SS40-02 IMPLEMENTATION CHALLENGES OF BASIC OCCUPATIONAL HEALTH SERVICES IN SOUTHERN AFRICA

Abstract

Abstract Introduction Access to occupational health services remains constrained in most southern African states. The discipline of occupational medicine and basic occupational health services (BOHS) have had a challenging gestation, and a grossly protracted delivery process. Access levels to occupational health services are below 20% in southern Africa. Materials and Methods A systematic review of literature was carried out to evaluate the implementation of BOHS. This was complemented by personal experiences of the author in southern Africa gathered through the implementation of several regional occupational health projects. Results Occupational health services are usually provided by general medical practitioners in most countries in southern Africa. Occupational medicine is not a developed specialty and lacks central coordination and implementation structures. In almost all countries, except South Africa, very few countries have ratified the key International Labour Organization (ILO) Conventions: C155 on Occupational Safety and Health, and C161 on Occupational Health Services. None of the countries in southern Africa have implemented BOHS. The legal frameworks in all the southern African countries are fragmented and lack harmonization. There is a severe shortage of human resources with requisite qualifications and experience in occupational health. Integration of occupational health services into primary health is constrained by lack of comprehensive legal frameworks and exclusion of such services from countries’ national health strategic plans. Conclusions Southern Africa is yet to implement BOHS. There is an urgent need to build the necessary human resources, infrastructure and supporting legal frameworks to support implementation of BOHS in southern Africa.