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Web site Udruženja Stručnjaka Medicine Rada u Federaciji Bosne i Hercegovine SALUTOGENEZA

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Association of Occupational Health in Federation of Bosnia and Herzegovina SALUTOGENESIS

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Web site Udruženja Stručnjaka Medicine Rada u Federaciji Bosne i Hercegovine SALUTOGENEZA

Strengthening the health system

Meeting summary

First Sub-Regional Workshop on "Strengthening Health Systems to Address Occupational Health Risks in the South-Eastern Europe" was held at the Institute of Occupational Health Skopje, Macedonia, on 18-19 December 2006. Experts from 8 countries and UNMIK Kosovo in the South Eastern Europe, including Albania, Bosnia & Herzegovina, Bulgaria, Croatia, Republic of Macedonia, Montenegro, Romania, and Republic of Serbia, contributed by presenting the status of occupational health in the region.

  1. The Meeting was co-organised by the Institute of Occupational Health in Skopje and Occupational Health Program of WHO Regional Office for Europe with the support of the WHO Office Country Macedonia, South-Eastern Europe Health Network, and International Commission on Occupational Health, ICOH. Professor Jovanka Karadzinska-Bislimovska and her staff from the Institute of Occupational Health, Skopje, Macedonia were acknowledged for excellent preparation and practical arrangements for the Meeting.
  2. Opening words of honor were presented by the Minister of Health of Republic of Macedonia, Dr Imer Selmani. He addressed the participants admitting that the meeting is an exceptional challenge for Republic of Macedonia and for the region. Believing that the meeting will provide the key directions for further strengthening of public health aspects of this specifically important segment of the health system and further development and efficiency of functional occupational services he wished successful meeting with expectations of positive results. Ms Snežana Čičevalieva on a behalf of the Chair of Executive Committee, SEE Health Network presented an overview of the South-Eastern Europe health network, its features and principles, the ongoing projects and importance of public health services for stability and economic development. She underlined the importance of regional cooperation and partnership gave a strong support to the meeting and its activities.
  3. The Meeting was presented with WHO Global Plan of Action (GAP) on Workers Health by Dr. Ivan Ivanov, WHO, Geneva. The role of Basic Occupational Health Services, BOSH was particularly discussed in view of the implementation of the GAP. The WHO Euro support for BOHS was introduced by Dr. Rokho Kim, WHO EURO Bonn Office. He particularly emphasised the need for development of occupational health services for the countries in the Sub-Region in view of providing support to the health policies and programmes in the Countries, health and safety of working populations in particular and that way also to support the overall socio-economic development of the Countries and the Sub-Region.
  4. Professor Jorma Rantanen, ICOH, introduced the concept and practical implementation of the WHO/ILO/ICOH initiative for Basic Occupational Health Services. He particularly emphasised the needs and opportunities to develop occupational health services for underserved groups and sectors (small-scale enterprises, self-employed and informal sector) with help of BOHS approach.
    Preventive approach should be given the first priority in development of occupational health services and important contributor to the total physical and mental health as well as social wellbeing of workers. Dr. Rantanen also emphasized that the long-time international evidence and experience has shown that only the countries, which take good care of working conditions and occupational health have been able to develop sustainable, wealthy and balanced societies, while countries which have compromised the conditions of work have shown very slow or no development at all. 
  5. The Reports on occupational health situation in the Countries of the Sub-Region were introduced, recognizing a number of strengths of the Sub-Region and identifying the needs for development of occupational health services system (See Annex 1).

Conclusions and recommendations

On the basis of the introductions of the International Programmes, the Country Reports, and discussions of the Meeting, following conclusions and recommendations were agreed upon:

1.) Social Transition and the Need of Occupational Health Policy

The society at large and the structures of economies, also the conditions of work and the situation in occupational health and safety in the South-Eastern European Sub-Region have experienced major transitions in the past decade. This has eliminated several problems of occupational safety and health, but simultaneously together with the rapid changes linked to the globalization and introduction of new technologies, presented new problems which need new strategies and approaches to be solved.

