Factory workers are the lifeblood of the ready-made garment (RMG) industry. Global factory research has repeatedly shown that investing in worker health and safety not only boosts individual satisfaction but also profoundly impacts production environments’ stability, efficiency, and overall success.
After the success of the 2020-2022 COVID-19 mitigation program in three textile mills, Integral Global (IG) was awarded another project with the John C. Martin (JCM) Foundation to reduce infectious disease spread and address the health and wellness concerns of ready-made-garment (RMG) factory workers in Bangladesh. This program is similarly implemented in collaboration with AYAT Education, a local organization based in Dhaka, that prioritizes sustainability, innovation, and bridging societal gaps in health education. The project has also received support from the Bangladesh Garment Manufacturers and Exporters Association (BGMEA), who have expressed sustained interest in IG and AYAT’s public health initiatives.
For first phase of the 3-year project, IG and AYAT worked together to conduct gap analyses, record baseline observations, and report findings to management teams at three garment factories and textile mills located in the cities of Ashulia and Gazipur just outside Dhaka.
In September 2023, IG and AYAT Education initiated 3-day in-house Worker Wellness Days in RMG factories and mills. The campaigns, which are tailored to the specific needs of each factory or mill, incorporate various activities designed with the goal of expanding access to vital health assessments, identifying existing health concerns, reducing the spread of infectious diseases, and strengthening basic health education. During Worker Wellness Days, IG offers primary healthcare screening from outside general practitioners, gynecologists, and nurses from the Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine, and Metabolic Disorders (BIRDEM); the Bangabandhu Sheikh Mujib Medical University (BSMMU); and Dhaka Medical College Hospital (DMCH). Each worker gets a vital signs and blood glucose assessment and is evaluated for skin, musculoskeletal, and gynecological concerns. On average, 83% of those screened will require further consultation and are offered prescriptions and referrals to local specialists where needed.
Each RMG Worker Health & Wellness Campaign follows a strategically designed process:
To date, across six RMG factories, IG and AYAT have screened approximately 4,000 workers. Of this total, 46% were considered “alert cases,” meaning there were abnormal levels of regulatory blood sugar (RBS), blood pressure (BP), pulse, oxygen saturation, and/or temperature. Once notified, each alert case was directed to one-on-one consultations with a primary care doctor. Women were also given the opportunity to have one-on-one consultations with a gynecologist regarding any women’s health concerns. IG and AYAT’s data collectors documented all clinical notes and numbers and are currently in the process of detailed data analysis and reporting.
At the end of September, IG, AYAT, and the JCM Foundation held a roundtable event titled “Fostering the Health and Wellness of Our Workforce.” Attendees included representative from the European Union (EU), International Labor Organization (ILO), World Health Organization (WHO), BGMEA, H&M Group, Primark Stores Limited, garment factory and textile mill management, and various other organizations engaged in RMG health and wellness. IG’s Director, Mr. Nabil Ahmed, gave the keynote presentation and moderated the discussion. The event fostered critical conversations about the future and sustainability of quality health initiatives across the industry. One key output of the roundtable was a consensus on the need to develop an RMG worker health and wellness group between BGMEA and leading health and trade organizations to discuss current initiatives in the sector and potential future activities that ensure long-term impact and standard, equitable efforts.
In December 2024, IG and AYAT launched their new online resource, titled “Fabric of Health: Bangladesh’s RMG Factory Worker Health & Wellness Toolkit.” This site acts as a standard source of information relevant to the RMG sector on the issues of factory worker health, wellness, and productivity. The site provides information on priority topics including respiratory illness, routine vaccinations, handwashing, nutrition, and everyday health concerns in both English and Bangla. The resources presented are intended to serve BGMEA member factories with essential information targeted toward both factory management and workers. Explore the Toolkit at rmghealthtoolkit.com.
In October 2025, IG hosted a meeting to celebrate the accomplishments of the last five years and discuss the sustainability of these initiatives. The event brought together diverse stakeholders, including AYAT Education and AYAT Nursing, BGMEA, ILO, factory owners, and brand representatives. In addition to presenting the outcomes and successes of the Fabric of Health initiatives, speakers and attendees shared their perspectives on the importance of promoting RMG worker health and explored various avenues for continuing the momentum of the work.
Findings from IG’s KAP survey show that 95% of the RMG workers surveyed rated the Worker Wellness Days as either excellent or good, 80% shared new knowledge with their families and friends, and ~99% want to see more Worker Wellness Days and are committed to attending two events per year.