Occupational Health in the Eastern Mediterranean Region Challenges

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Occupational Health in the Eastern Mediterranean
RegionChallenges Opportunities
Occupational Health Conference 11-13 December
2006 Muscat - Oman

• Dr. Said Arnaout
• RA/HSG,WHO-EMRO
• arnaouts_at_emro.who.int

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Six WHO Regional Offices

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Eastern Mediterranean Region
Palestine
LEB
Bahrain
22 Member States
Population 540 Million
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Per capita GDP in international dollars, 2004
Source WHO Core Health Indicators 2006
Qatar 27284
Afg 430
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Population of EMRin thousands, WHO 2005
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Percentage of 15-64 Age Group
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Percentage of non-nationals in the 15-64 age
group
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Labour Force in EMR

• 10 50 of the active population
• Non-local/ immigrant workers represent the
  majority of the workforce in some Gulf countries

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Labor Force by Sector in EMR
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Unemployed in EMR 13Source RDs AR 2004
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Informal labour force

• No precise estimates
• However, it represents about 24.7 of the
  currently employed labour force in Bahrain and
  about 46.8 in Pakistan

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Working children

• Working children (Child labour) are present in
  several countries
• Figures are available only in few of them
• The working children are usually present in
• agricultural activities,
• construction,
• industrial activities and
• small workshops

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Working Women Are in increase
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What are the main challenges, facing occupational
health in EMR?
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The Definition of Occupational Health (ILO WHO)

• The promotion and maintenance of the highest
  degree of physical, mental, social well-being of
  workers in all occupations total health for all
  at work

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OHS Dilemma in EMR

• Rapid growth of general population and young
  people reaching adulthood (huge increase in
  labour force, unemployment)
• Inequity, poverty, conflicts, disasters
• Conventional as well as new challenges
• Insufficient and inadequate OHS services (human
  resources, infrastructure, education, training,
  research)
• Diverse spectrum of occupational and general
  health risks (Triple Burden)

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Triple Burden of Disease

• Communicable Diseases
• Non-communicable Diseases
• Occupational and Work-related Diseases

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Regional Situation

• OH Services are significantly varied from one EM
  country to another
• Variations include both qualitative and
  quantitative parameters
• There are very good amount of experience in some
  EM countries, and could be used, exchanged or
  even replicated by other countries
• There is a pressing need to enhance and progress
  OH services in every EM country

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The greatest challenge

• How to transform the difficulties into
  opportunities?

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Role of WHO/EMRO

• Extensive efforts are being made in countries of
  the region, in collaboration with the Regional
  Office to further develop and strengthen national
  programmes on occupational health and work safety
  
• Main Goal By 2020 healthy workplaces and work
  practices will be widely adopted in Eastern
  Mediterranean Countries

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Important Country Activities

• Bahrain OSH Authority
• Tunisia
• - Regular publication of OHS Journal
• - Annual OHS Conference on regular basis
• Jordan National Strategy OHS
• Iran Training Course on ILO Classification of
  Pneumoconiosis
• Kuwait Healthy Work Places Workshop
• KSA national Workshop on OHS in Medical
  practices
• UAE National Training Workshop on OHS for PHC
  Physicians
• Egypt Several training courses for PHC workers
• National workshop on protecting HCWs preventing
  needlestick injuries, 4-5 Dec. 2006

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Important Regional Activities

• Regional Consultative meeting on the development
  trends of occupational health and safety in the
  EMR Current status and perspective, Damascus,
  Syria, 16-18 Dec. 2003
• Intercountry workshop on primary health care and
  basic occupational health services Challenges
  and opportunities in Eastern Mediterranean
  Region, Sharm ElSheikh, Egypt, 12-14 July 2005
• Regional activities at GCC Level

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Inter-regional activities the WHO/ILO Joint
Efforts on Occupational Health and Safety in
Africa

• Unified Country Profile on Occupational Health in
  Egypt, prepared jointly with all partners
  concerned on occupational health and safety at
  national level
• A workshop on the national occupational health
  and safety profile in Egypt was successfully
  organized in EMRO, Egypt, 2930 October 2003, as
  an activity of these joint efforts

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Collaborative Programmes With WHO in OSH for the
06-07 Biennium
Palestine
LEB
Bahrain
17 Countries
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The WHO Global Plan of Action on Workers
Health2008-2017

• A Fresh Look
• New Opportunities

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In 1996, the 49th WHA with Resolution 49.12
endorsed the Global Strategy on Occupational
Health for All

