Presentation at the WHO/TNO/Dutchgovernment Congres 'Connecting Health and Labour' 29 - 1 December 2012

1. Ministry Of Health And Social Services
Republic of Namibia
Occupational Health Services
In Namibia
Directorate: Primary Health Care Services
Division: Public and Environmental Health
Sub-Division: Occupational Health Services

2. Occupational Health in Namibia
• The Ministry of Health and Social Services
(MoHSS) established the Subdivision
Occupational Health Services (OHS) as part of
the Directorate Primary Health Care Services.
The role of OHS is preventative in nature and
serves in the promotion and maintenance of
health of all employees who are gainfully
employed

3. Occupational Health in Namibia
• The Sub-division at National Level comprises
of two units:
- Occupational Medicine and
- Occupational Hygiene
- 1 Chief Medical Officer (CMO)
- 1 Senior Health Program Administrator (SHPA)
- 1 Chief Environmental Health Practitioner (CEHP)
for Occupation Hygiene
- No structure exists at regional or district levels

4. Occupational Health in Namibia
• Namibia launched the Vision 2030, the
framework for national development –
aiming at industrializing the country and
to alleviate poverty. It is therefore
imperative that a high priority is given to
the development of Occupational Health
Services.

5. Occupational Health in Namibia
• Currently Occupational Health Services are provided
by certain large companies, providing enterprise
based occupational clinics and using the services of
an occupational medical specialist.
• Where enterprise based occupational health
services are absent, a number of small/ medium
enterprises are providing medical surveillance for
their employees using local general practitioners.

6. Program Aims (Mission):
• The overall goal is the promotion and
enhancement of socio-economic development
by providing a safe and healthy work
environment and preventing work-
environment related adverse health
conditions as far as reasonably practicable,
within the context of Primary Health Care.

7. Program Objectives:
• Human resource development and training.
• Formulation of policies, guidelines & standards.
• To control, monitor and evaluate the implementation
and enforcement of the relevant legislations relating
to occupational health issues pertinent in the
workplaces to meet national and international
conventions and treaties obligations
• The maintenance and promotion of employees’
health in general, by protection of employees against
any occupational health related hazards or injuries.

8. Program Objectives: Continued
Medical Surveillance: The maintenance and
promotion of the highest possible degree of
physical, mental and social welfare of all
persons gainfully employed in all branches of
economic activities.
Technical backstopping and support to
operational level: provision of Consultative
Services.

9. Program Objectives: Continued
• Execution of monitoring, supervision, quality
assurance and evaluation OHS programs.

10. Legal Framework for OHS in Namibia
The occupational health challenges at global
and regional levels are reflected within the
Namibian context and to address these
challenges, Namibia has developed various
legal framework. These include the following;

11. The Constitution of the Republic of
Namibia
The Constitution of the Republic of
Namibia (Government Notice No. 1 of
1990) highlights the fundamental rights to
well-being of all citizens, including
employees at various workplaces within
the country. It further protects children
below fourteen years of age from
unlawful employment and economic
exploitation.

12. Labour Act, 2007
• The Labour Act 2007, (Act No. 11 of 2007),
which repeals the Labour Act 1992 (Act 6 of
1992) consolidates and amends the labour law
to ensure the health, safety and welfare of
employees in the workplace. It is further
designed to maintain and improve work
related standards for the economically active
population in Namibia.

13. Labour Act, 2007
• The Ministry of Labour and Social Welfare
(MLSW) was established to be the umbrella
organization for all matters concerning
occupational health and safety issues in
Namibia.

14. “Regulations Relating to the
Health and Safety of Employees at Work”
under Labour Act 2007
• With Government Notice 156, the
President of the Republic of Namibia
promulgated, after consultation with the
Labour Advisory Council, under Section 101
of the Labour Act 1992, “Regulations
Relating to the Health and Safety of
Employees at Work” and determined that
the Regulations shall come into operation
on 31 July 1997.

