Health workers: Ethical aspects and dimensions Health workers

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Health workers Ethical aspects and
dimensionsHealth workers rights and working
conditions

• Christiane Wiskow
• Independent Specialist International Public
  Health
• Global Gerecht - Gesund
• International Conference, Berlin, Germany 17-18
  September 2010

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Why the work environment matters

• Competitive labour markets
• Poor work environments compromise HW supply
  contribute to early exits
• Challenge of recruitment and retention
• Work environments quality of care
• Poor work environments compromise quality of care
• Challenge to support effective performance

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Health workers right to healthOccupational
health protection

• The issues
• High level of exposure to occupational risks
• May lead to premature exits or reduced work
  ability
• Many occupational diseases/accidents are
  preventable

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Example Infection through sharp injuries
Estimated occupational infection rates annually
HBV 66000 HW HCV 16000
HW HIV 200-5000 HW
Source Prüss-Üstün et al, 2005
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Example workplace violence health workers most
at risk

• of surveyed health workers experienced
  workplace violence in the past 12 months ()

Case studies ( 2001) Verbal abuse Bullying/mobbing Physical violence
Bulgaria survey 32 31 7
Portugal (health centre) 51 23 3
South Africa (public sector) 60 21 17
Thailand 47 11 10
Brazil 39 15 6
Source Di Martino, 2002 (Country case studies of
ILO/ICN/WHO/PSI Joint Programme on Workplace
Violence in the Health sector
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Health workers right to fair working conditions
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Example remuneration
Percentage of workforce paid at or below the
minimum wage, selected CEE/CIS countries ( 2001)
Country Percentage of workforce paid at or below the minimum wage
Armenia 30
Bulgaria 25 (20 in 1996)
Georgia 90 (public sector) 50 (private sector)
Latvia 2.3 (public sector) 13.9 (private sector)
Poland 70
Russian Federation 0
Source adapted from Afford, 2002
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Health Workers right to participate and have a
voice

• Consultation regarding their employment and
  working conditions
• Participation in the planning of health services
• Professional autonomy
• Social dialogue
• Positive association with improvement of work
  environment
• Capacity building to strengthen social dialogue

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Creating attractive, supportive work environment

• Incentive to enter health professions - and to
  stay
• Enabling health workers to perform effectively
• Goal Quality health care services

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What is an attractive supportive work
environment?Quality of work environment
dimensions and elements
Source adapted from the job quality model of
Munoz de Bustillo et al, 2009
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Vision Universal Declaration of Human Rights
(1948)

• Everyone has the right to .
• Article 23.
• (1) work, to free choice of employment, to just
  and favourable conditions of work().
• (2) equal pay for equal work.
• (3) just and favourable remuneration ensuring
  for himself and his family an existence worthy of
  human dignity, ()
• (4) form and to join trade unions for the
  protection of his interests.
• Article 24.
• rest and leisure, including reasonable
  limitation of working hours and periodic holidays
  with pay.

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Thank you for your attention