Ministry Of Health And Social Services

Directorate: Primary Health Care Services

Division: Public and Environmental Health

Sub-Division: Occupational Health Services

Occupational Health Services

In Namibia

Republic of Namibia

Occupational Health in Namibia

• The Ministry of Health and Social Services (MoHSS) established the Subdivision Occupational Health Services (OHS) as part of the Directorate Primary Health Care Services. The role of OHS is preventative in nature and serves in the promotion and maintenance of health of all employees who are gainfully employed

Occupational Health in Namibia

• The Sub-division at National Level comprises of two units:

- Occupational Medicine and

- Occupational Hygiene

- 1 Chief Medical Officer (CMO)

- 1 Senior Health Program Administrator (SHPA)

- 1 Chief Environmental Health Practitioner (CEHP)

for Occupation Hygiene

- No structure exists at regional or district levels

Occupational Health in Namibia

• Namibia launched the Vision 2030, the framework for national development – aiming at industrializing the country and to alleviate poverty. It is therefore imperative that a high priority is given to the development of Occupational Health Services.

Occupational Health in Namibia

• Currently Occupational Health Services are provided by certain large companies, providing enterprise based occupational clinics and using the services of an occupational medical specialist.

• Where enterprise based occupational health services are absent, a number of small/ medium enterprises are providing medical surveillance for their employees using local general practitioners.

Program Aims (Mission):

• The overall goal is the promotion and enhancement of socio-economic development by providing a safe and healthy work environment and preventing work-environment related adverse health conditions as far as reasonably practicable, within the context of Primary Health Care.

Program Objectives:

• Human resource development and training.

• Formulation of policies, guidelines & standards.

• To control, monitor and evaluate the implementation and enforcement of the relevant legislations relating to occupational health issues pertinent in the workplaces to meet national and international conventions and treaties obligations

• The maintenance and promotion of employees’ health in general, by protection of employees against any occupational health related hazards or injuries.

Program Objectives: Continued

Medical Surveillance: The maintenance and promotion of the highest possible degree of physical, mental and social welfare of all persons gainfully employed in all branches of economic activities.

Technical backstopping and support to operational level: provision of Consultative Services.

Program Objectives: Continued

• Execution of monitoring, supervision, quality assurance and evaluation OHS programs.

Legal Framework for OHS in Namibia

The occupational health challenges at global and regional levels are reflected within the Namibian context and to address these challenges, Namibia has developed various legal framework. These include the following;

The Constitution of the Republic of Namibia

The Constitution of the Republic of Namibia (Government Notice No. 1 of 1990) highlights the fundamental rights to well-being of all citizens, including employees at various workplaces within the country. It further protects children below fourteen years of age from unlawful employment and economic exploitation.

Labour Act, 2007

• The Labour Act 2007, (Act No. 11 of 2007), which repeals the Labour Act 1992 (Act 6 of 1992) consolidates and amends the labour law to ensure the health, safety and welfare of employees in the workplace. It is further designed to maintain and improve work related standards for the economically active population in Namibia.

Labour Act, 2007

• The Ministry of Labour and Social Welfare (MLSW) was established to be the umbrella organization for all matters concerning occupational health and safety issues in Namibia.

“Regulations Relating to the Health and Safety of Employees at Work”

under Labour Act 2007

• With Government Notice 156, the President of the Republic of Namibia promulgated, after consultation with the Labour Advisory Council, under Section 101 of the Labour Act 1992, “Regulations Relating to the Health and Safety of Employees at Work” and determined that the Regulations shall come into operation on 31 July 1997.

Presidential Proclamation No. 10, Labour Act, 1992 (Part XI, Section 101 of the

Labour Act 2007)

• In order to enforce, implement, monitor and control the “Regulations Relating to the Health and Safety of Employees at Work”, the President of the Republic of Namibia assigned the administration of these regulations to be exercised and performed by the Ministry of Mines and Energy (MME), Ministry of Labour & Social Welfare (MLSW) and Ministry of Health & Social Services (MoHSS), as set out in the Presidential Proclamation.

Employees Compensation Act, 1941

• The Employees Compensation Act, Act 30 of 1941, provides for the payment of reasonable medical expenses and compensation in respect of work related injuries or occupational diseases contracted by employees out of and in the course of their employment.

HIV Code on Employment

• In response to the AIDS pandemic, the MLSW, in conjunction with the MoHSS and with tripartite consultation through the Labour Advisory Council formulated the “National Code on HIV/AIDS in Employment” for HIV prevention and AIDS management.

HIV Code on Employment

• This Code is proposed as an integral part of the government’s commitment to address most of the major issues related notably to the prevention of discrimination of HIV positive employees, as well as to the provision of optimal care and support for the affected workforce.

Guidelines: Post-Exposure Prophylaxis (PEP)

• the use of therapeutic agents to prevent infection following exposure to a pathogen

• for health-care workers, PEP commonly considered for exposures to HIV and Hepatitis B

• types of exposures include:

• percutaneous exposure: (needle stick injury, cut with sharp object),

• contact exposure: (splash, bite).

Affirmative Action (Employment) Act, 1998:

• The Affirmative Action (Employment) Act, Act 29 of 1998 indicates that people with disabilities should have an equal opportunity to employment and are equitably represented in the workforce of a relevant employer. The 2001 Population and Housing Census indicate that 4.7 percent of the people of Namibia have disabilities. This has important implications for workplace organization and the application of employment equity in workplaces.

• The above forms the legal framework for the provision of standardized OHS throughout workplaces in Namibia.