15. Presidential Proclamation No. 10, Labour
Act, 1992 (Part XI, Section 101 of the
Labour Act 2007)
• In order to enforce, implement, monitor and
control the “Regulations Relating to the Health
and Safety of Employees at Work”, the President
of the Republic of Namibia assigned the
administration of these regulations to be
exercised and performed by the Ministry of Mines
and Energy (MME), Ministry of Labour & Social
Welfare (MLSW) and Ministry of Health & Social
Services (MoHSS), as set out in the Presidential
Proclamation.

16. Employees Compensation Act, 1941
• The Employees Compensation Act, Act 30 of
1941, provides for the payment of reasonable
medical expenses and compensation in
respect of work related injuries or
occupational diseases contracted by
employees out of and in the course of their
employment.

17. HIV Code on Employment
• In response to the AIDS pandemic, the
MLSW, in conjunction with the MoHSS
and with tripartite consultation through
the Labour Advisory Council formulated
the “National Code on HIV/AIDS in
Employment” for HIV prevention and
AIDS management.

18. HIV Code on Employment
• This Code is proposed as an integral part of
the government’s commitment to address
most of the major issues related notably to
the prevention of discrimination of HIV
positive employees, as well as to the provision
of optimal care and support for the affected
workforce.

19. Guidelines: Post-Exposure Prophylaxis
(PEP)
• the use of therapeutic agents to prevent infection
following exposure to a pathogen
• for health-care workers, PEP commonly considered
for exposures to HIV and Hepatitis B
• types of exposures include:
• percutaneous exposure: (needle stick injury, cut with
sharp object),
• contact exposure: (splash, bite).

20. Affirmative Action (Employment) Act,
1998:
• The Affirmative Action (Employment) Act, Act 29
of 1998 indicates that people with disabilities
should have an equal opportunity to employment
and are equitably represented in the workforce of
a relevant employer. The 2001 Population and
Housing Census indicate that 4.7 percent of the
people of Namibia have disabilities. This has
important implications for workplace organization
and the application of employment equity in
workplaces.

21. • The above forms the legal framework for
the provision of standardized OHS
throughout workplaces in Namibia.
• The MoHSS is specifically responsible for
statutory control of the implementation
and monitoring of the pertinent legislation
relating to health & safety issues in the
various workplaces.

22. Operations
• At Regional and District levels, Environmental
Health Practitioners are responsible for
provision of Occupational Health Services
(particularly occupational hygiene component
of the service).
• Currently the occupational medical services
are absent at Regional and District level.

23. Intersectoral Collaboration
• MoHSS, MoLSW, MME, employees
representatives and employers federation
organization are all represented in the
following committees : Labour Advisory
Council, National Coordinating Task Force
Committee for Occupational Health and Safety
and Namibian Standard Institution Technical
Committee for Occupational Health and
Safety.

24. Classes of Economic Activities
100 000 registered employees with the
Workmen’s Compensation Commission;
now known as the Social Security Commission
(SSC).

25. Classes of Economic Activities
• In line with comparable developing
countries, the Agricultural sector
constitutes the largest sector, both in
regard to number of enterprises registered
(52%) and work force employed (19%).
• The Mining sector has the second largest
employee work force (17%), followed by
Trade and Commerce (12%) and thereafter
by Building and Construction (9%). The
above reflects the comparison of the
sectors with the highest work force.

26. Occupational Diseases
Generally there is a lack of comprehensive
statistics on occupational diseases in
Namibia. This is further reflected in the
under-reporting of notifiable occupational
diseases both to the SSC and the MoHSS.
During 01//03/2004 – 28/2/2005, a total of
4 693 incidents were reported to SSC for
compensation. Of these, 99.9% related to
traumatic and acute injuries and only 0.1%
to work place related diseases.

27. Occupational Diseases
A mere total of 6 incidents (0.1%) was
diagnosed and reported as occupational
disease.
• Dermatitis ranked first, followed in descending
order by tuberculosis, malaria, chronic lung
diseases and rubella (German measles).
The highest number of occupational diseases
was registered by the Mining sector, followed by
Government Services, namely the MoHSS.

