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Open AccessArticle

Preventing Occupational Tuberculosis in Health Workers: An Analysis of State Responsibilities and Worker Rights in Mozambique

1
School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
2
Division of Occupational Medicine, School of Public Health and Family Medicine, University of Cape Town, Rondebosch 7701, South Africa
3
International Labour Organization, 688 Av. do Zimbábwe, Maputo, Mozambique
4
Department of Internal Medicine, Maputo Central Hospital, 364 Av. Agostinho Neto, Maputo 1100, Mozambique
5
National Institute for Occupational Health, 25 Hospital St, Constitution Hill, Johannesburg 2000, South Africa
6
School of Health Systems and Public Health, University of Pretoria, Pretoria 0002, South Africa
7
International Labour Organization, Block C, Crestway Office Park, 20 Hotel St. Persequor, Pretoria 0020, South Africa
*
Authors to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(20), 7546; https://doi.org/10.3390/ijerph17207546
Received: 29 June 2020 / Revised: 11 October 2020 / Accepted: 13 October 2020 / Published: 16 October 2020
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. View Full-Text
Keywords: occupational health; health workers; rights; laws; governance; implementation science occupational health; health workers; rights; laws; governance; implementation science
MDPI and ACS Style

Garcia, R.; Spiegel, J.M.; Yassi, A.; Ehrlich, R.; Romão, P.; Nunes, E.A.; Zungu, M.; Mabhele, S. Preventing Occupational Tuberculosis in Health Workers: An Analysis of State Responsibilities and Worker Rights in Mozambique. Int. J. Environ. Res. Public Health 2020, 17, 7546.

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