OCCUPATIONAL SAFETY AND HEALTH IMPLEMENTATION STRATEGY

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Ministry of Health

OCCUPATIONAL SAFETY AND HEALTH

IMPLEMENTATION STRATEGY

FEB 2011

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CONTENTS CONTENTS .................................................................................................................... 2 INTRODUCTION ............................................................................................................. 4 THE OSH IMPLEMENTATION STRATEGY ................................................................... 4

The Development Process ........................................................................................... 5 DESCRIPTION OF THE OSH IMPLEMENTATION STRATEGY .................................... 5

General Objective ........................................................................................................ 5 Specific Objectives ....................................................................................................... 5 Activities ....................................................................................................................... 6 NATIONAL ACTIVITIES .............................................................................................. 7

Advocating for OSH at national level ........................................................................ 7 Developing a core team of technical resource persons in OSH ................................ 8 Updating curricula for both basic and post-basic health training to include OSH ...... 8 Development of IEC materials on OSH .................................................................... 8 Forming a National OSH Committee ........................................................................ 9 Developing a system for reporting workplace accident, incident and occupational diseases ................................................................................................................... 9

DISTRICT LEVEL ACTIVITIES .................................................................................... 9 District level Sensitization Meeting ......................................................................... 10 Training Members of the OSH Committees ............................................................ 10 Conducting CPD on OSH at Least Twice a Year .................................................... 11 Distribution of Guidelines and IEC Materials .......................................................... 11 Formation of district and health unit OSH Committees ........................................... 11 Carrying out OSH Inspection .................................................................................. 11 Each District OSH Committee shall endeavor to carry out ..................................... 12 Put in Place an Accident and Incident Reporting System ....................................... 12 Instituting an OSH Reporting System for OSH ....................................................... 12 Availing and Ensuring Use of Personal Protective Equipment by all Health workers ................................................................................................................................ 12 Instituting a Comprehensive Management Procedure for Managing Exposed and Injured Workers ...................................................................................................... 13

INSTITUTIONAL FRAMEWORK ................................................................................... 13 The National OSH Committee .................................................................................... 16 District OSH Committee ............................................................................................. 16

Roles and responsibilities of the chairperson district OSH committee .................... 17 Roles and responsibilities of the secretary district OSH committee ........................ 17

The Health Sub District OSH Committee ................................................................... 17 The Health Facility OSH Committee .......................................................................... 18

Roles and responsibilities of the chairperson health unit OSH committee .............. 18 Roles and responsibilities of the secretary health unit OSH committee .................. 19

OSH Coordinator ....................................................................................................... 19 Roles and responsibilities for Managers and Supervisors ......................................... 19 Roles and responsibilities of the health workers ........................................................ 20

MONITORING AND EVALUATION ............................................................................... 21 ANNEXES ..................................................................................................................... 21

Annex 1: Training Content ......................................................................................... 21

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Annex 2: Session plans for the training ...................................................................... 22 Annex 3: List of Central Resource Persons ............................................................... 26 Annex 4: Form No. 1a. Incident reporting form .......................................................... 27 Annex 5: Form No.1b incident investigation form ....................................................... 28 Annex 6: Form No. 2. Monitoring and Evaluation Checklist ....................................... 29

Annex 7: Form No. 3a OSH workplace inspection checklist ................................... 31 Annex 8: Form No. 3b OSH workplace inspection action sheet ............................. 32 Annex 9: TOR Chairperson District OSH Committee .............................................. 33 Annex 10: TOR Secretary District OSH Committee ................................................ 34 Annex 11: TOR members of District OSH Committee ............................................ 35 Annex 12: TOR Chairperson HSD OSH Committee ............................................... 36 Annex 13: TOR Secretary HSD OSH Committee ................................................... 37 Annex 14: TOR members of HSD OSH Committee ................................................ 38 Annex 15: TOR Chairperson health unit OSH Committee ...................................... 39 Annex 16: TOR Secretary health unit OSH Committee .......................................... 40 Annex 17: TOR members of health unit OSH Committee ....................................... 41

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INTRODUCTION

The health care setting presents a number of safety and health hazards to both health

worker and clients. The hazards include biological, physical, chemical, psycho‐social as

well as those associated with non‐application of ergonomic principles.Implementation of

good safety, health and environmental practices is therefore an important prerequisite for productive and decent work. Whereas safety and health at the workplace has improved in the developed countries over the past 20 to 30 years, the situation in developing countries is largely unclear. This is because of inadequate accident and

disease recognition, record‐keeping and reporting mechanisms. It is estimated that at

least 250 million workplace accidents occur annually world‐wide 335,000 of which are

fatal. Majority of these accidents are in the developing countries. The inadequate

record‐keeping and reporting mechanisms within developing countries implies that the

figures could be even much higher.

In Uganda, the situation is not any different. Although the Occupational Safety and Health (OSH) Act No 9, 2006 and the Worker’s Compensation Act 2000 recommends the reporting of all occupational injuries and diseases to the appropriate authorities, a number of occupational injuries and diseases among the health workers have gone unreported . The available records show that there are only 39 health worker claims for compensation and all of these were victims of the Ebola outbreak of 2000 (MOH 2008).

To promote safety and health within the sector, the Ministry of Health (MOH) developed the National Policy and Guidelines for OSH in 2008. The guidelines outline the basic principles and interventions that are important in order to deal with safety and health at the workplace for the health sector. Focus is on prevention of incidents and accidents at all workplaces; effective management of all incidents as well as exposures; and provision of rehabilitation and support to workers who get injured at the workplaces. However the guidelines remain too broad and were difficult to translate into measurable actions for improved safety and health in the sector hence the development of OSH implementation strategy.

THE OSH IMPLEMENTATION STRATEGY

The OSH implementation strategy outlines the steps to be undertaken by anyone who would like to ensure safety and health at the work place in the health sector. It simplifies the guidelines outlining the objectives of implementing a safety and health program at the work place, tools to use, areas of action, and how to monitor and evaluate progress of implementation. It is meant to be a simple reference for all levels of managers as they undertake the task of improving the safety and health of their workplaces. The implementation strategy can be used at any level of service delivery in both the public and private health sector.

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The Development Process

The OSH implementation strategy was developed through extensive consultations with different stakeholders coupled with lessons learnt from testing out its implementation in the three districts of Oyam, Amolatar and Kabarole. A number of stakeholder meetings were held with the Ministry of Gender Labor and Social Development (MGLSD) particularly the Labor and Occupational Safety and Health Departments; the MOH particularly the Human Resource Management Division (HRM), the Environmental Health Division (EHD), the Health promotion and Education Division (HPE) and the Pharmacy division. Other stakeholders consulted during the development process included Uganda National Association of Community and Occupational Health (UNACOH), AIDSTAR-One NDA and the three test districts.

