Inadequacies in human resource capital and expertise in occupational health and safety are noted as major constraints in the implementation and compliance to health and safety initiatives in the work place.
South Africa has a mature system than Botswana, Zambia and Zimbabwe. Lack of specialized training in occupational health services, such as occupational medicine specialization for physicians, has been a major drawback in Zimbabwe, Zambia and Botswana.
The above health situation is elegantly is captured in a 2015 research study paper titled “Review of Occupational Health and Safety Organization in Expanding Economies: The Case of Southern Africa” undertaken by Dingani Moyo, Muzimkhulu Zungu, Spoponki Kgalamon and Chimba D. Mwila.
According to the research paper, training and education in occupational health and safety, especially in occupational medicine, will enhance the development and maturation of occupational health in Southern Africa. Capacitating primary health services with basic occupational health knowledge would be invaluable in bridging the current deficit. Introducing short courses and foundational tracks in occupational medicine for general medical practitioners would be invaluable.
Access to health and safety in the workplace has had an inexplicably challenging gestation and a protracted and complicated delivery phase globally. Its development has not paralleled or matched the industrialization impetus in both the developed and expanding economies.
This is evidenced by the alarming statistics showing more than two million work-related deaths and about 300 million nonfatal occupational accidents occur annually, resulting in global economic costs contributing to four percent of the global gross domestic product (GDP).
Because workers represent half of the world’s population and are the major contributors to economic and social development, this magnitude of occupational accidents and fatalities calls for an urgent redress of the situation.
It is observed that less than 15 percent of the global workforce, primarily in big enterprises in developed countries, has access to occupational health and safety. It still remains a big challenge in expanding economies.
The imperative fundamentals to the genesis of wider coverage and improvement of OHS rests on the commitment of the member states both individually and collectively. The majority of expanding economies in Africa face an enormous challenge of improving coverage and access to OHS services.
Globally, OHS is generally a new discipline that is still in its infancy stage, as reflected by the accident and occupational health diseases statistics and the low global access to it. Despite the huge negative effect on the lives of the people, OHS has not received significant focus and support even when compared with the global support and attention given to HIV, malaria, and tuberculosis.
“OHS has remained an island whose existence has always been recognized but with no concerted efforts toward support. Southern Africa is no exception to this, as evidenced by the significant gaps in human resource capital, training, and education and programmatic approaches in the workplace…In Southern Africa, the practice of occupational health has found itself multi-tentacled and waddling between the ministries of health and the ministries of labour, although in some countries the ministry of health has assumed responsibility”, outlines the research study.
The study further notes that throughout Africa, “human resources capital in occupational medicine is scarce and where they are offered at company level, they are usually primary care in nature. Although specialist-level occupational medicine services are available to a limited extent in the public sector in South Africa, they exist to an even much lesser extent in Sub-Saharan Africa”.
According to the study, in most African countries, the gap between the number of practicing occupational medicine physicians and occupational nurse practitioners is alarmingly wide compared with the populations in the Southern African states. It has been asserted that there is generally a shortage of OHS practitioners in most developing countries.
“A survey of specialist occupational medical services in Africa in 2004 revealed that Zambia and Botswana had a specialist public-sector service provided through the Occupational Health and Safety Management Board and the Ministry of Health respectively. By then, Botswana had a single specialist occupational health clinic located with the Ministry of Health. This clinic provided and continues to provide diagnostic services, occupational hygiene, research, and pneumoconiosis screening”, states the research report.
It is observed by the study that to date there has been an emergency of private occupational medicine practitioner-run occupational health centers in mines and companies. Additionally, the private sector complements this function through enterprise-based occupational medicine services that are run by occupational medicine specialists, occupational medicine specialists, and general practitioners.
The study highlights that in Southern Africa, local specialist occupational training only exists in South Africa in five universities. Aspiring candidates in Southern Africa have to study either in South Africa or pursue their studies overseas.
The only available training in Zimbabwe, Zambia and Botswana in the field are the nonclinical general OHS courses at certificate, diploma, degree and master’s level.
“The quality of the training programmes for some occupational health professionals may require standardization and quality assurance because the training and development agencies are also the professional bodies”, states the research study.
According to the study, the four countries under review possess the foundational legislative frameworks and organization of OHS. However, just like the rest of the world, OHS access for workers remains greatly constrained.
The mining sector in these countries possesses relevant pieces of legislation. The major hold in these four countries is the inadequacy of the human capital, particularly in occupational medicine.
Development of clinical occupational health services infrastructure and support structures remains a critical component in the implementation of the basic occupational health concept. Introduction of short courses and seminars on occupational health for primary health care services personnel would be invaluable in advancing the cause of occupational health.
The research study concludes that the four Southern African countries under review have demonstrated a certain level of commitment to OHS, as shown by their ratifications of the International Labour Organization (ILO) conventions that have to do with health and safety.
Of the four countries reviewed, Zambia has the highest number of ratifications of ILO technical conventions with 36, followed by South Africa with 17, Zimbabwe 15 and lastly Botswana with 6. “However, these endorsements still fall far below the scheduled 177 technical conventions”, concludes the research study.
