Capacity Building for Occupational Health for Workers in South Africa
Inakshi NaikOHS Training Department, NIOH29th October 2013Hong Kong
Overview of the presentation
• Overview of the National Institute for Occupational Health (NIOH) SA
• Training needs assessment• Training in different categories and levels• Gaps in training – shortage of skills• Current initiative to fill in the training gaps• Short Courses/seminars/workshops to develop
capacity• Strengths of NIOH in delivering the programme
National Institute for Occupational Health (NIOH)
Established in 1956 (Pneumoconiosis Research Unit)
Advisory Statutory Service Autopsy
Services Specialized
Laboratories
HealthHazardEvaluations
ResourceNetwork
6
• Universities and other Institutions
• Local & International Partnership
• Trade Unions, NGO and Business
• Govt. and Public Entities
Services Research
Back Office
SupportTraining
Post Graduate Qualification in OH for Medical Practitioners
• Post Graduate Diploma in Occupational Health • Part Time: Offered over 2 years in 8-10 weeks• one week blocks. • Offered by 6 Universities. • UCT offers distant learning
Post Graduate Qualification for Occupational Health Nurses
• Post Basic Nursing qualification• 9 Universities and one private Academy offers
Masters, B. Tech, Diploma and Certificate courses over one-two years period.
• B Tech qualifications offered by University of Technology
• Registration with the SA Nursing Council with minimum DoH nursing
Qualification forOccupational Hygienists
Registered Hygienist in 3 different categories with SAIOH in SA• Hygiene Assistants• Hygiene Technologists• HygienistsEducation and Training Requirements• Occupational Hygienist Post Graduate Qualification
3 Universities offer a Diploma and Masters Degree in and PhD in Occupational Hygiene over two or three years (part time/ full time),
• Offered as DPH or MPH Occupational hygieneApplicants must have a four-year qualification from a university
• Being registered with the South African Institute for Occupational Hygiene (SAIOH) at the minimum of the Occupational Hygiene Technologist level.
The Wits School of Public Health, in association with the NIOH, offers a Diploma in Occupational Health (DOH) and MPH Occupational Hygiene
Weaknesses Identified in the Present System for Training of Different Categories of Hygienists:
In House Training• No defined requirements• High registration failure rates• No mentorship programme • Present application form – summary of educational qualification
and employment history • Assessors lack full understanding
of candidate level of competency• Little practical and experiential learning• Provider also is accreditor
New Proposed Training for Occupational Hygienists in SA
• Registration model based on competency levels• Bench mark proposed skill requirements against
international standards • Meet IOHA registration requirements• Develop a skills matrix • Develop detailed skill definitions per grade• Mentorship programme support development of
practical skills• Promote use of Personal Learning Portfolio as part of
assessment processAdapted from SAIOH Deon Van Vuuren (Chairperson SAIOH)
OH Learning for Occupational Hygiene Qualification
• The Occupational Hygiene Training Association (OHTA) was formed to promote better standards of occupational hygiene practice throughout the world.
• They develop training materials and make them freely available for use by students and training providers.
• Promote an international qualifications framework so that all hygienists are trained to a consistent, high standard, recognized in all participating countries.
• Three levels of course: Foundation level, and progress through intermediate level to advanced level
Downloading of training materials is free of charge but is subject to the Terms of Use of OHlearning.com.
Training for Other Occupational Health Workers Provided at NIOH
• Occupational epidemiology (MPH)
• Information sciences
• Residency training in Occupational Medicine
Partnerships with universities, internship programmes and experiential learning.
Laboratory based sciences (Scientists. Technologists & Technicians)
Toxicology Analytic chemistry Pathology Immunology/Microbiology
Students from India trained in the Analytical Laboratories for metals, organic exposures
PHC Training Initiative by the Department of Health, SA
The re-engineered approach to providing PHC services proposes a population based approach for delivering of PHC outreach service
Who is the Training for ?
• Community Health Workers• Primary Health Care Nurses• Family Medicine Doctors• Hygienists/Technologist/Technicians/
Environmental Health Officers• Health and Safety Representatives• Labour Inspectors• NGOs, Trade Unions
Clinic / PHC
District Hospital
Regional HospitalTer
tiary
Hospita
l
Outreach CHWShort
Courses
Academic Learning
CHW
s, Nur
ses,
Envir
onm
enta
l Hea
lth
Office
rs & H
ygien
ists,
Docto
rs
Proposed Training at Different Levels
OHLearning
and other support
Ward Based PHC Outreach Programme- CHW• DoH Project: Funded by USAID• Ward based PHC Outreach Team• 10 000 CHW trained in phase 1• HIV, TB, ANC, Child nutrition but not OH • Introduce OH screening tools
6 CHW 270
Families each
Professional Nurse
Team Leader
EHO
Health Promoter
Functions stipulated for EHO:
Monitor OH and safety in local businesses
Manage environmental noise hazards
Clinic / PHC
District Hospital
Regional HospitalTer
tiary
Hospita
l
Outreach CHWShort
Courses
Academic Learning
CHW
s, Nur
ses,
Envir
onm
enta
l Hea
lth
Office
rs & H
ygien
ists,
Docto
rs
Proposed Training at Different Levels
OHLearning
and other support
Motivation for Training PHC Nurses in OH
• Where an employee develops ill health due to occupational causation the client may consult a health care worker at a public clinic.
• PHC nurses are the gatekeepers of the health system
• They are not taught the basics of occupational health in their training and are thus not skilled in the identification of an occupational disease.
• Through the early detection of disease the morbidity associated with occupational disease can be reduced thereby decreasing the disease burden in the country.