DESCRIPTION OF THE OSH IMPLEMENTATION STRATEGY

The underlying principle in the implementation of an OSH program is the utilization of the existing MOH and district structures. The main pillars during implementation will be built around building and maintaining a preventive safety and health culture, using a systems approach to safety and health management, ensuring that the right to a safe and healthy working environment is respected at all levels, and ensuring active participation by management and health worker in securing a safe and health working environment.

General Objective

The major objective of implementing an OSH program is to create a safe and healthy working environment, for a healthy motivated health workforce in all workplaces within the health sector in Uganda.

Specific Objectives

The specific objectives include:

1. To raise awareness and build capacity of health worker and managers to manage OSH.

2. To put in place structures/systems for preventing and managing ill health due to occupational hazards

3. To strengthen linkages with other relevant sectors in the public service e.g. MGLSD, MFPED, MOES (especially health training institutions) and MOPS in the implementation of OSH.

4. To institute systems for monitoring implementation of OSH interventions.

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Activities

In promoting safe and health workplaces a number of activities need to be carried out at different levels for the different objectives. These are summarized in the table below by objective.

Rising awareness and building capacity for OSH

National Level Activities District and health unit level activities

1. Advocating for OSH at national level

2. Developing a core team of technical resource persons in OSH.

3. Updating curricula for both basic and post-basic health training to include OSH.

4. Developing OSH Standard Operating Procedures (SOPs)

1. District level sensitization meeting for both political and technical leaders

2. Building capacity of OSH committee members

3. Conducting CPD on OSH at least twice a year.

4. Distribution of guidelines, SOPs and other IEC materials

Putting in place structures/systems for preventing and managing ill health due to occupational hazards

National Level Activities District and health unit level activities

1. Forming a National OSH Committee 2. Holding biannual meetings of the

National OSH Committee 3. Holding annual interagency OSH

meetings 4. Integrating workplace accident ,

incident and occupational diseases reporting into the HMIS

1. Forming district and health unit OSH Committees

2. Holding quarterly meetings of the District and Health Unit OSH Committees Carrying out regular OSH Inspections

3. Putting in place an accident, Incident and occupational diseases reporting system

4. Instituting a reporting system on OSH 5. Availing and ensuring use of Personal

Protective Equipment by all Health worker 6. Instituting a comprehensive management

procedure for managing exposed and Injured workers

Strengthening linkages with other relevant sectors in the public service

National Level District and Health Unit Levels

1. Holding national annual interagency meetings on Health Sector OSH.

1. Holding annual district and health unit interagency meetings on OSH in the health sector

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Objective 4: Putting in place systems for monitoring implementation of OSH

National Level District and Health Unit

1. Putting in place a team of Technical Resource persons in OSH to carryout capacity building and inspections

2. Carrying out regular annual district OSH training and Inspection visits (backstopping District OSH Teams)

3. Integrating workplace accident, incident and occupational diseases reporting into the HMIS

4. Carrying out biannual national review of workplace accident and incident and occupational diseases based on HMIS Reports

1. Put in place district and health unit OSH training and inspection teams

2. Carrying out regular quarterly Health Sub-District or health unit OSH training and inspection visits (backstopping Health Unit OSH Teams)

3. Integrating health workplace accident, incident and occupational diseases reporting into the HMIS reports

4. Carry out quarterly district and health unit reviews of workplace accident, incident and occupational diseases based on HMIS Reports.

NATIONAL ACTIVITIES

Advocating for OSH at national level

The major challenge in the implementation of the OSH program is the inadequate financial and human resources allocated both centrally and at district level for its implementation. Although OSH is a key staff welfare issue it is not give due priority for example by the end of HSSPII the OSH policy and guidelines had not yet to be operationalised. Effort will be made centrally to advocate for funding for OSH interventions from both government and development partners.

The MOH Headquarters, Mulago National Referral and Teaching Hospital, and Butabika National Mental Referral and Teaching Hospital shall be particularly targeted to lead the way by operationalising functional OSH services which will cover comprehensive safety and Health. Infection control, medical and general waste management, staff clinics, HIV/AIDS programme, exercise and nutrition, counseling, substance abuse control, personal protective equipment and an active IEC programme are examples of contents of these national level OSH Services.

Other advocacy activities shall include holding annual interagency OSH meetings which shall be held annually and more frequently in case of emergencies. Represented at this meeting will be all stakeholders including MOH, MOPS, MGLSD and representatives of the different partners. These meetings will be aimed at garnering support for implementation of OSH services; discuss major challenges in implementation; lessons learnt and guide annual planning of implementation.

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Developing a core team of technical resource persons in OSH

A multi sectrol team of resource persons has been formed at the central level and they will spear head the rolling out of OSH to the district level. Members of the team were drawn from the different stakeholder organizations including: MGLSD, MOH, MOPS and other partners like Uganda National Association of Community and Occupational Health (UNACOH). This team underwent training in OSH and developed a training content and materials for the district based training. The key role of this team shall be to build capacity of the district OSH committees and support the district committees to cascade the capacity building downwards to health facility OSH committees. This central resource team shall also back stop the district OSH committees in carrying out workplace inspections. A detailed list of the OSH resource persons and the training materials are attached in annexes 1, 2 and3.

Updating curricula for both basic and post-basic health training to include OSH

If OSH is to be institutionalized in the sector, there is need to update both the basic and post basic training curricula for all health workers to include OSH. In a special way however since Heath Assistants, Health Inspectors and Environment Health Officers have the mandate of promoting good environmental health behaviors and practices, their courses should have a bigger and more practical content (skills building) of OSH. In addition the job descriptions of these officers and all health workers should be updated to emphasize OSH.

Development of IEC materials on OSH

There is hardly and IEC materials on OSH targeting health workers except a few on infection control and injection safety. Majority of the available IEC in areas of controlling outbreaks target the community and not the health workers. There will be a need therefore to develop OSH IEC materials targeting health workers and managers for improved safety and health in the health sector. During the test of the draft implementation strategy it became apparent that health workers were not familiar with the OSH act and their roles in ensuring safety and health. They were also not conversant with the workers compensation act and particularly the compensation process. To mitigate this, OSH Standard Operating Procedures (SOPs) have been developed covering the key OSH procedures and related laws. These have been developed into posters and booklets to act as readily available reference materials for health workers. The SOPs include the following:

1. Standard precaution for infection control 2. Occupational Safety and Health – the law 3. Procedure for reporting and compensation of occupation injury 4. Managing fire safety at work 5. Procedure for occupational Post Exposure Prophylaxis 6. Step by step guide to risk assessment

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7. Managing cholera outbreak at work 8. Managing bird flu at work 9. Managing chemical hazards at work 10. Procedure for carrying out safety and health inspection at work 11. Managing viral hemorrhagic fever out break at work

Forming a National OSH Committee

In line with the OSH act that recommends that formation of an OSH committee for all workplaces with twenty staff and more, a National OSH Committee for the health sector shall be formed. Members of the committee will be selected as follows

1. Three freely chosen representatives of health workers 2. Three members from management 3. Three members shall be technical specialists in OSH 4. The chairperson shall be appointed by DGHS while the secretary shall be from

the HRM Division

This committee will oversee OSH activities in the sector and particularly the committee will:

Coordinate capacity building activities to district OSH committees. Receive all reports from the districts on workplace incidents and events. Receive and discuss OSH issues from the districts at least twice a year. Compile health sector workplace accidents and incidents for submission to the

MGLSD Follow up with the MGLSD and other stakeholders on all issues of compensation

for health workers.

