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Capacity B uilding for Occupational Health for Workers in South Africa

Capacity B uilding for Occupational Health for Workers in South Africa. Inakshi Naik OHS Training Department, NIOH 29 th October 2013 Hong Kong. Overview of the presentation. Overview of the National Institute for Occupational Health (NIOH) SA Training needs assessment

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Capacity B uilding for Occupational Health for Workers in South Africa

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  1. Capacity Building for Occupational Health for Workers in South Africa Inakshi Naik OHS Training Department, NIOH 29th October 2013 Hong Kong

  2. Overview of the presentation • Overview of the National Institute for Occupational Health (NIOH) SA • Training needs assessment • Training in different categories and levels • Gaps in training – shortage of skills • Current initiative to fill in the training gaps • Short Courses/seminars/workshops to develop capacity • Strengths of NIOH in delivering the programme

  3. Johannesburg, SA The City of Gold

  4. National Institute for Occupational Health (NIOH) Established in 1956 (Pneumoconiosis Research Unit)

  5. Advisory Statutory Service Autopsy Services Specialized Laboratories Health Hazard Evaluations Resource Network

  6. Post Graduate Qualification in OH for Medical Practitioners • Post Graduate Diploma in Occupational Health • Part Time: Offered over 2 years in 8-10 weeks • one week blocks. • Offered by 6 Universities. • UCT offers distant learning

  7. Post Graduate Qualification for Occupational Health Nurses • Post Basic Nursing qualification • 9 Universities and one private Academy offers Masters, B. Tech, Diploma and Certificate courses over one-two years period. • B Tech qualifications offered by University of Technology • Registration with the SA Nursing Council with minimum DoH nursing

  8. Qualification forOccupational Hygienists Registered Hygienist in 3 different categories with SAIOH in SA • Hygiene Assistants • Hygiene Technologists • Hygienists Education and Training Requirements • Occupational Hygienist Post Graduate Qualification 3 Universities offer a Diploma and Masters Degree in and PhD in Occupational Hygiene over two or three years (part time/ full time), • Offered as DPH or MPH Occupational hygiene Applicants must have a four-year qualification from a university • Being registered with the South African Institute for Occupational Hygiene (SAIOH) at the minimum of the Occupational Hygiene Technologist level. The Wits School of Public Health, in association with the NIOH, offers a Diploma in Occupational Health (DOH) and MPH Occupational Hygiene

  9. Weaknesses Identified in the Present System for Training of Different Categories of Hygienists: In House Training • No defined requirements • High registration failure rates • No mentorship programme • Present application form – summary of educational qualification and employment history • Assessors lack full understanding of candidate level of competency • Little practical and experiential learning • Provider also is accreditor

  10. New Proposed Training for Occupational Hygienists in SA • Registration model based on competency levels • Bench mark proposed skill requirements against international standards • Meet IOHA registration requirements • Develop a skills matrix • Develop detailed skill definitions per grade • Mentorship programme support development of practical skills • Promote use of Personal Learning Portfolio as part of assessment process Adapted from SAIOH Deon Van Vuuren (Chairperson SAIOH)

  11. OHLearningfor Occupational Hygienists www.ohlearning.com

  12. OH Learning for Occupational Hygiene Qualification • The Occupational Hygiene Training Association (OHTA) was formed to promote better standards of occupational hygiene practice throughout the world.  •  They develop training materials and make them freely available for use by students and training providers.  • Promote an international qualifications framework so that all hygienists are trained to a consistent, high standard, recognized in all participating countries. • Three levels of course: Foundation level, and progress through intermediate level to advanced level

  13. Downloading of training materials is free of charge but is subject to the Terms of Use of OHlearning.com.

  14. Training for Other Occupational Health Workers Provided at NIOH • Occupational epidemiology (MPH) • Information sciences • Residency training in Occupational Medicine Partnerships with universities, internship programmes and experiential learning.

