Capacity Building for Occupational Health for Workers in South
Africa Inakshi Naik OHS Training Department, NIOH 29 th October
2013 Hong Kong
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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
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Johannesburg, SA The City of Gold
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National Institute for Occupational Health (NIOH) Established
in 1956 (Pneumoconiosis Research Unit)
6 Universities and other Institutions Local & International
Partnership Trade Unions, NGO and Business Govt. and Public
Entities ServicesResearch Back Office Support Training
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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
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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
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Qualification for Occupational 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
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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
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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)
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OHLearning for Occupational Hygienists www.ohlearning.com
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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
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Downloading of training materials is free of charge but is
subject to the Terms of Use of OHlearning.com.Terms of Use
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Training for Other Occupational Health Workers Provided at NIO
H Occupational epidemiology (MPH) Information sciences Residency
training in Occupational Medicine Partnerships with universities,
internship programmes and experiential learning.
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Laboratory based sciences (Scientists. Technologists &
Technicians) Toxicology Analytic chemistry Pathology
Immunology/Microbiology Students from India trained in the
Analytical Laboratories for metals, organic exposures
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Developing Capacity for the Government Health System
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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
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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
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Clinic / PHC District Hospital Regional Hospital Tertiary
Hospital Outreach CHW Short Courses Academic Learning CHWs, Nurses,
Environmental Health Officers & Hygienists, Doctors Proposed
Training at Different Levels OH Learning and other support
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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 6 CHW 270 Families each Professional Nurse Team Leader EHO
Health Promoter Functions stipulated for EHO: Monitor OH and safety
in local businesses Manage environmental noise hazards
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Clinic / PHC District Hospital Regional Hospital Tertiary
Hospital Outreach CHW Short Courses Academic Learning CHWs, Nurses,
Environmental Health Officers & Hygienists, Doctors Proposed
Training at Different Levels OH Learning and other support
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Statistics of South African Nursing Council - 2012 Over the 9
year period 2003 to 2012, the total number of nurses on the
register has grown from 177721 to 248736 i.e. a net increase of
71015 (+40,0% growth). The growth in nursing figures has exceeded
that of the population of SA by quite a margin. There is currently
a shortage of occupational health nursing practitioners in South
Africa (1147 Registered OH Nurses -2012 SANC stats) Taken from
http://www.sanc.co.za/stats.htmo.za/stats.htm
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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 They are 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.
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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
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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.
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Current Short Courses Available for Medical Practitioners
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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
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Structure of the GPOHP
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OHTA Recognition and incorporation of Hygiene Modules in
OHLearning
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
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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
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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
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WHO Modules in Occupational Health Course in Johannesburg, SA
(2009) This course was directly in line with the overarching aims
of the WHO Global Network Plan for Occupational Health (2009-2012),
which is driven by the Global Plan of Action (GPA) for Workers
Health 2008-2017.
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Corse Conducted at NIOH: Team from UIC, SPH, USA and Nayati
Int. India
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The week-long course was attended by close to 90 participants
from both public and private sectors. A certificate 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
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Field Visit-Hospital Laundry/Kitchen/Laboratory
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Learners During Lectures and Exercises
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Training for Medical Officers (Namibia) WHO: Protection of the
Human Environment Workers 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
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Health and Safety Representatives (HSR) Course for NHLS -
online
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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
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Stoffenmanager Version 5.1 www.stoffenmanager.nl
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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 Arbo Unie (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
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Changing Focus of Occupational Risk Management for Workplaces
Exposure to Chemicals 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.
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
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DVDs and facilitators guides
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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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Thank You
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S A Nursing Council Growth in the Registers 2003-2012 RN / RM =
Registered Nurses and Registered Midwives. EN / EM = Enrolled
Nurses and Enrolled Midwives. ENA = Enrolled Nursing Auxiliaries.
www.sanc.co.za/stats
ProvinceRegisteredEnrolledAuxiliariesTotal
Limpopo536:11060:1615:1226:1 North West418:11269:1714:1218:1
Mpumalanga638:11514:1995:1309:1 Gauteng382:1848:1726:1193:1 Free
State353:11393:1845:1211:1 KwaZulu Natal380:1489:1857:1171:1
Northern Cape511:12541:1910:1290:1 Western Cape377:1988:1695:1196:1
Eastern Cape449:11486:11021:1258:1 TOTAL417:1882:1785:1208:1
Population Per Qualified Nurse per Province) Population figures -
Statistics South Africa (2011 census). (All population figures have
been rounded off to the nearest 100.) 2013 South African Nursing
Council