There is a need to re-orientate and upgrade the occupational health policies and practices to give a response to the new challenges and needs of the modern work life. Such upgrading needs strong contribution from ministries of labour and ministries of health, from institutes of occupational health, expert communities and universities as well as from social partners, employers and workers unions.

Occupational health and safety have been shown to contribute substantially and positively to health and safety of working people in the view of prevention and control of traditional and new occupational health hazards. Simultaneously it has provided support for maintenance and promotion of work ability, productivity and overall socio-economic developments of the countries. On the other hand, poor working conditions, occupational accidents and diseases cause substantial economic loss amounting up to 5% of GDPs and stealing thus limited resources, which should be available for development of the countries in transition.

The Governments and policy-makers should make more effective use of occupational health approach and practices to support overall socio-economic development, development of modern work life and social and economic dimensions in their national development programmes. Occupational health services provide also an important instrument for genuine practical implementation of the Conventions and recommendations of International Organizations, WHO and ILO as well as implementation of the principles of European Directives on Occupational safety and health. There is a need to draw up concise national policies and programmes for development of occupational health services as a system providing expert support for enterprises and working people.

2.) Backgrounds of Occupational Health Services in the region 

The Countries of the South-Eastern European Sub-Region have a strong tradition on provision of occupational health services for the whole working population. The Institutions and senior experts have remarkable experience and competence in content and methods of comprehensive occupational health. Due to the reorganization of the systems for health and other services the structures for service provision have largely disappeared and the existing occupational health resources are partly under-utilized.

The Countries of the South-East European Region have National Institutes and a good expert capacity to develop well-working occupational health services system. The needs of such development were duly recognized by the Meeting and in part urgent actions for restoring the services particularly for high-risk sectors and for underserved groups were identified.

3.) Infrastructure and primary health care

The infrastructures for occupational health services need to be further developed. The full coverage of the total working population of the Country should be set as a long - term objective. In the first stage priority should be given to the high-risk sectors and the seriously underserved groups which are most in need.

While specialized comprehensive occupational health services are the best way to support the well established industrial and services sectors, for the underserved sectors it was found appropriate to combine such development with the overall development of primary health care services system. In organization of such service the possibilities to utilise the WHO/ILO/ ICOH Basic Occupational Health Services approach was found appropriate.

Without prejudicing the responsibility primary responsibilities of the employers and of tripartite collaboration, social partners and the Government the provision of services to sectors which do lack tripartite mechanism are the responsibility of the Government and other public sector in general.

4.) Human resources

The competence basis of experts in the Sub-Region is good and provides many opportunities for further development. The numbers of human resources are, however, limited and the existing resources partly utilized in other sectors than occupational health. The generation shift is also ahead and the retiring experts should be replaced by the new ones with good training and competence. Systematic national training programmes and curricula, harmonized with the respective European programmes, should be developed and implemented. This is important for upgrading the competences of existing experts and to prepare for generation shift in the expert communities.

5.) Networking

The Sub-Region is characterized by several common features and trends in their work life and they also share several common problems and challenges in development of occupational health. They also have a rich spectrum of strengths and special competencies, which complete each others. The resources are limited in each country and the needs for occupational health activities are obvious. All this provides good basis for collaborating in network.

The networking of institutions and experts in the Sub-Region is found necessary to provide more mutual support between the institutions expert communities and to make the best possible uses of resources available. The initiative for establishment of the South- East European Network on Workers Health in close collaboration with the South-Eastern Europe Health Network was welcomed by the participant countries and the International Organizations as a timely and highly relevant movement for development of occupational health in the Sub-Region.

6.) Funding

The development of National Programmes and infrastructures for occupational health services in general and Basic Occupational Health Services in particular needs additional funding and resources. In addition to national funding and primarily from public sources the opportunities for getting financial support from potential international sources, European Stability Pact, pre-accession funding, from other EU sources, including EU Social Fund and from International Organizations as well as from bilateral sources may be available.

Innovative initiatives should be taken to design Sub-Region wide programmes for development of occupational health capabilities and infrastructures and particularly for Basic Occupational Health Services. In addition to national funding, international funding should be applied for.

Rest of the report can be viewed HERE

 

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