girls reached and to increase their numbers;

6.2.7.To make 2 periodical check-ups to each children reached.

7.Major outputs

7.1.Increased awareness among the employers of the small scale enterprises on child labour and the means to improve the working conditions of the girl workers

7.2.Obtained support of the owners and workers of the small scale enterprises for the activities of the programme to improve the working conditions for the sustainability of the objectives;

7.3.Collected information on working environment of children in small scale enterprises;

7.4.Reached individual workplaces and working little girls under 15.

7.5.Made minimum 2 periodical check-ups to each children in the target group in one year.

8.Main list of activities

8.1.Making the health checks at the entry and throughout the period of employment;

8.2.Informing the child labour about a health unit that can reach them in case of occupational diseases and accidents;

8.3.Meeting the social needs of the working girls through the health and social services of the unit;

8.4.Attracting and getting the support of the owners and workers of the small scale enterprises for the activities of the programme to improve the working conditions;

8.5.Evaluating the working environment of girls and use environmental measurement equipment in addition to the observatory check list;

8.6.Training the employers and workers;

8.7.Reaching 100 workplaces with 50 or less workers and 1000 working girls under 15.

8.8.Making at least 2 periodical check-ups to each children in the target group during the course of the programme.