Developing a system for reporting workplace accident, incident and occupational diseases

Inadequate systems for reporting occupational incidents, accidents and diseases are recognized as a major constraint in advocating and implementing OSH. Without evidence it will continue to be hard to advocate for the prioritization of OSH in the sector and also in assessing the magnitude of the problem. There is need therefore to develop a reporting system where all incidents, accidents and prevalence of occupational diseases can be captured. This can be achieved by integrating workplace accident, incident and occupational diseases reporting into the routine HMIS.

DISTRICT LEVEL ACTIVITIES

District level activities will focus mainly on raising awareness, capacity building , risk prevention and management of exposures and injuries and rehabilitation/reinsertion and or compensation of injured staff. Activities will include:

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1. District level sensitization meeting for both political and technical staff 2. Training of members of the OSH committees. 3. Conducting CPD on OSH at least twice a year. 4. Distribution of guidelines and IEC materials 5. Formation of district, Health Sub District and health unit OSH Committees 6. Carrying out regular OSH Inspections 7. Putting in place an accident, incident and occupational diseases reporting system 8. Instituting an OSH reporting 9. Availing and ensuring the use of Personal Protective Equipment(PPE) by all

Health worker 10. Instituting a comprehensive management procedure for managing exposed and

injured workers

District level Sensitization Meeting

A one day sensitization meeting shall be held in each district. Participants targeted for this meeting include; members of the District Health Management Team, departmental heads, the district political leadership, health unit in charges and chairmen of Health Unit Management Committees (HUMC). The main objective of this sensitization meeting would be to raise awareness and garner support for the implementation of OSH. The need to get support from both the political and technical leadership has been demonstrated from the experience gained during the implementation in the three districts since they are key stakeholders in the implementation of identified OSH actions. At the sensitization meeting the OSH Policy, Guidelines and implementation strategy would be discussed and the legal framework emphasized with the aim of getting participants’ buy in and commitment.

Training Members of the OSH Committees

Although the knowledge of the health workers and managers was not assessed explicitly, it was clear during the trainings carried out in the test districts that the health workers had knowledge on the different kinds of hazards and how to prevent exposure to them but limited knowledge on their roles in maintaining a safe and healthy work environment. Particularly the health workers and managers had limited knowledge of the procedures involved in management of occupational exposures and injuries and procedures followed for compensation. The training is therefore intended increase health worker and mangers’ knowledge of roles and responsibilities and the legal framework of OSH in addition to imparting skills for management of risks, exposures injuries and HIV/AIDs in particular.

The TOT approach shall be used to roll out the training in the different districts. The central team of trainers would train the district teams composed of members of the OSH committees. Those trained at the district would in turn be expected to roll out the training within their work places. The course content is attached in annex 1 while detailed session plans are attached in annex 2.

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Conducting CPD on OSH at Least Twice a Year

In addition to the initial training of health workers on OSH, health workers would have refresher training at least twice a year. The aim of the additional training is to refresh health worker memory on OSH and also to act as an opportunity to train new health worker. This training would be in built in the routine Continuous Professional Development (CPD). The Health Sub District OSH committee together with the health unit in charge will manage this training. Duration of each of these refresher trainings would not exceed two hours and could cover one topic at a time. Such training would also be used as forum for communicating new procedures in the management of OSH.

Distribution of Guidelines and IEC Materials

The OSH policy and guidelines need to be widely distributed to ensure that at least every health unit has a copy as a reference. In addition the SOPs shall be widely distributed to act as reference materials and reminders to health workers and managers as they implement OSH programs at their work places.

Formation of district and health unit OSH Committees

District, HSD and health facility OSH committees shall be formed to operationalise the implementation of OSH in the district (even though for other workplaces the requirement is where there are more than 20 staff (MGLSD 2006). The overall task of the committees would be to manage and monitor the implementation of OSH in the district. The details of how each of the OSH committees would be formed and their roles are described under the institutional framework on page 15.

Carrying out OSH Inspection

Proper management of OSH entails among others continuous monitoring and assessment of the work environment. There is need therefore for regular OSH inspections at least once every quarter. This would be the responsibility of the OSH committees under the technical leadership of the jurisdictional environmental health officer with support from the labor officer whenever possible. The aim of the inspections would be to identify hazardous conditions and review hazard control measures, monitor and evaluate effectiveness of safety and health practices and procedures, improve safety and health practices and procedures, measure OSH compliance, collect information that identifies new safety initiatives , maintain interest in safety and health through consultation ,display supervisory commitment to safety and health and empower health worker, leading to ownership of safe work environment.

Depending on the level of service delivery, the composition of the inspection team would vary. Some of the inspections would be supported by members of the national OSH Committee. To ease the process however each inspection team would have at least one health worker familiar with the work area. The inspection process involves three main steps: identifying the hazards; assessing the risks; and controlling the risks.

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Prior to an inspection, the team should review the previous inspection report to ensure that any outstanding actions have been completed. Where a hazard is identified, the team will arrange for the immediate rectification of the issue if possible. Any action taken shall be noted on the inspection action sheet. On completion of the inspection, the team would agree on the best actions to rectify the identified hazard and responsible persons. (refer to the inspection checklist in annex 8).

Each District OSH Committee shall endeavor to carry out at least one quarterly inspection/monitoring visit to each Government, PNFP and PFP hospital, HCIV, HCIII, and HCII facility in the districts. The National Health Sector OSH Committee will endeavor to carry out at least one quarterly inspection/monitoring visit to at least one hospital, one HCIV, one HCIII and one HCII in each, and to a sample of Private Clinics, Pharmacies and Drug Shops in each of the districts of Uganda.

Put in Place an Accident and Incident Reporting System

A clear system for recording and reporting all workplace exposures, injuries and diseases should be put in place so that all accidents and incidents are reported, investigated and managed in a timely manner. The form used for reporting is attached in annex 4 while the form to investing the accident/incident is attached in annex 5.

Instituting an OSH Reporting System for OSH

To be able to closely monitor and evaluate performance of procedures put in place, there will be a reporting system. OSH reporting will be integrated into the current Health Management Information System (HMIS). The reporting system will follow the present reporting structure i.e. reports will be submitted monthly from the lower level health units, through the HCIV to the district and finally the MoH. Districts would also make consolidated monthly district OSH reports to be submitted to the national OSH committee with copies to the Human Resource Management Division, Resource Centre and Environmental Health Division of the MOH.

