Ensuring a Positive Practice Environment: Occupational Safety and Health for Health Worker Productivity

August 2012

Rachel Deussom, IntraHealth International; Wanda Jaskiewicz, IntraHealth International; Elizabeth Adams, International Council of Nurses; and Kate Tulenko, IntraHealth International

Saving lives should not mean you risk your own
Providing high-quality health care should not be hazardous to the health worker. Historically, the focus on improving health service delivery quality and ensuring patients’ rights has superseded attention to the personal safety and health of the provider (NIOSH 2009). But if health workers are not protected, how can the wellness of their patients be assured?

Health workers are adversely affected by biological, physical, chemical, and psychosocial occupational safety and health (OSH) hazards they face in their work—the HIV infection a Tanzanian doctor contracts because there is no postexposure prophylaxis when she is accidently stuck by a patient’s needle; the violence an Afghan nurse subjects himself to by treating communities in a conflict zone; the chronic headaches a Bangladeshi lab technician endures from chemical exposure; the fear and insecurity a Congolese midwife faces by traveling at night to tend to a mother in labor. (See Appendix: Occupational Hazards Faced By Health Workers in Resource-Constrained Settings.) In spite of global, national, regional, and local initiatives to develop a skilled health workforce to deliver better health outcomes, efforts to reduce OSH risks for health workers in developing countries are far from sufficient to protect their health. Particularly for developing countries facing a health workforce shortage, saving lives should not be accomplished by sacrificing providers’ own lives. Without healthy, well-prepared, motivated workers, the Millennium Development Goals for health cannot be achieved (PPE 2012).

Effective OSH measures are universally recognized as essential contributors to national workforce health and productivity (WHO 1994; ILO 2001; Houtman, Jettinghoff, and Cedillo 2007). However, only 5%-10% of workers in developing countries have adequate occupational health services (Houtman, Jettinghoff, and Cedillo 2007), and the rate of on-the-job injuries among health workers increased in the last decade (NIOSH 2009). Sub-Saharan Africa represents the area with the highest occupational exposures (Houtman, Jettinghoff, and Cedillo 2007; Reda et al. 2010).

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