28. Occupational Injuries
Basic data from the occupational injury reports
produced in work places are internationally
often poor, particularly with regard to the
description of the accident, sequence and
contributing environmental factors.
In Namibia, the same trend can be identified.
Data regarding the type and causes of an
accident is incomplete.

29. Occupational Injuries
• For the period March 2004 –February 2005,
the accident type could not be classified in
46% of the claims forwarded to the SSC
resulting in occupational injuries, as
insufficient data was provided by the
reporting person.
• In line with internationally recognized
grading of accident types and causes, the
available statistical evidence indicates that
common causes of occupational injuries are
mainly found in ordinary industrial actions
rather than in the use of dangerous
machines or substances.

30. Occupational Injuries
• The main underlying causes of accidents are,
in descending order,
- working in unsafe positions or postures,
- operating or working at an unsafe speed and
- failure to use personal protective equipment
(PPE).

31. Occupational Health Services and the
Community
• Occupational health is one of the most
direct contributions that the employer can
make to the community’s productivity, and
therefore to its welfare.
• Hazardous waste and atmospheric
pollution arising from
enterprises/industries has an impact on the
environment and subsequent implications
on the health of the community.

32. Occupational Health Services and the
Community
• If occupational hazards/pollution are
controlled at the source (i.e. at enterprise
and industrial levels); then environmental
pollution is prevented, safeguarding the
health not only of employees but also the
community at large.

33. Challenges:
• Inadequate enforcement of legislation due to
insufficient staff allocation and lack of trained
OH personnel within the MoHSS at all levels.
• Lack of familiarity of OH&S legislation
resulting in:
• a) Employers and employees ignorant of their
legal responsibilities and duties. No formal
OH&S training for employees, including
management for the majority of workplaces
• b) OH&S structures not evident in private /
public sectors and SMEs

34. Challenges Continued:
c) Lack of a consistent approach to participatory
risk assessment at workplaces
d) Lack of medical surveillance programs based
on the participatory risk assessment
e) Notification and submission of compensation
reports for occupational diseases/ injuries is
very weak
f) Notification, compensation and other OH&S
statistics are not available

35. Challenges Continued:
g) Shortage of trained experts needed for OHS
h) Inadequate funding for OHS
The above challenges can only be successfully
addressed if there is sufficient allocation of
financial resources and staff, in both the public
and private sectors.

36. Future Action
• Establishment and strengthening of OHS in the public
and private sectors & enhance financing;
• Capacity building and human resource development of
occupational health staff in public sector (13 regions) &
private sector in all categories;
• Formulation of policy strategies & guidelines;
• Strengthen M&E mechanism for the implementation of
the relevant legislation relating to the health & safety in
the workplaces;

37. Future Action Continued
• Dissemination of OH information, advocacy of OHS and
appropriate resource mobilization for the provision of
regular and enabling information on OHS for tripartite
structures;
• Strengthen the notification of occupational diseases and
establish a database of notifiable diseases;
• Strengthen regional and international links and channels
of communication with OHS services including WHO
Collaborating Centers and ILO Centers;

38. Future Action Continued
• The maintenance and promotion of employees’
health in general, by protection of employees
against workplace related hazards. (Engineering/
Admin. Methods, PPE);
• Provide scientific information and support to
facilitate the implementation of participatory risk
assessment and medical surveillance (based on
the risk assessment) at workplaces;

39. Future Action Continued
• Incorporating essential elements of
occupational health in PHC services;
• Linking occupational health to other public
health programs - HIV, TB, malaria, non-
communicable diseases;
• To strengthen intersectoral collaboration on
occupational health and safety under the
different committees;

40. Future Action Continued
• Establish a national fund for health and safety
to finance national activities, campaigns,
research, training, information on health and
safety;
• Establish national program for occupational
health and safety of public health workers
under the MOHSS to ensure that public health
facilities comply with the Health and Safety
regulations and to protect and promote the
health and safety of health workers as a mean
to improve human resources for health.

41. THANK YOU.