Availing and Ensuring Use of Personal Protective Equipment by all Health workers

Personal protection equipment is of paramount importance in protecting health worker against common health hazards. However experience from the three test districts shows that PPEs are seldom in stock and even when available they are most times not used by the health workers. Health worker need be sensitized on the need and importance of using PPE. The health unit in charges will use the established systems to plan for and ensure adequate supplies of PPE if possible. The following PPE will be considered essential and their constant availability will be ensured by the health unit in charges: gloves, masks, plastic aprons, gowns, and over-boots for health workers who work in departments where there is a potential risk of being splashed or sprayed with body fluids. The PPE must however be considered only as an essential component of the mindset of the Universal Precautions principle.

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Instituting a Comprehensive Management Procedure for Managing Exposed and Injured Workers

Although prevention of exposure to hazards is the primary strategy for reduction of Workplace injuries, sometimes exposure to biological, physical, chemical, ergonomic and psycho-social hazards is inevitable. Health workers, who get injured, infected, or whose health is adversely affected otherwise, in the course of their work therefore need to benefit from care, rehabilitation and workplace reinsertion. Health unit in charges will therefore put in place and communicate clear systems to handle immediate care, counseling and treatment as required. The systems put in place will have a component for quick reporting and immediate response from the health facility management that includes thorough investigation and appropriate management.

The care for exposed/injured health worker will be provided free and will include:

1. Diagnostic tests and professional care 2. Hospitalization services, including surgery, as needed

3. Drugs such as the anti‐tuberculosis, antiretrovirals and for management of

opportunistic infections in case of HIV; anti‐malarials etc.

4. Nutritional counseling and supplements 5. Rehabilitation, including physiotherapy and stress reduction 6. Referral to appropriate levels of care as necessary 7. Social support for health workers affected by disease and their families. 8. Compensation to the injured or diseased health worker in line with the Workers’

Compensation Act 2000; Cap 225, which provides for redress in cases where there is permanent disability arising out of the workplace hazard.

9. Any other medical intervention deemed necessary by the authorized medical attendant

Developing a clear management procedure for managing exposed and injured health worker alone is not enough. Health worker should know the procedure and be able to use it easily. Health Workers therefore need to be sensitized on the procedure of managing workplace injuries and exposures. This could be done at the time of training or could be communicated during staff meetings or during the routine CPD trainings. In addition to training health worker about the procedure, it should be written down and a copy availed to every health worker

INSTITUTIONAL FRAMEWORK

The workplace policy guidelines will be implemented within the existing health sector framework with close partnership and collaboration with other sectors and partners. In line with the decentralized health system, OSH committees will be created at the different levels of the sector building on the infection control committees. At the national and district level, the committees will work very closely with other sectors particularly the Ministry of Gender Labor Social Development (MGLSD) and the Ministry of Public Service (MOPS).

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For effective implementation it is important for the supervisors and managers in the health sector to understand the current legislation and their individual roles. This will be achieved by training the supervisors and managers on how to carry out their OSH responsibilities, and by including OSH responsibilities in their job descriptions and including OSH responsibilities in their job performance assessment processes.

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Institutional Framework for Implementing the OSH

National

Level

National (OSHC): 11 members

3 reps of health workers 3 from Management 3 technical persons Chair and secretary

To handle OSH concerns for all the health workers in the sector

District

Level District (OSHC): 9 members 4 reps of health workers 3 from Management The chairman is the DHO Secretary from inspectorate

Receiving all reports from the HSD

Discussing issues from the HSDs

Compiling district reports

Coordinating capacity building

activities in the district

Providing technical support supervision

to the HSD and health facilities

Following all issues of compensation

for workers

HSD Level

HSD (OSHC): 9 members

4 reps of health workers 3 from Management The chairman is the in charge Secretary from inspectorate

Receiving all reports from the HUs

Discussing issues from the HUs

Compiling HSD reports

Coordinating capacity building

activities in the HSD

Providing technical support supervision

to the health facilities

Following all issues of compensation

for workers

HCIII Level

HCII Level

Health Unit (OSHC): 5 members

2 reps of health workers

1 from HUMC

The chairman is the HU in charge

Secretary

Coordinate consultation and

implementation

Evaluate hazards and make

recommendations for prevention

Review and analyze data

Follow‐up and post‐exposure prophylaxis

Coordinator for workplace OSH Coordinator could be the in charge or he/she selects a staff as coordinator

Coordination with HSD OSHC for

training, implementation, supervision

and reporting

Level of Health Care Delivery

Type and membership of OSH Committee (OSHC)

Roles of the OSH Committee

Work with MGLSD

Technical support and Supervision

Technical support and

Supervision


Supervision


Supervision

Work with District Labor office

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The National OSH Committee

Formation of the national level OSH Committee shall be finalized. The committee shall have eleven (11) members. Members of the committee will be drawn from different departments but with selective representation as follows: three shall be freely chosen representatives of the health workers; three shall be drawn from the management group; and the other three shall comprise of technical persons in the field of OSH. The Committee shall have a Chairman who shall be appointed by the Director General of Health Services and the Secretariat will be housed in the Human Resource Management Division. The Human Resource Management Division will ensure that an officer is dedicated to the committee on full time basis.

This committee shall be in charge of the overall OSH in the sector. Particularly they will:

1. Coordinate capacity building activities as well as provide regular support supervision to the district OSH committees.

2. Receive all reports from the districts on workplace incidents and events and give timely feedback.

3. Receive and discuss OSH issues from the districts at least twice a year. 4. Compile health sector workplace accidents and incidents for submission to the

MGLSD 5. Follow up with the MGLSD and other relevant offices all issues of compensation

for workers in the sector with permanent disability arising from Workplace exposure.

District OSH Committee

At district level the District OSH Committee will be formed and will have nine (9) members. Membership of the committees shall be constituted as follows: Four members shall be freely chosen representatives of health workers, three members shall be chosen from the DHMT while the chairperson shall be the DHO who will assign an officer from the District Health Team (DHT) to be the Secretary and preferably from the inspectorate section. )

The district OSH committee shall be in charge of the overall Workplace Safety and Health in the district. Particularly they will:

Coordinate capacity building activities as well as provide regular support supervision to the HSD and health unit committees.

Receive all reports from the HSD and health units on workplace incidents and events and give timely feedback.

Receive and discuss OSH issues from the HSD and health units at least every quarter.

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Compile district workplace accidents and incidents for submission to the office responsible for labor in the district and the National OSH committee

Follow up with the MGLSD and other relevant offices on all issues of compensation for workers in the district with permanent disability arising from occupational exposure.

Roles and responsibilities of the chairperson district OSH committee

The chairperson shall be responsible for the overall implementation of the OSH program in the district and particularly he/ she shall be responsible for:

Ensuring that OSH committees are in place at the different levels and that they meet regularly.

