Abstract:
Given the very high incidence of tuberculosis (TB) among health workers in Mozambique,
a low-income country in Southern Africa, implementation of measures to protect health workers from
occupational TB remains a major challenge. This study explores how Mozambique’s legal framework
and health system governance facilitate—or hinder—implementation of protective measures in
its public (state-provided) healthcare sector. Using a mixed-methods approach, we examined
international, constitutional, regulatory, and policy frameworks. We also recorded and analysed the
content of a workshop and policy discussion group on the topic to elicit the perspectives of health
workers and of officials responsible for implementing workplace TB policies. We found that despite a
well-developed legal framework and national infection prevention and control policy, a number of
implementation barrier persisted: lack of legal codification of TB as an occupational disease; absence
of regulations assigning specific responsibilities to employers; failure to deal with privacy and stigma
fears among health workers; and limited awareness among health workers of their legal rights,
including that of collective action. While all these elements require attention to protect health workers
from occupational TB, a stronger emphasis on their human and labour rights is needed alongside
their perceived responsibilities as caregivers.