• The MoHSS is specifically responsible for statutory control of the implementation and monitoring of the pertinent legislation relating to health & safety issues in the various workplaces.

Operations

• At Regional and District levels, Environmental Health Practitioners are responsible for provision of Occupational Health Services (particularly occupational hygiene component of the service).

• Currently the occupational medical services are absent at Regional and District level.

Intersectoral Collaboration

• MoHSS, MoLSW, MME, employees representatives and employers federation organization are all represented in the following committees : Labour Advisory Council, National Coordinating Task Force Committee for Occupational Health and Safety and Namibian Standard Institution Technical Committee for Occupational Health and Safety.

Classes of Economic Activities

100 000 registered employees with the Workmen’s Compensation Commission;

now known as the Social Security Commission (SSC).

Classes of Economic Activities

• In line with comparable developing countries, the Agricultural sector constitutes the largest sector, both in regard to number of enterprises registered (52%) and work force employed (19%).

• The Mining sector has the second largest employee work force (17%), followed by Trade and Commerce (12%) and thereafter by Building and Construction (9%). The above reflects the comparison of the sectors with the highest work force.

Occupational Diseases

Generally there is a lack of comprehensive statistics on occupational diseases in Namibia. This is further reflected in the under-reporting of notifiable occupational diseases both to the SSC and the MoHSS.

During 01//03/2004 – 28/2/2005, a total of 4 693 incidents were reported to SSC for compensation. Of these, 99.9% related to traumatic and acute injuries and only 0.1% to work place related diseases.

Occupational Diseases

A mere total of 6 incidents (0.1%) was diagnosed and reported as occupational disease.

• Dermatitis ranked first, followed in descending order by tuberculosis, malaria, chronic lung diseases and rubella (German measles).

The highest number of occupational diseases was registered by the Mining sector, followed by Government Services, namely the MoHSS.

Occupational Injuries

Basic data from the occupational injury reports produced in work places are internationally often poor, particularly with regard to the description of the accident, sequence and contributing environmental factors.

In Namibia, the same trend can be identified. Data regarding the type and causes of an

accident is incomplete.

Occupational Injuries

• For the period March 2004 –February 2005, the accident type could not be classified in 46% of the claims forwarded to the SSC resulting in occupational injuries, as insufficient data was provided by the reporting person.

• In line with internationally recognized grading of accident types and causes, the available statistical evidence indicates that common causes of occupational injuries are mainly found in ordinary industrial actions rather than in the use of dangerous machines or substances.

Occupational Injuries

• The main underlying causes of accidents are, in descending order,

- working in unsafe positions or postures,

- operating or working at an unsafe speed and

- failure to use personal protective equipment (PPE).

Occupational Health Services and the Community

• Occupational health is one of the most direct contributions that the employer can make to the community’s productivity, and therefore to its welfare.

• Hazardous waste and atmospheric pollution arising from enterprises/industries has an impact on the environment and subsequent implications on the health of the community.

Occupational Health Services and the Community

• If occupational hazards/pollution are controlled at the source (i.e. at enterprise and industrial levels); then environmental pollution is prevented, safeguarding the health not only of employees but also the community at large.

Challenges:

• Inadequate enforcement of legislation due to insufficient staff allocation and lack of trained OH personnel within the MoHSS at all levels.

• Lack of familiarity of OH&S legislation resulting in:

• a) Employers and employees ignorant of their legal responsibilities and duties. No formal OH&S training for employees, including management for the majority of workplaces

• b) OH&S structures not evident in private / public sectors and SMEs

Challenges Continued:

c) Lack of a consistent approach to participatory

risk assessment at workplaces

d) Lack of medical surveillance programs based on the participatory risk assessment

e) Notification and submission of compensation reports for occupational diseases/ injuries is very weak

f) Notification, compensation and other OH&S statistics are not available

Challenges Continued:

g) Shortage of trained experts needed for OHS

h) Inadequate funding for OHS

The above challenges can only be successfully addressed if there is sufficient allocation of financial resources and staff, in both the public and private sectors.

Future Action • Establishment and strengthening of OHS in the public

and private sectors & enhance financing;

• Capacity building and human resource development of occupational health staff in public sector (13 regions) & private sector in all categories;

• Formulation of policy strategies & guidelines;

• Strengthen M&E mechanism for the implementation of the relevant legislation relating to the health & safety in the workplaces;

Future Action Continued

• Dissemination of OH information, advocacy of OHS and appropriate resource mobilization for the provision of regular and enabling information on OHS for tripartite structures;

• Strengthen the notification of occupational diseases and establish a database of notifiable diseases;

• Strengthen regional and international links and channels of communication with OHS services including WHO Collaborating Centers and ILO Centers;

Future Action Continued

• The maintenance and promotion of employees’ health in general, by protection of employees against workplace related hazards. (Engineering/ Admin. Methods, PPE);

• Provide scientific information and support to facilitate the implementation of participatory risk assessment and medical surveillance (based on the risk assessment) at workplaces;

Future Action Continued

• Incorporating essential elements of occupational health in PHC services;

• Linking occupational health to other public health programs - HIV, TB, malaria, non-communicable diseases;

• To strengthen intersectoral collaboration on occupational health and safety under the different committees;

Future Action Continued • Establish a national fund for health and safety

to finance national activities, campaigns, research, training, information on health and safety;

• Establish national program for occupational health and safety of public health workers under the MOHSS to ensure that public health facilities comply with the Health and Safety regulations and to protect and promote the health and safety of health workers as a mean to improve human resources for health.

THANK YOU.