Appointing a secretary for the district OSH committee. Mobilizing and availing resources for OSH implementation in the district Reviewing implementation of OSH activities and reporting progress Ensuring that there are viable operational policies and procedures to manage

OSH in the district. Including OSH responsibilities in the job schedules of all health workers in the

district.

Roles and responsibilities of the secretary district OSH committee

The Secretary shall act as the link between the District OSH Committee and the Health Sub‐District OSH Committees. He/she will be specifically responsible for:

Coordinating capacity building activities and technical support supervision for OSH

Following up issues in regard to OSH & workers’ compensation with relevant offices & authorities

Receiving and compile reports of occupational incidents & accidents for discussion by the committee and submission to Labor office at district & national levels.

The Health Sub District OSH Committee

Like at the national and district levels, at HSD level a HSD OSH Committee shall be formed to oversee all OSH issues in the HSD. Membership to the committee shall be similar to that of the district committee with 9 members. The committee will be chaired by the HSD in charge. The HSD in charge shall assign an officer from the health

sub‐district the responsibility of a secretary and will act as a link between the HSD OSH

Committee and the committees at health facilities. The responsibilities of the HSD OSH Committee and those of the chairperson and the secretary shall be the same as those of the district OSH committee, chairperson and secretary respectively but at HSD level.

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The Health Facility OSH Committee

According to the OSH Act of Uganda all employers with at least twenty workers are required to have an OSH committee to cater for the OSH of the employees. So in line with this all health units up to the level of HCIII shall establish facility OSH Committees and the HCII in charge will be designated and trained as OSH Coordinator.

At the hospital and HCIV level the committee shall have seven (7 members) composed of the following:

Three freely chosen representatives of the health workers Two members chosen from health facility management committee The chair shall be the health unit in charge/ hospital medical superintendent The secretary shall be assigned by the chairperson and shall be from health

unit’s community health department

The health unit OSH shall be in charge of the overall OSH in the facility and particularly they will:

Coordinate consultation and risk management implementation. Evaluate the hazards, and make recommendations for prevention. Compile and analyze injury data for appropriate action. Regularly review and analyze data from the exposure incidents within the

institution Ensure appropriate follow up and post exposure prophylaxis as determined by

the nature of the injury and source client.

Roles and responsibilities of the chairperson health unit OSH committee

The chairperson of the health unit is responsible for the overall implementation of the OSH program in the health unit. Specifically he/she shall:

1. Ensure that an OS&H Committee is in place and facilitated to meet regularly. 2. Mobilize and avail the resources for the workplace program. 3. Ensure that there are viable operational policies and procedures to manage

Workplace Safety and Health in the health unit. 4. Disseminate the national Workplace Safety and Health Guidelines within the

facility and ensure that all health workers are knowledgeable. 5. Identify training needs and ensure that all staff members are appropriately

trained in Workplace Safety and Health. 6. Support consultations and worker participation in facility workplace program. 7. Ensure that steps are taken to correct deficiencies in the workplace program,

including investigation of incidents and accidents as well as taking corrective action.

8. Ensure undertaking of regular risk management activities and maintenance of effective risk controls.

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9. Ensure that injury management procedures, including HIV Workplace post‐ exposure prophylaxis and workplace reinsertion are followed.

10. Review OSH activities and report progress and issues to the district OSH committee and other relevant authorities.

11. Include Workplace Safety and Health responsibilities in the job descriptions of all health workers in the facility.

Roles and responsibilities of the secretary health unit OSH committee

The secretary of the health unit OSH committee shall act as a link between the Health unit OSH committee and the health workers. He/she shall be specifically responsible for:

1. Receiving and compiling on a regular basis, reports of workplace accidents and incidents from the health workers

2. Preparation and presentation on a regular basis, OSH issues from the health workers for discussion by the health unit committee

3. Coordinating the provision of regular OSH training and capacity building for the health workers

4. Following up with relevant offices and authorities, all issues of compensation for workers from the health unit with permanent disability arising from workplace exposure to hazards.

OSH Coordinator

At HCIIs where according to the establishment the number of health workers is less than the twenty required for the formation of an OSH committee, the HCII in-charge will be designated and trained as the OSH Coordinator. The OSH Coordinator will be the main contact person between the HSD OSH Committee and the health worker in the unit. The main responsibility of the OSH Coordinator shall be to coordinate training, risk management implementation, support supervision and reporting. Specifically the coordinator will:

1. Coordinate consultation, policy setting, and risk management implementation 2. Evaluate the hazards, compile the injury data, and make recommendations for

prevention 3. Regularly review and analyze data from the exposure experience of the unit,

incorporating an analysis of near‐misses to determine the need for change

4. Ensure appropriate follow‐up and post‐exposure prophylaxis as determined by

the nature of the injury and source patient.

Roles and responsibilities for Managers and Supervisors

The importance of the commitment of the managers and supervisors in the implementation of the safely guidelines cannot be overemphasized. Ensuring a safe and healthy work and general environment is a major responsibility for all managers and

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supervisors. In this regard the following are the key roles and responsibilities of managers and supervisors:

1. Ensure that an OSH Committee is in place and facilitated to meet regularly. 2. Mobilize and avail the resources for the workplace programme. 3. Establish the workplace programme for all health workers. 4. Ensure that there is a viable and operational system in place that includes the

health facility policies and procedures. 5. Disseminate the national OSH Guidelines within the facility and ensure that all

health workers are knowledgeable.

6. Set the goals and objectives for workplace programme, including the time‐frames

and indicators for achieving the objectives. 7. Define and allocate responsibilities to the relevant management and supervisory

positions. 8. Identify training needs and ensure that all health worker members are

appropriately trained. 9. Support consultations and worker participation in facility workplace programme. 10. Ensure that steps are taken to correct deficiencies in the workplace programme,

including investigation of incidents and accidents as well as taking corrective action.

11. Ensure that emergency procedures are in place and operating effectively in the workplace.

12. Ensure undertaking of regular risk management activities and maintenance of effective risk controls.

13. Ensure that injury management procedures, including HIV Workplace post‐ exposure prophylaxis and workplace reinsertion are followed.

14. Review OSH activities and report progress and issues to senior facility management.

15. Report on the progress and/or issues to the Ministry and other relevant authorities.

Roles and responsibilities of the health workers

In addition, every worker has the following responsibilities in relation to OSH:

1. Comply with the established OSH guidelines 2. Report to the management through the OSH Committees all incidents and

accidents 3. Look after their own safety and health as well as that of the other health workers

at the workplace 4. Follow safe work practices and use personal protective equipment 5. Participate in OSH consultation and training initiatives 6. Cooperate with managers and supervisors so that the facility can meet its OSH

objectives 7. Do not deliberately or intentionally put themselves or anyone else at risk or

misuse anything provided in the interest of safety and health.

