The Occupational Safety and Health (OSH) scenario in India is complex. Unprecedented growth and progress go hand in hand with challenges such as huge workforce in unorganised sector, contract workers, availability of cheap labour, meagre public spending on health, inadequate implementation of existing legislation, lack of reliable OSH data, shortage of OSH professionals, multiplicity of statutory controls, apathy of stakeholders, and infrastructure problems. C. Mahadevan, HSE consultant gives a comprehensive picture of the situation.
The Constitution of India states that ‘state shall make provisions for securing just and humane conditions of work.’ This provides the basis for provision of occupational health services to all citizens of the country. It is gathered that there are around 1,000 qualified occupational health professionals in India and only around 100 qualified hygienists for various factory and other services.
However, in reality, there is plenty of opportunity to provide occupational health services to all working population, not only in India but also even in developed world. Occupational health services are available only to 10%-15% of workers worldwide and to a much less percentage of working population in developing countries. Even where services are available, the quality and relevance may be low. Though there is an intense economic pressure on cost of production all over the world, there cannot be a tradeoff between health and productivity at work.
The Basic Occupational Health Services (BOHS) are an application of the primary healthcare principles in the occupational health sector. The BOHS seek to provide occupational health services for all working people in the world regardless of mode of employment, size of workplace or geographic location – that is, according to the principle of universal services provision. These services are most-needed in countries and sectors which do not have services at all or which are seriously underserved. It lays stress on the importance of a national strategy and plan of action to incorporate occupational health in all policies.
The concept of BOHS, developed jointly by World Health Organisation (WHO), International Labor Organisation (ILO) and International Commission on Occupational Health (ICOH), has its roots in the ‘Alma Ata’ declaration (1978) by WHO. The BOHS principles were first discussed at the WHO/ILO Joint Committee of Occupational Health in 2003. The BO HS has become a central piece of global occupational health services development plans of WHO and ILO. WHO, with its collaborating centres in occupational health, ILO, ICOH and other international organizations work for the BOHS.
The BOHS concept envisages coverage of all workers, and has a strong focus on prevention. They are to be provided for small and medium enterprises as well as self-employed persons through public services. There will have to be different modalities for the same. There has to be a strong primary healthcare approach, which needs strong coordination between the health and labour ministries. The expert institutions on occupational health have an important role to play in BO HS and they need to support the provision of BOHS by developing low-cost solutions.
The BO HS aims at:
(Read more from the September Issue of Safety Messenger Magazine 2015)