Presentation by prof. Benjamin Fayani of the Faculty of Medicine, Cotonou, Benin at the WHO/TNO/Dutchgovernment Congres 'Connecting Health and Labour' 29 - 1 December 2012
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How occupational services are provided in the context of integrated primary health care, case of Benin
1. How occupational health
services are provided in the
context of integrated primary
health care:Case of Bénin
Professor Benjamin FAYOMI
Occupational and Environnement Unit
Faculty of Medecine
Cotonou, Bénin
2. Key points
Who are the workers in our Context
Our experience 1
Our experience 2
Our difficulties
Our perspectives
5. The results of the study reveal in 2008 that
while the public service hardly offers 29 400
jobs (about 9 % of the working population),
and while the modern private sector offers
approximately 34 400 jobs (about 11 %)
the informal sector occupies the front stage
with about 269 800 jobs (that is 80 %)
Therefore, this sector is a strategic sector
6. Example
The sector of transport, in particular that of
the motorcycle taxis ( zémidjan ) alone offers
more than 185 000 jobs to the young
Beninese, meaning more than half of formal
activities.
Based on a daily average profit of fcfa 2500,
this sector would generate nearly 46,250
billions fcfa every year. = > 7 000 000
Euro/year
7. Resources put in place for 10%
of workers
Existence of legal resources
Human resources(doctors, nurses, engineers
etc.)
Material resources
Financial resources, etc.
8. 90 % of the working population which is part of the
informal economy are not survey
Conclusion : the health protection in the informal
economy workers is not assured
9. Our FIRST experience of integrated
primary health care in informal
secteur in Bénin was named :
Joint "Occupational health
care program for the Benin
informal economy "
10. Basis for the program: Context
and justification
Occupational healthcare has at all times been
set up to favor the government-regulated)
workers (formal Economy).
As previously explained, these workers represent
only 10 % of the working population
12. Motobycycle repair
Washing hand with
hydrocarbure
product
soil pollution
13.
14. Our Mission/objectif
Reach one of the Millennium objectives
which is “the fight against poverty" through
Accessibility to quality health care
General objective
Contribute to the improvement of the health of
the Benin informal economy workers
15. Specific Objectives
Enable access to primary healthcare for all
the socio professional sectors of the informal
economy
Set up a system of health protection and
prevention.
16. Expected results
- Ensure accessibility to quality health care
- The professional pathologies are detected
and taken care of immediately
- The statistics of occupational hazards in the
informal economy are available.
- Local care of nearness are supplied.
- Self medication is reduced.
18. Strategy 1
Active screening consists in:
Providing local health care through
workplaces visits in order to:
Know fields of activity and working
conditions
Detect the work related diseases
Satisfy the expressed needs.
19. Strategy 2
Workers’ participation meaning
Membership to the program
Collective choice of the services to be offered
20.
21. ACTIVITES
1- Preventive care activities
Systematic medical visits of the workers
Additional health assessments (blood, eyes,
etc.)
Practice of specific vaccinations or not
2-Activities of promotional care
Communication and raising awareness for a
change of behavior (contagious and not
contagious Diseases)
22.
23. ACTIVITIES OF CURATIVE
CARE
Provision of health care on the workplace
Refer for specialized care
To the medical base the humanitarian Health
center Call Holy LEONIE
or in case of emergency to the Health center
which is closest and well equipped.
24.
25. FUNCTIONNING
A medical team is organized:
A general practitioner
A nurse
A nurse's aide
Car driver specially trained for the
maintenance and the disinfection of the
installations once the medical truck parked
This team is supported by an occupational
health doctor or Occupational heath student
26. Hospital truck
AIR-CONDITIONED with adequate plugs no
matter the type of site electric installation.
Truck amenities include:
4 waiting cabins,
2 consultations rooms with at least one equipped
with accessories for visual screening
(Ophthalmology),
Electrocardiogram ( ECG).
27. Hospital truck (Cont’d)
Biomedical analyses Laboratory
(place for sampling)
Pharmacy.
1 Consultation office
A mapping of the closest Health
centers for the cases to refer
urgently.
28. COST
Consultation and medical care: all inclusive of
1000 FCFA / person =
1,5 Euro
Pharmacy: chargeable to the beneficiary
Occupational health visit : 2.000 FCFA / person
= 3 Euro
Biological assessment depending on the risk:
Chargeable to the beneficiary.
29. PROGRAM’S POTENTIAL PARTNERS
Occupational Health and Environment training
and research university unit (URESTE),
International Labour Organization (regional office
of West Africa) NOT ACTIVE SUPPORT
…….etc.
30. MANAGEMENT OF THE PROGRAM
MUSANT, a complementary insurance
organization with headquarters at Fidjrossè
(Cotonou)
FAILURE
31. CAUSES OF THE FAILURE
Management method was not collective
Fast deviation towards general healthcare
Fast deviation towards government-
regulated companies
34. Métabolites urinaires du benzène et du
benzopyrène
1
0,8
0,6 Vm benzène
Vm PMA/10
0,4 Vm 1-HOP
0,2
0
Taxi-moto Témoin
35. Adduits et des bases hydroxylées et
méthylées d ’ADN
5
4
Témoins
3
Conducteurs de
2 taxi-moto
1
0
Adduits d’ADN en 8-HO dG /108 dG m 5 dC (%) 10µg
fmol/µg ADN X10 ADN /10
42. Global engagement
Regional engagement = ILO/WHO (Thinking
about the project called JOINT EFFORT (NO
CONCRETE RESULT IN AFRICA)
National engagement (different ministery)
Workers engagement