  15. Laboratory based sciences (Scientists. Technologists & Technicians) • Toxicology • Analytic chemistry • Pathology • Immunology/Microbiology Students from India trained in the Analytical Laboratories for metals, organic exposures

  16. Developing Capacity for the Government Health System

  17. PHC Training Initiative by the Department of Health, SA The re-engineered approach to providing PHC services proposes a population based approach for delivering of PHC outreach service

  18. Who is the Training for ? • Community Health Workers • Primary Health Care Nurses • Family Medicine Doctors • Hygienists/Technologist/Technicians/ Environmental Health Officers • Health and Safety Representatives • Labour Inspectors • NGOs, Trade Unions

  19. Proposed Training at Different Levels • Outreach CHW Short Courses CHWs, Nurses, Environmental Health Officers & Hygienists, Doctors OH Learning and other support Academic Learning

  20. Ward Based PHC Outreach Programme- CHW • DoH Project: Funded by USAID • Ward based PHC Outreach Team • 10 000 CHW trained in phase 1 • HIV, TB, ANC, Child nutrition but not OH • Introduce OH screening tools Functions stipulated for EHO: Monitor OH and safety in local businesses Manage environmental noise hazards

  21. Proposed Training at Different Levels • Outreach CHW Short Courses CHWs, Nurses, Environmental Health Officers & Hygienists, Doctors OH Learning and other support Academic Learning

  22. Motivation for Training PHC Nurses in OH • Where an employee develops ill health due to occupational causation the client may consult a health care worker at a public clinic. • PHC nurses are the gatekeepers of the health system • Theyare not taught the basics of occupational health in their training and are thus not skilled in the identification of an occupational disease. • Through the early detection of disease the morbidity associated with occupational disease can be reduced thereby decreasing the disease burden in the country.

  23. Training of Public Health Care (PHC) Nurses in Fundamentals in Occupational Health- NIOH Initiative Aim: • To equip a PHC nurse with information/skill to be able to take an appropriate occupational history • Refer suspected occupational disease cases to the next level of referral, i.e. The Regional/ District hospital. • To have a high index of suspicion for work-related problems and identify sentinel events. • Knowledge of referral systems that exist within the district. • To liaise with the Environmental Health Officer, Labour inspectors

  24. Structure of the Course for the PHC Nurses • The course will be five days in duration. A combination of theory and practical teaching methods • A site visit and a virtual site visit will be included in the teaching methods. • Assessment will be conducted through continuous formative assessment and a summative assessment. • Learners will be required to complete 10 health assessments of employees in the PHC setting. • On successful completion of assessments a competency certificate will be issued by the NIOH. • SANC accreditation of this course will be requested.

  25. Current Short Courses Available for Medical Practitioners

  26. Global Program in Occupational Health Practice (GPOHP) What is the GPOHP? • The Global Program in Occupational Health Practice is an internet-based, instructor-led distance-learning program for professionals in either occupational health services or occupational hygiene. • The program consists of two tracks, the Occupational Health Practice Certificate and the Occupational Hygiene Practice Certificate. • Each contains three consecutive courses that build on each other. However, the courses may be taken separately. Courses are ten weeks long. • All participants receive a "Certificate of Competency” on completion from UIC. School of Public Health

  27. Structure of the GPOHP

  28. OHTA Recognition and incorporation of Hygiene Modules in OHLearning

  29. Other Short Courses for OHS Workers

  30. http://www.who.int/occupational_health/publications/whomodules/en/http://www.who.int/occupational_health/publications/whomodules/en/

  31. WHO Modules in Occupational Health, Hygiene and Safety • The WHO Modules in OH were developed by a team of experts from the Division of Environmental and Occupational Health Sciences, School of Public Health, University of Illinois - Chicago, USA, also a WHO CC in OH. • The modules were developed to execute the 49th World Health Assembly Global Strategy for OH • The materials are case-based modules in the specific sectors of agriculture, manufacturing, and the health service

  32. Aim of the Course The aims of the course were to develop and strengthen the following approaches in OH: • Anticipate and recognize workplace hazards • Describe exposure to workplace hazards and their health effects • Generate recommendations for preventing exposure using available resources and technologies • Develop a programme plan for addressing workplace hazards

