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

Regiane Garcia, Jerry M. Spiegel, Annalee Yassi, Rodney Ehrlich, Paulo Romão, Elizabete A. Nunes, Muzimkhulu Zungu and Simphiwe Mabhele
Additional contact information
Regiane Garcia: School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
Jerry M. Spiegel: School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
Annalee Yassi: School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
Rodney Ehrlich: Division of Occupational Medicine, School of Public Health and Family Medicine, University of Cape Town, Rondebosch 7701, South Africa
Paulo Romão: International Labour Organization, 688 Av. do Zimbábwe, Maputo, Mozambique
Elizabete A. Nunes: Department of Internal Medicine, Maputo Central Hospital, 364 Av. Agostinho Neto, Maputo 1100, Mozambique
Muzimkhulu Zungu: National Institute for Occupational Health, 25 Hospital St, Constitution Hill, Johannesburg 2000, South Africa
Simphiwe Mabhele: International Labour Organization, Block C, Crestway Office Park, 20 Hotel St. Persequor, Pretoria 0020, South Africa

IJERPH, 2020, vol. 17, issue 20, 1-16

Abstract: 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.

Keywords: occupational health; health workers; rights; laws; governance; implementation science (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (2)

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