Training of Public Health Care (PHC) Nurses in Fundamentals in Occupational Health- NIOH Initiative
Aim: • To equip a PHC nurse with information/skill to be able to take an
appropriate occupational history
• Refer suspected occupational disease cases to the next level of referral, i.e. The Regional/ District hospital.
• To have a high index of suspicion for work-related problems and identify sentinel events.
• Knowledge of referral systems that exist within the district.
• To liaise with the Environmental Health Officer, Labour inspectors
Structure of the Course for the PHC Nurses • The course will be five days in duration. A combination of theory and
practical teaching methods
• A site visit and a virtual site visit will be included in the teaching methods.
• Assessment will be conducted through continuous formative assessment and a summative assessment.
• Learners will be required to complete 10 health assessments of employees in the PHC setting.
• On successful completion of assessments a competency certificate will be issued by the NIOH.
• SANC accreditation of this course will be requested.
Global Program in Occupational Health Practice (GPOHP)
What is the GPOHP?• The Global Program in Occupational Health Practice is an internet-based,
instructor-led distance-learning program for professionals in either occupational health services or occupational hygiene.
• The program consists of two tracks, the Occupational Health Practice Certificate and the Occupational Hygiene Practice Certificate.
• Each contains three consecutive courses that build on each other. However, the courses may be taken separately. Courses are ten weeks long.
• All participants receive a "Certificate of Competency” on completion from UIC. School of Public Health
WHO Modules in Occupational Health, Hygiene and Safety
• The WHO Modules in OH were developed by a team of experts from the Division of Environmental and Occupational Health Sciences, School of Public Health, University of Illinois - Chicago, USA, also a WHO CC in OH.
• The modules were developed to execute the 49th World Health Assembly Global Strategy for OH
• The materials are case-based modules in the specific sectors of agriculture, manufacturing, and the health service
Aim of the CourseThe aims of the course were to develop and strengthen
the following approaches in OH:• Anticipate and recognize workplace hazards
• Describe exposure to workplace hazards and their health effects
• Generate recommendations for preventing exposure using available resources and technologies
• Develop a programme plan for addressing workplace hazards
On Completion of the CourseThe participants are equipped to:• Complete an occupational history• Recognize a work related injury or illness• Conduct a qualitative risk assessment of a workplace• Conduct an incident investigation• Categorize exposure groups• Complete an exposure and health effect rating chart• Develop a strategy for collecting quantitative data• Recommend intervention strategies for reducing
exposure• Begin a programme plan for various workplaces
• The week-long course was attended by close to 90 participants from both public and private sectors.
• A certificate of competency (from the University of Illinois - Chicago and the NIOH, Johannesburg) was issued to all participants scoring higher than 70% on post-course performance- and knowledge-based evaluations.
• A CD of the full course was created as an Integrated E-Learning Platform – essentially a video recording of the presentations, to be used as a training tool by trainers for future capacity building.
• With the aid of the CD further 330 delegates in 10 centres ( 9 provinces and 1 national centre) were trained within 4 months in 2010.
• The delegates were HSR, wellness managers, safety officers, nurses
• The course has a “Train the Trainer” component
Training for Medical Officers (Namibia)• WHO: Protection of the Human Environment
Worker’s Health• Ministry of Health and Social Services.• Swakopmund, Namibia 2011• District Health Medical Officials in Namibia • Delivered by Dr. Ivan Ivanov (WHO), Dr. Norbert
Wagner (UIC, SPH, and Dr. Tony Cantrell (NIOH, SA)• 2 weeks course: 1 week Occupational Diseases , 1
week Occupational Hygiene
Health and Safety Representative (HSR) in Pathology Laboratories (Course Overview)
We trained 268 HSR countrywide on our intranet in 2012.
Current around 170 HSR being trained
Course specifically designed to identify hazards and risks associated in pathology laboratories
Modified for any environment
Stoffenmanager: Background and History
• Web-based IT-tool (public and freely available) to help small- and medium-sized enterprise (SME) which allows non-expert users in the companies to manage their dangerous substances more efficiently.
• Developed by consortium: Dutch ministry of social affairs (owner & funding) ,
BECO , TNO and Arbo Unie (research & development)
• First development: risk prioritization (control banding)
• Subsequent: quantification and validation of the exposure process modelinitially inhalation
• March 2008: version 4.0 Separate exposure estimation for dermal exposure
Changing Focus of Occupational Risk Management for Workplaces Exposure to Chemicals
Traditional• Rely on technical
experts to evaluate workplace hazards and risks.
• Carry out exposure monitoring
• Compare with OELs • Recommend
controls.
Innovative• Empower
owners/operators to evaluate their own workplaces for hazards and risks.
• Focus resources on practical control solutions rather than expensive exposure measurements.
Other Courses Conducted at NIOH• Biological monitoring of chemical exposures• Ergonomics incl. Manual material handling• Occupational allergies/asthma• Substance abuse in the workplace• Chemical and biological hazards for Labour inspectors• Personal Protective Equipments• ILO-CXR for silicosis• Management of Chemical exposures in the workplace• Stoffenmanager• GHS for chemical communication • Continuing Professional Development with HPCSA
Strengths of NIOH• NIOH is a WHO CC in OH. • Network with NIOSH, CDC, WHO, FIOH,
UIC SPH, USA, etc• Linkage with DoH, DoL, DMR, MBOD, CCOD• Affiliated with Universities• Staff highly knowledgeable and skilled in various
fields of OH• Infrastructure (lecture rooms, video-conference units • New learning technologies (eLearning)• National, Regional and International activities• Visionary leadership