Implementation of community-based occupational health programs for informal workers in indonesia
Astri Ferdiana, MPH ; Fahmi Baiquni, SKM ; DHIYA URRAHMAN ; dr. Sri Awalia Febriana, M.Kes., Sp.KK., Ph.D. ; dr. Ajeng Viska Icanervilia, MPH. ; Fitrina Mahardani Kusumaningrum, S.K.M., M.P.H. ; Dr. Supriyati, S.Sos., M.Kes. ; dr. Fatwa Sari Tetra Dewi, MPH., Ph.D (2019)
Informal workers account for 60% of workforce in Indonesia. Most do not have access to occupational health and safety (OHS) services. The study aims to explore the implementation of community-based OHS program consisting of OHS post and cadres (referred to as UKK program) among informal workers in rural areas in Indonesia. This study was an implementation research using focus group discussion (FGDs) and key informant interviews (KIIs) to workers, primary health care (PHC) staff, and provincial and district program managers. Thematic analysis was used to identify barriers and enablers of UKK implementation at intrapersonal, interpersonal, community, organizational and policy level.
A total of 10 FGDs with informal workers from different areas of occupation, two FGDs with PHC staff and 6 KIIs with program managers were conducted. Informal workers faced various occupational risks yet personal protective equipment were rarely available or used. OHS was perceived as important, however, participation in UKK was low because of lack of time and information. There was lack of workers empowerment, resulting in top-down planning of activities by PHC. Informal workers expected PHC health workers to provide OHS services rather than UKK cadres. Not all PHCs have implemented UKK. Few programmers were trained on OHS. The program was assigned low priority and resource allocation by PHC and District Health Office. The absence of OHS regulation for informal workers offered little incentive for government departments to implement OHS programs and services for informal workers. Informal workers had unmet needs of OHS. Substantial efforts are needed to implement UKK, especially investment in financial and human resources. UKK establishment should be focused at workplace with the highest occupational risks. Technical capacity of programmers responsible for health promotion and OHS should be improved. Local policy on social protection and OHS services for informal workers should be developed.
Selengkapnya: https://oem.bmj.com/content/76/Suppl_1/A99.2.abstract
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