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8. Make sure they do not pollute the general environment (soil, water, air and psycho-social).

Specific Terms of Reference for the various health workers are detailed in annex 9-17.

MONITORING AND EVALUATION

Monitoring and evaluation of implementation is a key responsibility of the OSH committees at different levels. The national OSH committee will be responsible for the overall monitoring and evaluation of implementation in the sector and will provide technical support supervision to the district OSH committees at least bi annually while the district OSH committee will have the same responsibility at district level providing technical support supervision on a quarterly basis. Daily monitoring of implementation in health units will be a responsibility of the health unit OSH committee under the direct supervision of the health unit OSH committee chairperson.

The OSH program implementation is monitored using the following indicators:

1. Presence of a functional OSH committee 2. Number of OSH committee members trained 3. % of workplaces which carryout workplace inspections regularly (quarterly)

evidenced by inspection reports 4. % of OSH committees that develop action plans after workplace inspections

evidenced by presence of action plans 5. % of OSH committees that implement the action plans developed evidenced by

action plans with reports on implementation 6. % of OSH committees that monitor and evaluate the implementation of the action

plans evidenced by action plans with reports on progress of implementation

ANNEXES

Annex 1: Training Content

The training content outlining the topics and technical content to be covered for each topic are summarized in the table below. Estimated duration of each topic and the teaching methods are also included. The objectives of the district training are: General Objectives To raise awareness and build capacity of health workers and managers to manage workplace safety and health Specific Objectives By the end of the training participants should be able to:

1. Explain the importance of workplace safety and health in their work 2. Identify hazards in the workplace and come up with control measures.

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3. Outline their roles and responsibilities in ensuring a safe and healthy work environment.

4. Use the existing guidelines to put systems for managing work workplace safety and health

TRAINING AREA TECHNICAL CONTENT DURATION TEACHING METHODS

Importance of OSH and benefits of implementing an OSH program at the workplace

Back ground to OSH

Definitions of OSH

Legal framework of OSH in Uganda

Discussions on some examples of OSH problems in the Uganda health sector

The consequences of poor OSH practices at the workplace

Benefits of good OSH practices at the workplace

1 hour

Modified lecture Individual reflections

Hazard identification and control

Definitions/Concepts

Importance of hazard assessment

Classification of Hazards

Common hazards

Likely sources of hazards in the Health Sector

Methods of Hazard Identification

Control Measures

Hierarchy of Controls

Good safety Practices

Action Plan

3 hours Modified Lectures Group Exercise and Plenary

OSH reporting and monitoring tools

Incident Reporting Tool

Incident Investigation Tool

Monitoring and Evaluation Tool

1 hour 30 minutes Modified lecture Demonstration and return demonstration Group work and Plenary

Work place inspection

Practical assignment 3 hours Field work

Annex 2: Session plans for the training

TOPIC : WHY SAFETY AND HEALTH

Duration: 30 minutes

Objectives:

By the end of the session, participants will be able to:

1. List the objectives of implementing and Occupational Safety and Health program at the work place

2. Explain the importance of OSH in their workplaces 3. Mention some examples of OSH problems in the Uganda health sector

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Technical content

The following content will be covered:

Back

ground to OSH

Definitions of OSH

Legal framework of OSH in Uganda

Discussions on some examples of OSH problems in the Uganda health sector

The consequences of poor OSH practices at the workplace

Benefits of good OSH practices at the workplace

Teaching Methods:

Modified lecture

Individual reflections

Teaching Aids(Resource materials)

Power point presentation, Flip charts, brochures and flyers, handouts

Reference Documents (for additional reading)

The constitution of the republic of Uganda

The Ugandan OSH policy and guidelines

Workers’ Compensation Act 2000

OSH act

TOPIC : HAZARD IDENTIFICATION

Duration: 1 hour 30 minutes

Objectives:


Identify occupational hazards in their workplaces

Technical content


Definitions/Concepts

Importance of hazard assessment

Classification of Hazards

Common hazards

Likely sources of hazards in the Health Sector

Methods of Hazard Identification

Teaching Methods:

Modified Lectures

Group Exercise and Plenary

Field work


PowerPoint presentations (LCDs / visual aids), hand outs

Flip charts

Handouts

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National Policy Guidelines on Post Exposure Prophylaxis for HIV, Hepatitis Band Hepatitis C,( MOH –November 2007)

Safety –Health and Working Conditions Training manual, Joint Industrial Safety Council, Sweden, 1987

Occupational Health and Hygiene, Jeremy Stranks, 1995

TOPIC : HAZARD CONTROL


Objectives:


Describe the suitable hazard control measures

Develop hazard control action plan

Technical content


Control Measures

Hierarchy of Controls

Good safety Practices

Action Plan

Teaching Methods:

Modified Lectures

Group Exercise and Plenary

Field work


PowerPoint presentations (LCDs / visual aids), hand outs

Flip charts

Handouts


National Policy Guidelines on Post Exposure Prophylaxis for HIV, Hepatitis Band Hepatitis C,( MOH –November 2007)

Safety –Health and Working Conditions Training manual, Joint Industrial Safety Council, Sweden, 1987

Occupational Health and Hygiene, Jeremy Stranks, 1995

TOPIC : OSH REPORTING AND MONITORING TOOLS


Objectives:


Outline the key tools used for reporting and monitoring OSH

Explain the importance of the tools

Demonstrate their skills by using the tools correctly

Technical content


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Incident Reporting Tool

Incident Investigation Tool

Monitoring and Evaluation Tool

Teaching Methods:

Modified lecture

Demonstration and return demonstration

Group work and Plenary


Power point presentation

The tools

Group assignments- scenarios

Flip charts

Markers


The tools

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Annex 3: List of Central Resource Persons

No Names Sex Title Organisation Telephone Email

1. Barbara Clara

Khayongo

F Ag. General Health Inspector MGLSD / OSH 0782-454 245 [email protected]

2. Fred Nsubuga M Occupational Physician MGLSD / OSH 0712-450 863 /

0754-450 863

[email protected] /

[email protected]

3. Yusuf Katula M Principal General Safety Inspector MGLSD 0772-641 177 [email protected]

4. Rebecca Nabwire F Senior Labor Officer

(Productivity)

MGLSD 0772-518 791 [email protected]

5. Gerald Makumbi M Occupational Psychologist /

Senior Medical Clinic Officer

UNACOH / MUH 0772-446 836 [email protected]

6. Douglas Nkonge M Senior General Safety Inspector MGLSD 0782-301 651 [email protected]

7. Christine Alura F Principal UNACOH / MSCN 0782-313 992 [email protected]

8. Emmery Mbaha M Senior Environmental Health

Officer

MH / EHD 0772-650 616 [email protected]

9. Sarah Kakonge F Executive Director Uganda Safety

Council

0701-199 991 [email protected]

