Safeguarding the health, safety and wellbeing of health workers in the United Republic of Tanzania

The health sector is one of the most hazardous work settings for health and safety, presenting specific risk factors. While contributing to the enjoyment of the right to health for all, health workers should also enjoy the right to healthy and safe working conditions to maintain their own health [1]. Providing healthy and safe workplaces in the health sector prevents avoidable harm to patients and health workers, improves quality of care, patient safety, health worker retention and environmental sustainability [2].

Therefore, the Ministry of Health, Community Development, Gender, Elderly and Children (Ministry of Health) of the United Republic of Tanzania (Mainland) requested WHO support to improve working conditions in the health sector by developing and implementing a national programme for occupational health and safety programme for health workers. The process started in 2016 with a train-the-trainers workshop using ILO/WHO training package for workplace improvement in health services (HealthWISE) which was followed by a series of consultations with stakeholders from the central and regional health authorities and associations of health workers. In March 2019, the Ministry of Health issued the national guidelines for workers’ health and safety in health care facilities and emergency responders [3]. These guidelines provide specific recommendations about prevention and control of occupational hazards and protecting the health and safety of health workers in different types of healthcare facilities. The guidelines were printed with WHO support and disseminated to all health care facilities. Additional assistance was provided for implementation of the programme at sub-national and healthcare facility levels. By the end of 2021, the programme has been implemented in 9 out of the 26 administrative regions covering 26,045 health workers and 3,674 health facilities, representing 46% of health workers and 36% of health facilities.

How did the United Republic of Tanzania do it, and how did the WHO Secretariat support?

• Technical and financial support – In 2020 and 2021, WHO provided technical and financial support for the development and implementation of occupational health and safety programmes for health workers at sub-national and facility levels in four regions (Mtwara, Mwanza, Dodoma and Ruvuma) covering 10,757 health workers in 1,463 health facilities. Data obtained from the national health information system show that in the last biennium there was a 22% increase in the number of health workers who received hepatitis B vaccination and a 36% reduction in the number of health workers needing post-exposure prophylaxis (PEP) for HIV/AIDS following exposure to blood and body fluids. In addition, there was better reporting of violence and harassment in health facilities in the regions where the programmes have been implemented. This suggests that the practical implementation of occupational health and safety programmes has stimulated interventions to mitigate occupational health and safety risks for health workers.

• Coordination and mobilization of partners – WHO has mobilized partners such as ILO to support the development and implementation of occupational health and safety programmes for health workers. This included capacity building HealthWISE workshops, assisting with the development of facility policies and action plans for workplace improvement as well as the appointment of facility focal points and labour-management committees for occupational health and safety in the aforementioned four regions. In the last biennium there has been a 65% increase in the number of health workers who received a five-day training on workplace improvement in health facilities and who were enabled to take up functions for developing and implementing measures for improving working conditions as focal points for occupational health and safety and members of facility health and safety committees. Furthermore, the proportion of health facilities with appointed occupational health and safety focal points and health workers covered by occupational health and safety programmes has more than doubled.

• Communication and awareness raising – OpenWHO online training course “Occupational health and safety for health workers in the context of COVID-19” was translated to Swahili and disseminated by the Ministry of health [4]. In collaboration with the Ministry of Health and ILO, WHO co-organized a webinar in July 2021 on the progress and lessons learned from the implementation of the occupational health and safety programme for health workers in Tanzania in the context of COVID-19 response and recovery. The event which attracted national, regional and international participation, has stimulated other African countries and the African Union Development Agency (AUDA-DA) to take action on protecting the health and safety of health workers.

WHO’s technical assistance, financial support and partner mobilization has enabled the implementation of occupational health and safety programmes for health workers at the national, sub-national and facility levels. The programme in the United Republic of Tanzania (Mainland) has been used as an example of good practice in several WHO normative and standard-setting products on safeguarding the health and safety of health workers.

REFERENCES

[1] https://apps.who.int/iris/handle/10665/351107

[2] https://apps.who.int/iris/handle/10665/351436

[3] https://www.moh.go.tz/en/guidelines

[4] https://openwho.org/courses/COVID-19-afya-na-usalama-mahala-pa-kazi

Photo Credit: © Ministry of Health, Community Development, Gender, Elderly and Children

Photo Caption: Training workshop on workplace improvement in health care facilities in Kigoma Region (February 2020)