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

Author

Listed:
  • 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
    School of Health Systems and Public Health, University of Pretoria, Pretoria 0002, South Africa)

  • Simphiwe Mabhele

    (International Labour Organization, Block C, Crestway Office Park, 20 Hotel St. Persequor, Pretoria 0020, South Africa)

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.

Suggested Citation

  • Regiane Garcia & Jerry M. Spiegel & Annalee Yassi & Rodney Ehrlich & Paulo Romão & Elizabete A. Nunes & Muzimkhulu Zungu & Simphiwe Mabhele, 2020. "Preventing Occupational Tuberculosis in Health Workers: An Analysis of State Responsibilities and Worker Rights in Mozambique," IJERPH, MDPI, vol. 17(20), pages 1-16, October.
  • Handle: RePEc:gam:jijerp:v:17:y:2020:i:20:p:7546-:d:430211
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    References listed on IDEAS

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    1. Elizabeth S. Wilcox & Ida Tsitsi Chimedza & Simphiwe Mabhele & Paulo Romao & Jerry M. Spiegel & Muzimkhulu Zungu & Annalee Yassi, 2020. "Empowering Health Workers to Protect their Own Health: A Study of Enabling Factors and Barriers to Implementing HealthWISE in Mozambique, South Africa, and Zimbabwe," IJERPH, MDPI, vol. 17(12), pages 1-17, June.
    2. Rodney Ehrlich & Jerry M. Spiegel & Prince Adu & Annalee Yassi, 2020. "Current Guidelines for Protecting Health Workers from Occupational Tuberculosis Are Necessary, but Not Sufficient: Towards a Comprehensive Occupational Health Approach," IJERPH, MDPI, vol. 17(11), pages 1-11, June.
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    Cited by:

    1. Rodney Ehrlich & Jerry M. Spiegel & Prince Adu & Annalee Yassi, 2020. "Current Guidelines for Protecting Health Workers from Occupational Tuberculosis Are Necessary, but Not Sufficient: Towards a Comprehensive Occupational Health Approach," IJERPH, MDPI, vol. 17(11), pages 1-11, June.
    2. Sikhethiwe Masuku & Ramadimetja Shirley Mooa & Mmapheko Doriccah Peu, 2024. "Exploring the Role of Healthcare Personnel in Designing Tuberculosis Infection Prevention and Control Measures in Healthcare Settings: A Scoping Review," IJERPH, MDPI, vol. 21(5), pages 1-11, April.

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