Preventing Occupational Tuberculosis in Health Workers: An Analysis of State Responsibilities and Worker Rights in Mozambique

International Journal of Environmental Research and Public Health

ElizabeteA. Nunes¹  Rodney Ehrlich²  Paulo Romão³  Simphiwe Mabhele⁴  Muzimkhulu Zungu⁵  Annalee Yassi⁶  Regiane Garcia⁶  Jerry M. Spiegel⁶ 

[1] Department of Internal Medicine, Maputo Central Hospital, 364 Av. Agostinho Neto, Maputo 1100, Mozambique;Division of Occupational Medicine, School of Public Health and Family Medicine, University of Cape Town, Rondebosch 7701, South Africa;International Labour Organization, 688 Av. do Zimbábwe, Maputo, Mozambique;International Labour Organization, Block C, Crestway Office Park, 20 Hotel St. Persequor, 0020 Pretoria, South Africa;National Institute for Occupational Health, 25 Hospital St, Constitution Hill, 2000 Johannesburg, South Africa;School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, V6T 1Z3, Canada;

关键词: occupational health;    health workers;    rights;    laws;    governance;    implementation science;   

DOI  :  10.3390/ijerph17207546

来源: DOAJ

【 摘 要 】

Given the very high incidence of tuberculosis (TB) among health workers in Mozambique, a low-income country in Southern Africa, implementation of measures to protect health workers from occupational TB remains a major challenge. This study explores how Mozambique’s legal framework and health system governance facilitate—or hinder—implementation of protective measures in its public (state-provided) healthcare sector. Using a mixed-methods approach, we examined international, constitutional, regulatory, and policy frameworks. We also recorded and analysed the content of a workshop and policy discussion group on the topic to elicit the perspectives of health workers and of officials responsible for implementing workplace TB policies. We found that despite a well-developed legal framework and national infection prevention and control policy, a number of implementation barrier persisted: lack of legal codification of TB as an occupational disease; absence of regulations assigning specific responsibilities to employers; failure to deal with privacy and stigma fears among health workers; and limited awareness among health workers of their legal rights, including that of collective action. While all these elements require attention to protect health workers from occupational TB, a stronger emphasis on their human and labour rights is needed alongside their perceived responsibilities as caregivers.

【 授权许可】

Unknown