Knowledge, Attitude, and Practice on Occupational Safety and Health in the Formal and Informal Sectors – 2024, Freetown, Sierra Leone: A Workplace-Base Survey

Introduction: Workplaces are vital for Occupational Safety and Health (OSH) knowledge dissemination. This study examines OSH knowledge, attitudes, and practices among formal and informal sector workers in Freetown, Sierra Leone, and their associations with workplace characteristics. Methods: A cross-sectional survey was conducted using a validated, semi-structured questionnaire to collect data on sociodemographic characteristics, workplace safety factors, and occupational safety indicators. The survey assessed 3 primary outcomes variable adequate knowledge, good attitude, and good practice. Multivariable analyses were used at significant level ( P < .05) to examined associations between independent and outcomes variables. Results: The study included 516 respondents, predominantly were male (84.3%). Educational attainment varied, with 23.6% having tertiary education and 4.7% non-formal education. Literacy rates showed 76.6% were literate. Significant disparities emerged between sectors: formal sector workers demonstrated higher rates of adequate knowledge (60.7%), good attitudes (54.9%), and good practices (77.3%) compared to informal workers. Formal sector employment was significantly associated with better OSH outcomes, including knowledge (aOR = 2.4, 95%CI: 1.43-4.15, P < .001) and practices (aOR = 16.2, 95%CI: 2.80-95.81, P < .002). These findings highlight substantial sector-based differences in occupational safety and health indicators. Conclusion: This study reveals substantial and significant disparities in occupational safety and health (OSH) between formal and informal sector workers. Formal sectors employment is strongly associated with better OSH outcomes, particularly safer practices, thus, underscoring an urgent need for targeted policy, tailored training programmes, gender-sensitive interventions, and regulatory interventions to protect vulnerable informal workers.