• strengthening of international and national
  policies for health at work
• promotion of a healthy work environment, healthy
  work practices and health at work
• (iii) strengthening of occupational health
  services
• (iv) establishment of appropriate support
  services for occupational health

• (v) development of occupational health standards
  based on scientific risk assessment
• (vi) development of human resources
• (vii) establishment of registration and data
  systems and
• (viii) strengthening of research

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New political realities, initiatives and requests
by the Member States call for renewed attention
and global action by WHO on occupational health
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WHO Response

• There is a need to move from strategy to
  practical action in the area of workers health
• WHO developed the Global Plan of Action on
  Workers Health 2008-2017 to provide new impetus
  for action

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The plan is based on the proposals for action
made by

• the Member States,
• the consultations with
• WHO Regional Offices,
• relevant WHO technical programmes,
• the WHO Collaborating Centres for Occupational
  Health,
• the International Labour Office/ILO and
• international organizations of employers and
  workers

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The health of the workers depends on a
combination of factors and a complex interaction
between them

• Working environment mechanical, physical,
  chemical, biological, ergonomic, psycho-social
  factors
• Social determinants related to work employment
  status, occupational position, social
  inequalities and poverty
• Work-related health behaviour individual
  preventative health practices and personal
  health-related behaviour
• Access to health services adequate and
  affordable occupational health services for
  promotion, prevention, cure and rehabilitation

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This plan of action deals with workers health in
a broader context

• Workers health is a public health approach to
  addressing the health problems of working
  populations
• It focuses on
• primary prevention of occupational and
  work-related diseases and injuries
• protection and promotion of the health of workers
  
• Occupational health constitutes the core of this
  approach

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GPA on Workers Health2008 - 2017

• Outlines newly emerging challenges
• Sets goals for protection and promotion of
  workers health
• Recommends a series of strategic actions to be
  taken by the Member States and the WHO
  Secretariat over a ten year period

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Objectives of GPA on Workers Health

1. Develop and implement policy instruments on
   workers health
2. Protect and promote health at the workplace
3. Improve the performance of and the access to
   occupational health services
4. Provide and communicate evidence for action and
   practice
5. Incorporate workers health into other polices

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The Challenges

• Too many workers are still
• exposed to unacceptable levels of occupational
  hazards,
• fall victim to occupational diseases and work
  accidents, and
• lose their working capacity and income potential
• In many countries the existence of occupational
  health services is very limited and less than 15
  of workers have access to them

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The Challenge Opportunity Globalization

• Major impact through
• growing internationalization, competition,
• changes in the regulatory strategies,
• major changes in enterprise structures and
  associated technology changes.
• Numerous positive effects
• Increasing world trade
• Growing interaction among countries,
• The development of new information technologies

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Positive Role of Some Multinational Enterprises

• Play an increasing role in shaping working
  conditions in the different countries
• They can bring jobs, expertise, new work
  practices, better working conditions, and
  preventive health culture to the host countries

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Negative Role of Some Multinational Enterprises

• Different standards for health protection at work
  in the different countries
• Commercial advantage

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The Challenge Unemployment, Job Insecurity
increasing human interaction

• Certain working methods and emerging forms of
  work organization such as
• outsourcing,
• downsizing, and
• flexible work practices have an impact on workers
• Psychosocial hazards, and work-related stress,
  resulting in burn-out, depression, coronary heart
  disease, musculoskeletal and other physical and
  mental disorders

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The Challenge Informal Economy

• The traditional worker-employer relationship does
  not exist
• No healthy and safe working conditions
• The costs are borne by the community and not by
  the employers

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The Challenge OpportunityCollaboration between
all actors in the health sector

• Occupational health is an integral part of public
  health and its activities can be enhanced with
  the involvement of
• health promotion,
• environmental health,
• disease prevention,
• the provision of general health services at work
  and other public health programmes

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The Challenge OpportunityMDGs

• What actions are needed to break the vicious
  cycle?

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The Challenge OpportunityMDGs

• Elimination of hazardous child labour,
• Promotion of women's health and protection of
  reproductive health at work,
• Combating HIV/AIDS, tuberculosis, malaria, and
  other major diseases at the workplace
• Introduction of clean technologies and systems
  for management of health at work

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Further improvement of the health of workers
requires a holistic public health approach

• Combining occupational health with health
  protection and promotion,
• Reaching out to workers families and communities,
• Tackling social determinants of health
• Providing health services adequate to the
  specific needs of working populations

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Thanks?????