  33. On Completion of the Course The participants are equipped to: • Complete an occupational history • Recognize a work related injury or illness • Conduct a qualitative risk assessment of a workplace • Conduct an incident investigation • Categorize exposure groups • Complete an exposure and health effect rating chart • Develop a strategy for collecting quantitative data • Recommend intervention strategies for reducing exposure • Begin a programme plan for various workplaces

  34. Corse Conducted at NIOH: Team from UIC, SPH, USA and NayatiInt. India

  35. The week-long course was attended by close to 90 participants from both public and private sectors. • Acertificate of competency (from the University of Illinois - Chicago and the NIOH, Johannesburg) was issued to all participants scoring higher than 70% on post-course performance- and knowledge-based evaluations. • A CD of the full course was created as an Integrated E-Learning Platform – essentially a video recording of the presentations, to be used as a training tool by trainers for future capacity building. • With the aid of the CD further 330 delegates in 10 centres ( 9 provinces and 1 national centre) were trained within 4 months in 2010. • The delegates were HSR, wellness managers, safety officers, nurses • The course has a “Train the Trainer” component

  36. Field Visit-Hospital Laundry/Kitchen/Laboratory

  37. Learners During Lectures and Exercises

  38. Training for Medical Officers (Namibia) • WHO: Protection of the Human Environment Worker’s Health • Ministry of Health and Social Services. • Swakopmund, Namibia 2011 • District Health Medical Officials in Namibia • Delivered by Dr. Ivan Ivanov (WHO), Dr. Norbert Wagner (UIC, SPH, and Dr. Tony Cantrell (NIOH, SA) • 2 weeks course: 1 week Occupational Diseases , 1 week Occupational Hygiene

  39. Health and Safety Representatives (HSR) Course for NHLS - online

  40. Health and Safety Representative (HSR) in Pathology Laboratories (Course Overview) We trained 268 HSR countrywide on our intranet in 2012. Current around 170 HSR being trained Course specifically designed to identify hazards and risks associated in pathology laboratories Modified for any environment

  41. Stoffenmanager Version 5.1www.stoffenmanager.nl

  42. Stoffenmanager: Background and History • Web-based IT-tool (public and freely available) to help small- and medium-sized enterprise (SME) which allows non-expert users in the companies to manage their dangerous substances more efficiently. • Developed by consortium: Dutch ministry of social affairs (owner & funding) , BECO , TNO and ArboUnie (research & development) • First development: risk prioritization (control banding) • Subsequent: quantification and validation of the exposure process model initially inhalation • March 2008: version 4.0  Separate exposure estimation for dermal exposure

  43. Traditional Rely on technical experts to evaluate workplace hazards and risks. Carry out exposure monitoring Compare with OELs Recommend controls. Innovative Empower owners/operators to evaluate their own workplaces for hazards and risks. Focus resources on practical control solutions rather than expensive exposure measurements. Changing Focus of Occupational Risk Management for Workplaces Exposure to Chemicals

  44. Stoffenmanager estimation: reasonable worst-case = 90-percentile

  45. Other Courses Conducted at NIOH • Biological monitoring of chemical exposures • Ergonomics incl. Manual material handling • Occupational allergies/asthma • Substance abuse in the workplace • Chemical and biological hazards for Labour inspectors • Personal Protective Equipments • ILO-CXR for silicosis • Management of Chemical exposures in the workplace • Stoffenmanager • GHS for chemical communication • Continuing Professional Development with HPCSA

  46. DVDs and facilitators’ guides

  47. Strengths of NIOH • NIOH is a WHO CC in OH. • Network with NIOSH, CDC, WHO, FIOH, UIC SPH, USA, etc • Linkage with DoH, DoL, DMR, MBOD, CCOD • Affiliated with Universities • Staff highly knowledgeable and skilled in various fields of OH • Infrastructure (lecture rooms, video-conference units • New learning technologies (eLearning) • National, Regional and International activities • Visionary leadership

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