Building Capacity to Secure Healthier and Safer Working Conditions for Healthcare Workers: A South African-Canadian Collaboration

Abstract

Healthcare workers face difficult working conditions, particularly where HIV and tuberculosis add to understaffing. Questionnaires, workplace assessments, and discussion groups were conducted at a regional hospital in South Africa to obtain baseline data and input from the workforce in designing interventions. Findings highlighted weaknesses in knowledge, for example regarding the use of N95 respirators and safe handling of sharps, and suggested the need for improved training. Access to supplies and personal protective equipment was the major reported reason for failure to follow proper procedures; this was confirmed by workplace assessments. Discussion groups highlighted the important role for worker Health and Safety Committees (HSC), including in combating stigma and encouraging reporting. Interest in data to support decision-making resulted in development of the Occupational Health and Safety Information System (OHASIS); further training of HSCs is still needed. Multi-stakeholder international collaboration aimed at building HSC capacity is well-received.

Collaboration between infection control and occupational health in three continents: a success story with international impact

“…Again, working closely with local colleagues, we revised the assessment tools, then invited 76 participants to a three-day workshop on occupational health and infection control to complete the initial survey. Invited participants included all the 54 representatives elected from the workforce to serve as health and safety representatives as well as the 16 occupational health and infection control staff members from Pelonomi Hospital, the health facility selected for our pilot study [26]. The participants were then divided into ten groups to conduct workplace audits, covering five domains; Physical Environment, Specific Occupational Health Practices and Hazards, Specific Infection Control Practices, Equipment and Procedures, and Ergonomics.…”

Considerations for preparing a randomized population health intervention trial: lessons from a South African–Canadian partnership to improve the health of health workers

“…We agreed to focus on workplace-based endeavors in one province, and chose Free State province after some preliminary assessments. As we wrote in our first collaborative article from this work, we chose one hospital in the Free State for the pilot work due to strong management support; a well-developed occupational health department; strong national, provincial, and academic support; and, most importantly, a Health and Safety Committee (HSC) committed to working for occupational justice that welcomed the international multi-stakeholder support (38). Support was needed not only from frontline, senior healthcare managers and provincial decision-makers but also from unions and representatives of frontline workers.…”

“…Considering the importance of union support for our work, considerable effort and patience was necessary to address the multiple concerns raised by local unions. This necessitated several meetings, including bringing Canadian union leaders to South Africa to interact directly with South African counterparts (38). Another issue that arose was that while the partnership began with solid relationships among the Canadian researchers and national-level South Africa counterparts, relationships had to be built not only with healthcare workers and representatives from the DoH in the Free State where the envisioned trial would take place but also with local university colleagues, in keeping with the ethical imperative to build local capacity (44).…”

Innovative Training for Occupational Health and Infectio Control Workplace Assessment in Health Care

“…2 A field guide and its companion assessment worksheet, originally from an infection control audit 2 but expanded with respect to other occupational health concerns, 3 was piloted and validated for use in low and middle income countries such as South Africa. 4 Its intent was to provide a template for consistent identification of potential workplace hazards, assessment of risk, a process for prioritization and assignment of responsibility with timelines for completion. These tools were revised based on pilot testing in a South African hospital, 4 and were intended to be introduced in clinical units within two hospitals in the Free State Province to train practitioners on their use in real settings.…”

“…4 Its intent was to provide a template for consistent identification of potential workplace hazards, assessment of risk, a process for prioritization and assignment of responsibility with timelines for completion. These tools were revised based on pilot testing in a South African hospital, 4 and were intended to be introduced in clinical units within two hospitals in the Free State Province to train practitioners on their use in real settings. An unanticipated public sector strike 5 led to the need to change the training format -as access to the health care facilities during this time was not possible.…”