Preventing occupational tuberculosis in health workers : an analysis of state responsibilities and worker rights in Mozambique
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Date
Authors
Garcia, Regiane
Spiegel, Jerry M.
Yassi, Annalee
Ehrlich, Rodney
Romão, Paulo
Nunes, Elizabete A.
Zungu, Muzimkhulu
Mabhele, Simphiwe
Journal Title
Journal ISSN
Volume Title
Publisher
MDPI
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.
Description
Keywords
Occupational health, Health workers, Rights, Laws, Governance, Implementation science, Mozambique, Tuberculosis (TB)
Sustainable Development Goals
Citation
Garcia, R., Spiegel, J.M., Yassi, A. et al. 2020, 'Preventing occupational tuberculosis in health workers: an analysis of state responsibilities and worker rights in Mozambique', International Journal of Environmental Research and Public Health, vol. 17, no. 20, art. 7546, pp. 1-16.