Presentation by prof. Benjamin Fayani of the Faculty of Medicine, Cotonou, Benin at the WHO/TNO/Dutchgovernment Congres 'Connecting Health and Labour' 29 - 1 December 2012

1. How occupational health
services are provided in the
context of integrated primary
health care:Case of Bénin
Professor Benjamin FAYOMI
Occupational and Environnement Unit
Faculty of Medecine
Cotonou, Bénin

2. Key points
 Who are the workers in our Context
 Our experience 1
 Our experience 2
 Our difficulties
 Our perspectives

3. 9 Millions peoples

4. workers in our Context

5. The results of the study reveal in 2008 that
 while the public service hardly offers 29 400
jobs (about 9 % of the working population),
 and while the modern private sector offers
approximately 34 400 jobs (about 11 %)
 the informal sector occupies the front stage
with about 269 800 jobs (that is 80 %)
 Therefore, this sector is a strategic sector

6. Example
 The sector of transport, in particular that of
the motorcycle taxis ( zémidjan ) alone offers
more than 185 000 jobs to the young
Beninese, meaning more than half of formal
activities.
 Based on a daily average profit of fcfa 2500,
this sector would generate nearly 46,250
billions fcfa every year. = > 7 000 000
Euro/year

7. Resources put in place for 10%
of workers
 Existence of legal resources
 Human resources(doctors, nurses, engineers
etc.)
 Material resources
 Financial resources, etc.

8. 90 % of the working population which is part of the
informal economy are not survey
Conclusion : the health protection in the informal
economy workers is not assured

9. Our FIRST experience of integrated
primary health care in informal
secteur in Bénin was named :
Joint "Occupational health
care program for the Benin
informal economy "

10. Basis for the program: Context
and justification
 Occupational healthcare has at all times been
set up to favor the government-regulated)
workers (formal Economy).
 As previously explained, these workers represent
only 10 % of the working population

11. Category of occupation
 Painters (children)
 Mechanics
 Vulcanizers
 Farmers etc.

12. Motobycycle repair
Washing hand with
hydrocarbure
product
soil pollution

14. Our Mission/objectif
 Reach one of the Millennium objectives
which is “the fight against poverty" through
Accessibility to quality health care
 General objective
Contribute to the improvement of the health of
the Benin informal economy workers

15. Specific Objectives
 Enable access to primary healthcare for all
the socio professional sectors of the informal
economy
 Set up a system of health protection and
prevention.

16. Expected results
- Ensure accessibility to quality health care
- The professional pathologies are detected
and taken care of immediately
- The statistics of occupational hazards in the
informal economy are available.
- Local care of nearness are supplied.
- Self medication is reduced.

17. Strategies
Two types of strategies are combined
 Active screening
 Workers’ participation

18. Strategy 1
Active screening consists in:
 Providing local health care through
workplaces visits in order to:
 Know fields of activity and working
conditions
 Detect the work related diseases
 Satisfy the expressed needs.

19. Strategy 2
 Workers’ participation meaning
Membership to the program
Collective choice of the services to be offered

21. ACTIVITES
1- Preventive care activities
 Systematic medical visits of the workers
 Additional health assessments (blood, eyes,
etc.)
 Practice of specific vaccinations or not
2-Activities of promotional care
 Communication and raising awareness for a
change of behavior (contagious and not
contagious Diseases)

23. ACTIVITIES OF CURATIVE
CARE
 Provision of health care on the workplace
 Refer for specialized care
 To the medical base the humanitarian Health
center Call Holy LEONIE
 or in case of emergency to the Health center
which is closest and well equipped.

25. FUNCTIONNING
 A medical team is organized:
 A general practitioner
 A nurse
 A nurse's aide
 Car driver specially trained for the
maintenance and the disinfection of the
installations once the medical truck parked
This team is supported by an occupational
health doctor or Occupational heath student

26. Hospital truck
 AIR-CONDITIONED with adequate plugs no
matter the type of site electric installation.
 Truck amenities include:
 4 waiting cabins,
 2 consultations rooms with at least one equipped
with accessories for visual screening
(Ophthalmology),
 Electrocardiogram ( ECG).

27. Hospital truck (Cont’d)
 Biomedical analyses Laboratory
(place for sampling)
 Pharmacy.
 1 Consultation office
 A mapping of the closest Health
centers for the cases to refer
urgently.

28. COST
Consultation and medical care: all inclusive of
1000 FCFA / person =
1,5 Euro
Pharmacy: chargeable to the beneficiary
Occupational health visit : 2.000 FCFA / person
= 3 Euro
Biological assessment depending on the risk:
Chargeable to the beneficiary.

29. PROGRAM’S POTENTIAL PARTNERS
 Occupational Health and Environment training
and research university unit (URESTE),
 International Labour Organization (regional office
of West Africa) NOT ACTIVE SUPPORT
 …….etc.

30. MANAGEMENT OF THE PROGRAM
 MUSANT, a complementary insurance
organization with headquarters at Fidjrossè
(Cotonou)
FAILURE

31. CAUSES OF THE FAILURE
 Management method was not collective
 Fast deviation towards general healthcare
 Fast deviation towards government-
regulated companies

32. Other experience (a)

33. Motocycle taximen in
Cotonou
Clinical and biological survey since 2004
Our Others experiences

34. Métabolites urinaires du benzène et du
benzopyrène
1
0,8
0,6 Vm benzène
Vm PMA/10
0,4 Vm 1-HOP
0,2
0
Taxi-moto Témoin

35. Adduits et des bases hydroxylées et
méthylées d ’ADN
5
4
Témoins
3
Conducteurs de
2 taxi-moto
1
0
Adduits d’ADN en 8-HO dG /108 dG m 5 dC (%) 10µg
fmol/µg ADN X10 ADN /10

36. Other experience (b)

37. Use of watering cans to spray pesticides

39. Our perspectives: Based on our experience

40. Link Governement health service with informal workers
group

41. Concretely
 Global engagement
 Re-organisation
 Training
 Implementation progressively

42. Global engagement
 Regional engagement = ILO/WHO (Thinking
about the project called JOINT EFFORT (NO
CONCRETE RESULT IN AFRICA)
 National engagement (different ministery)
 Workers engagement

43. 9 Millions peoples

44. HEALTHY FLOWER S SELLER