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Occupational Health and Primary Health Care. What are the opportunities?

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Presentation by Dr Maria Neira, Director, Public Health and Environment, WHO at the WHO/TNO/Dutchgovernment Congres 'Connecting Health and Labour' 29 - 1 December 2012

Presentation by Dr Maria Neira, Director, Public Health and Environment, WHO at the WHO/TNO/Dutchgovernment Congres 'Connecting Health and Labour' 29 - 1 December 2012

Published in: Health & Medicine
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  • 1. Occupational Health and Primary Health Care What are the opportunities? Dr Maria Neira Director, Public Health and Environment
  • 2. Why occupational health? 2
  • 3. Occupational risks are amongthe leading risk factors for burden of disease
  • 4. Occupational healthhas serious economic consequences• Annual costs of occupational ill-health – Britain – 2.5 billion costs to employers – United States US$ -52 billion workers compensation – China - US$37 billion – direct and indirect costs• Good occupational health can be an investment – Lower costs for medical care – Greater productivity – Social wellbeing
  • 5. Is there political commitment? 5
  • 6. 60th World Health Assembly, 2007Resolution 60.26 "Workers Health: Global Plan of Action" • Devise national plans of action on workers health • Work towards full coverage of all workers with essential interventions and basic services for prevention • Strengthen core institutional and human resource capacities • Incorporate workers health in other national and sectoral polices • Stimulate reintegration of sick and injuries workers
  • 7. On 16 September 2011 the UN General Assemblycalled upon the private sector "to promote and create an enabling environment for healthy behaviours among workers, including by establishing tobacco- free workplaces and safe and healthy working environments through occupational safety and health measures, including, where appropriate, through good corporate practices, workplace wellness programmes and health insurance plans."*Political Declaration of the High-level Meeting of the General Assembly on thePrevention and Control of Non-communicable Diseases. UN GeneralAssembly, Sixty-sixth session, Agenda item 117, 16/09/2011
  • 8. On 21 October 2011 in Rio de Janeiro120 governments pledged"To strengthen occupational health safety and health protection and their oversight and encourage the public and private sectors to offer healthy working conditions so as to contribute to promoting health for all."* *Rio Political Declaration on Social Determinants of Health, World Conference on Social Determinants of Health, Rio de Janeiro, Brazil, 19-21 October 2011
  • 9. 33 years ago - Alma Ata Declaration "It [Primary health care] is the first level of contact of individuals, the family and community with the national health system bringing health care as close as possible to where people live and work,.."What happened with primary health care at work?
  • 10. What capacity we have? 10
  • 11. There are specialized OH servicesbut access remains low Global population – 100% Access to health services – 70% Access to social protection for occ. ill- health – 30% Access to occ. health services – 15%
  • 12. There are effective interventions for preventionand control of occupational ill-health• Primary – Legislation and incentives – Engineering controls – Personal protective equipment – Training Which interventions are the most effective?• Secondary Which interventions can be – Medical surveillance delivered at the primary care – Screening level? – Recognition of occupational diseases• Tertiary – Job modification – Return-to-work – Rehabilitation
  • 13. There are human resources - but are they sufficient?• Human resources for health – 9 million physicians – 19 million nurses/midwives – 307 thousand environmental health/public health workers (low and upper middle income countries only) – 1,5 million community health workers• Human resources for safety – 120 thousand labour inspectors 57 countries with critical shortage of – XXX workplace actors (health health workforce and safety committees, safety agents, workers volunteers)
  • 14. What are the policy options? 14
  • 15. Option 1: Basic occupational health servicesfor all• Provide specialized service using occupational health methods• Physician and nurse with 3 month training in occupational health• 1 physician and 2 nurses required per 5,000 workers• Human resource estimates 3 billion workers - 6% increase required + 600,000 physicians + 1,2 million nurses• Current situation – 4.3 million global shortage
  • 16. Option 2: Integrated primary health care for allworkers• Provide preventive and curative care for workers as part of comprehensive primary care• Incorporate essential OH interventions in the national packages of basic health services/interventions • Potential to reach out to 70% of working population • Enhance prevention in primary care• Strengthen specialized occupational health services • Focus on quality, effectiveness, community outreach • Provide OH specialized support to primary care• Increase collaboration between occupational health services and primary care centres? • Ensure continuity of care • Avoid duplication
  • 17. Occupational health in the context of integrated primary health care
  • 18. Challenges• Defining and costing essential OH interventions• Introducing mechanisms for financing• Building capacities in primary care• Empowering work communities for health• Implementing policies and regulations for health protection at work
  • 19. Urgent action is needed• What can be done by governments, service providers, social partners, financing and research in moving to universal access to occupational health?• Which are the three things that we could do in collaboration that would make a difference at an international level? 19

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