Connecting Health and Labour

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Connecting Health and LaBringing together occupational hea

and primary care to improve

the health of working peopleExecutive Summary

Global Conference Connecting Health and LaboWhat Role for Occupational Health in Primary Health

The Hague, the Netherlands, 29 November 1 Decem


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E X E C U T I V E S U M

Key messages:

l Workers health is an integral part of general health and daily lif

l Health systems should facilitate local strategies to meet workers

l In moving towards universal coverage, those at greatest risk or hneeds should be included first.

l When developing policies about workers health all relevant stakbe involved.

l Training in health and work should be part of all health care pro

l Empowerment of workers and the encouragement of decision-mfor the promotion of the health and safety of workers


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Introduction

1. Currently, a number of countries are reformingtheir health systems based on the values andprinciples of primary health care to improveservice delivery and cost-efficiency and to ensure

equity. National debates on health reforms oftentouch upon the insufficient collaboration betweenhealth and labour sectors, the organization ofpreventive and curative health services for workingpopulations, and their relation to primary care.

2. The Alma Ata Declaration from 1978 calledfor bringing health care as close as possible to

where people live and work. Recently, the WorldHealth Assembly urged countries to work towards

full coverage of all wooccupational and worinjuries (Resolution WHAfor implementing vertical

context of integrated primWHA 62.12 from 2009).

3. The Hague Confereprocess to improve covoccupational health sethe 60th World Health contributes to the debate

and WHO are now enga

Health and labour

4. Employment and working conditions have

powerful effects on health equity. When these aregood, they can provide social protection, socialstatus, personal development, social relationsand self-esteem, protection from physical andpsychosocial hazards, and positive health effects.The health of workers is an essential prerequisitefor household income, productivity and economicdevelopment. Therefore, maintaining and restoring

working capacity is an important function of healthservices.

5. However, hazardous working conditionsand substandard forms of employment result inconsiderable burden of ill-health and injuries

6. There are many e

primary prevention of odeveloping healthy work pand restoring functional coverage of occupationalow, and where they domeet the expectations oaccess to the most basiand measures for protec

diseases.

7. At the same time, tthe provision of health cimpact on peoples abilit


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9. Currently, health services based on thesevalues are not as widely available as is desirable.Closer collaboration between occupational healthand primary care would enhance the opportunitiesto contribute to productivity and to extend working

life. This requires movinon diseases and healthemphasizes optimizingindividuals.

Towards an integrated approacfor addressing work by health serv

10. A more integrated approach to occupationalhealth and primary health care will yield a biggerimpact on the health of people, than each can

achieve on their own, to secure work-focusedhealth care. How that integration works in practice,depends on national and local circumstances.Substantial global demographic trends (ageing,migration etc.), changing health problems and thechanging nature of work mean that this integratedapproach will become even more important in thedecades to come. This will require more care to

be provided, without the certainty of any increasethe professional manpower. Important assets ininitiating this collaboration are the experiments thatcan be found in a number of countries and settingsaround the world.

11. The following princidevelopment in pursuingto occupational health an

a. Workers' health is part

b. Health systems shouldto meet workers healt

c. In moving towards ungreatest risk or havingtargeted first.

d. When developing poliall relevant stakeholde

e. Training in health and health care profession

f. Empowerment of workeof decision-makers areof the health and safe

Delivering occupational healthin the context of integrated primary hea


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of basic primary health care. New mechanismsmay need to be developed where existingones are inadequate to meet priority needs.These should, as far as possible, be integratedinto existing national or local health financingsystems.

d. Developing human resource and technologicalcapacities at the primary care level for theeffective delivery of essential interventionsand basic health services for prevention ofoccupational and work-related injuries anddiseases through training, consultation,information, and supportive tools, includingtelecare.

e. Strengthening and expanding specializedoccupational health services, including thebasic occupational health services and scalingup access to such services and increasing thenumber of interventions with priority on primaryprevention of occupational hazards;

f. Evaluating the models for service delivery andfinancing for occupational health and primarycare, and carrying out research on barriersto access to and coverage with preventiveinterventions.

14.People in their environment, including work,should be in the center of health care. This requires:

a. Strengthening the role and responsibilities

of the primary care providers for all health-related aspects of personal life, including earlyrecognition of occupational and work-relatedill-health, as well as preserving and restoringworking capacity of individuals;

b Building the capacities of primary care centers

d. Providing clinical guidhealth care professionthe impacts of workworking capacity;

e. Empowering and suwork communities to their own health, to poccupational hazardsat the workplace, for developing programmintroducing tools for work improvement, sand safety representatactivists;

f. Carrying out researchfor empowering worketo take control over teffectiveness of work and community based

15. Protecting and prorequires a new, participat

should include:a. An integrated respons

health systems1 to thein the ongoing healthbeing given to the neemigrant and self-empenterprises;

b. Involving labour stakehtrade unions, governmprivate sector in the dreforms and the deveregional (preclinical, and plans;


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such as Occupational Safety and HealthConvention 155, Occupational Health ServicesConvention 161 and Promotional Frameworkfor Occupational Safety and Health Convention187, establishing connections between labourInspections and occupational health services andpromotion of good practices on occupational

health and safety and primary care.

16. The health of workers should be taken intoaccount in designing and implementing policies inall sectors. This requires:

a. Identification of workers' health impacts andco-benefits of national policies and strategiesin the area of labour, environment, education,agriculture, economic development, trade etc.as well as capitalization of benefits and risks, andenabling healthy public policies as a commonground for dialogue across sectors.;

b. Development of natiworkers health involvsectors, creating comof-government health the non-health benefihealth;

c. Ensuring input fromdevelopment and impublic programmes fosafety, identifying, methe benefits of such prof integrated, compre

d. Addressing the healthazardous working c

dealing with the indevelopment, and labthe provision of hpopulations,

Next steps

17. WHO, and its networks of collaboratingcentres for occupational health and primary carewill collaborate with ILO, the non-governmentalorganizations in official relations with WHO andwith the other international stakeholders, such asthe World Bank and the International Social Security

Association, on the following actions:a. Developing policy options, methodologies and

case studies and integrated financing mecha-nisms, including costing of the delivery of essen-tial interventions for occupational health at theprimary care level

technicians and commfacilitating the inclusiointo under graduate aand education in medhealth;

d. Collecting, evaluating

studies and exampleinterventions and basnal health in the conhealth care and settindisciplinary research oaspects of health sys


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Connecting Health and Labour