10. Ritah Mwagale F Media Relations Officer MH / HEP 0774-287 976 [email protected]

11. Simon Bwire M Human Resource Officer MH / HRM 0712-219 897 [email protected]

12. Abraham John Bwire M Principal Labor Officer /

Inspection

MGLSD 0772-437 776 [email protected]

13. Cilia Bamwonjobora F Senior Personnel Officer Cancer Institute 0772-642 456 [email protected]

14. Grace Namaganda F Senior Advisor HRM UCP 0772-439 968 [email protected]

mailto:[email protected]















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Annex 4: Form No. 1a. Incident reporting form

Note: This form should be filled in by the individual staff member involved in an incident and should be submitted to the immediate supervisor/ in-charge Name of health facility: ……………………………………. Date: …….…………………… 1. Details of person involved in the incident Name: ……………………………………………….…………Date of birth: ………………… Contact address:……………………..……………………….Job title ………………………. Unit/department:……………………Sex: Male…………... Female……………...….……… 2. Details of the incident /injury / accident Date of incident: …………………………………..………… Time: ………….……………… Place where it happened……….…………………………… What was he/she doing at the time of incident?................................................................. ………………...……………………………………………………………..…………………….. 3. What were the causes of the incident?(e.g. slippery floor, sharps, blood & other body fluids, lifting, physical / verbal assault, etc ) …………………………………………………………………………………………………….. …………………………………………………………………………………………………….. 4. What was the outcome of the incident? (e.g. needle stick injury, bruise, sprain, fracture skin disease, burns, stress, pain & discomfort etc) …………………………………………………………………………………………………….. …………………………………………………………………………………………………….. 5. Action taken (e.g. reported, got treatment, got first aid, given off duty, counseled, cautioned, incident investigated, etc) …………………………………………………………………………………………………….. …………………………………………………………………………………………………….. Comment: This form should be availed to every department/section/unit and accessible to all workers in the health facility.

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Annex 5: Form No.1b incident investigation form

This form should be filled in by the chairperson of the OSH committee/in-charge of the facility in consultation with affected person and /or other persons present at the scene of the incident. Health facility: …………………………………………. Date: ……………………….……… 1. Details of the investigator: Name: …………………….……………………………….Job Title:…………...………………. Signature:………………………………………................Date……………………………… 2. What was the affected person/worker doing at the time of incident? …………………………………………………………………………………………………….. …………………………………………………………………………………………………….. 3. Outcome of incident (e.g. injury, disease, near miss, damage to property etc) …………………………………………………………………………………………………….. …………………………………………………………………………………………………….. 3a.If injury, mention the type and part of the body affected: …………………………………………………………………………………………………….. 3b.If disease sustained mention type and part of the body affected …………………………………………………………………………………………………….. 4a.Did this task require PPE? Yes………….………. No…………………….…. 4b.If yes, what was the type of PPE being used at the time of the accident? …………………………………………………………………………………………………….. 5. Was there any other person involved in the accident? …………………………………………………………………………………………………….. 5. Recommended action to be taken (e.g., Report to the Labor officer, remove the hazard, treat, compensate affected person, training session, supervision etc)

NB: The manager/ in charge should report any incident that keeps away a worker from duty for more than 3 days to the district Labor officer

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Annex 6: Form No. 2. Monitoring and Evaluation Checklist

This form should be filled in by the secretary/ focal point person to the Health and Safety committee in the facility and forwarded to Health Sub District OSH committee. 1. Detail Of The Health Facility Health facility: …………………………………. Health Sub-district…..……………………… District……………………………………………Date: ………………………………………… Name of evaluator:……………………………. Job title:………………………...……………. Signature:………………………………….…… 2. Safety Policy Does the facility have safety and health workplace policy? Yes…..…..No…….. If No, Give reasons……………….……………………………………………………………… 3. Health And Safety Committee 3a Does the facility have safety and health committee? Yes…..…..No…….. If No, Give reasons ………………………………………………………………… 3b Have members of safety and health committee been trained? Yes…..…..No…….. If No, Give reasons……………….……………………………………………………………… 4 Workplace Inspections 4a has the safety and health committee conducted Inspections? Yes…..…..No…….. If Yes, How many……………………………………………………………………………….. Please specify the dates of the previous inspections …………..…………………………… If No, Give reasons……………….……………………………………………………………… 4b Have you compiled the inspection reports Yes…..…..No…….. If Yes, please show the inspection reports Seen…Not Seen… If No, Give reasons……………….……………………………………………………………… 5. Health and Safety Action Plan 5a.Is there a safety and health action plan in place Yes…..…..No…….. If yes, please show the safety and health action plan Seen…Not Seen… If No, Give reasons……………….………………………………………………………………

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5b.Is the Occupational Safety and Health action plan evaluated? Yes…..…..No…….. If Yes, check review date on action plan Action plans reviewed………Not reviewed……. If No, reason ………………...…………………………………………………………………… 6. Summary of incidents 6a.Near miss (incidents)…………………………6b Minor accidents……………………….. 6c Compensable accidents………………………6d Occupational diseases……………….

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Annex 7: Form No. 3a OSH workplace inspection checklist

Note: This form should be used as a reminder of the things to look out for during inspection by the inspection team. It is not to be filled. Identified hazards are noted in a notebook and later filled in form 2 – OSH workplace inspection the action sheet

OBSERVATIONS ITEMS

1 Infrastructure Building - state of repair

Adequacy of space, Floor condition/even floor

Stairs, steps and landings - nature of surface, and state of repair

2 Work areas Layout - Equipment layout,

Ventilation, lighting and temperature

Evidence of food/drink?

Housekeeping - tidiness, access

Tripping hazards

3 Electrical Safety Exposed wires

Accessibility to main switch

Broken plugs, sockets and switches

4 Emergency Preparedness

Fire extinguishers/sand buckets/hoses - accessibility, serviceability and adequacy

Emergency Preparedness Plan

Fire Exits - marked

Emergency Safety procedures Notices (in corridor)

Eye-wash facilities- clean running water

First Aid Box (where necessary)

Availability of PEP plan

5 Chemical/ Hazardous substances

Type

Labeling and storage

6 Blood and other body fluids handling

Disposal method (segregation, waste bins, bin liners, sharp containers, location)

Availability of color coded bins

Use and availability of PPE (gloves, boots, mask, coats)

Hand washing facilities (water, soap)

7 Material Storage Stacks stable

Adequate space for moving stock

Housekeeping

No danger of falling objects and sharp edges

Safe means of accessing high shelves

Heights correct - not more than 8 feet

8

Compound Fencing

Tidiness ,Status of Waste Disposal sites (Incinerator, placenta pit, dumping pits)

9 Other

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Annex 8: Form No. 3b OSH workplace inspection action sheet

Note: This form should be filled on quarterly basis by the chairperson of the OSH committee or any other member of the committee delegated by the chairperson. Workplace name……………………………………………… Date of inspection………………………………………….……. Inspection Team leader:………………………………………. Title:………………………….Signature: ………………………..

# Identified Hazard Location of hazard

Required Action Action by Date to be resolved

Action taken ( yes/no)

Review date

1

2

3

4

5

6

7

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Annex 9: TOR Chairperson District OSH Committee

Telephone: General Lines: 0414-340874/231563/9 Permanent Secretary’s Office +256-41-340872 Fax: + 256-41-231584 / 340887 IN ANY CORRESPONDENCE ON THIS SUBJECT PLEASE QUOTE NO: ADM 97/150/01

THE REPUBLIC OF UGANDA

Ministry of Health, Plot 6 Lourdel Road, Wandegeya P. O. Box 7272 Kampala Uganda.

…………………………………………….. 2011

Dear ……………………………………………………… RE: NOMINATION AS CHAIRPERSON DISTRICT OSH COMMITTEE The MOH developed an Occupational Safety and Health policy to promote safe and healthy work practices within the sector. In line with this every workplace within the sector is expected to implement an OSH program to ensure safety and health at the workplace starting with the formation of an OSH committee. The purpose of this letter is to nominate you as the chairperson of the district OSH committee. As the chairperson of this committee you shall be responsible for the overall implementation of the OSH program in the district. Specifically you shall be responsible for:

Ensuring that OSH committees are in place at the different levels and that they meet regularly.

Appointing a secretary for the district OSH committee. Mobilizing and availing resources for OSH implementation in the district Reviewing implementation of OSH activities and reporting progress Ensuring that there are viable operational policies and procedures to manage OSH in

the district. Including OSH responsibilities in the job schedules of all health workers in the district.

You will report to the chairperson of the National OSH. The following deliverables are expected from you:

1. Lists of members of HSD and health unit OSH committees. 2. Quarterly reports of workplace incidents and events in the district

I wish you success as you undertake this assignment Sincerely, Dr Kenya Mugisha DIRECTOR GENERAL HEALTH SERVICES Cc CA

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Annex 10: TOR Secretary District OSH Committee




…………………………………………….. 2011

Dear ……………………………………………………… RE: NOMINATION AS SECRETARY DISTRICT OSH COMMITTEE The MOH developed an Occupational Safety and Health policy to promote safe and healthy work practices within the sector. In line with this every workplace within the sector is expected to implement an OSH program to ensure safety and health at the workplace starting with the formation of an OSH committee. The purpose of this letter is to nominate you as the secretary of the district OSH committee. As the secretary of this committee you shall act as the link between the District OSH Committee and the Health Sub‐District OSH Committees. You shall be specifically responsible for:

Coordinating capacity building activities and technical support supervision for OSH Following up issues in regard to OSH & workers’ compensation with relevant offices &

authorities Receiving and compile reports of occupational incidents & accidents for discussion by

the committee and submission to Labor office at district & national levels. You will report to the chairperson of the district OSH committee. The following deliverables are expected from you:

1. Lists of members of HSD and health unit OSH committee. 2. Minutes of meeting held 3. Quarterly reports of workplace incidents and events in the district 4. Reports of district workplace accidents and incidents submitted to the MGLSD

I wish you success as you undertake this assignment Sincerely, ………………………………………………….. DISTRICT HEALTH OFFICER Cc CAO

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Annex 11: TOR members of District OSH Committee




…………………………………………….. 2011

Dear ……………………………………………………… RE: NOMINATION AS MEMBER DISTRICT OSH COMMITTEE The MOH developed an Occupational Safety and Health policy to promote safe and healthy work practices within the sector. In line with this every workplace within the sector is expected to implement an OSH program to ensure safety and health at the workplace starting with the formation of an OSH committee. The purpose of this letter is to nominate you as the member of the district OSH committee. As a member of this committee you shall activity participate in OSH activities in the district. Specifically you shall work with other committee members to:

1. Coordinate capacity building activities as well as provide regular support supervision to the HSD and health unit committees.

2. Receive reports from the HSD and health units on workplace incidents and events and give timely feedback.

3. Receive and discuss OSH issues from the HSD and health units at least every quarter. 4. Compile district workplace accidents and incidents for submission to the MGLSD and the

National OSH at the MoH 5. Follow up with the MGLSD and other relevant offices all issues of compensation for

workers in the district with permanent disability arising from workplace exposure. You will report to the chairperson of the district OSH committee. The following deliverables are expected from you:

1. Participation in all workplace and safety activities including meetings, trainings and supervision.

2. Quarterly reports of workplace incidents and events in the district 3. Reports of district workplace accidents and incidents submitted to the MGLSD

I wish you success as you undertake this assignment Sincerely, ………………………………………………….. DISTRICT HEALTH OFFICER Cc CAO

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Annex 12: TOR Chairperson HSD OSH Committee




…………………………………………….. 2011

Dear ……………………………………………………… RE: NOMINATION AS CHAIRPERSON HSD OSH COMMITTEE The MOH developed an Occupational Safety and Health policy to promote safe and healthy work practices within the sector. In line with this every workplace within the sector is expected to implement an OSH program to ensure safety and health at the workplace starting with the formation of an OSH committee. The purpose of this letter is to nominate you as the chairperson of the HSD OSH committee. As the chairperson of this committee you shall be responsible for the overall implementation of the OSH program in the HSD. Specifically you shall be responsible for:

Ensuring that OSH committees are in place at the different health units and that they meet regularly.

Appointing a secretary for the HSD OSH committee. Mobilizing and availing resources for OSH implementation in the HSD Reviewing implementation of OSH activities and reporting progress Ensuring that there are viable operational policies and procedures to manage OSH in

the HSD. Including OSH responsibilities in the job schedules of all health workers in the HSD.

You will report to the chairperson of the district OSH committee. The following deliverables are expected from you:

3. Lists of members of HSD and health unit OSH committees. 4. Quarterly reports of workplace incidents and events in the HSD

I wish you success as you undertake this assignment Sincerely, ……………………………………………… District Health Officer Cc CAO

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Annex 13: TOR Secretary HSD OSH Committee




…………………………………………….. 2011

Dear ……………………………………………………… RE: NOMINATION AS SECRETARY HSD OSH COMMITTEE The MOH developed an Occupational Safety and Health policy to promote safe and healthy work practices within the sector. In line with this every workplace within the sector is expected to implement an OSH program to ensure safety and health at the workplace starting with the formation of an OSH committee. The purpose of this letter is to nominate you as the secretary of the HSD OSH committee. As the secretary of this committee you shall act as the link between the HSD OSH Committee and the Health unit OSH Committees. You shall be specifically responsible for:

Coordinating capacity building activities and technical support supervision for OSH Following up issues in regard to OSH & workers’ compensation with relevant offices &

authorities Receiving and compiling reports of occupational incidents & accidents for discussion by

the committee. You will report to the chairperson of the HSD OSH committee. The following deliverables are expected from you:

5. Lists of members of HSD and health unit OSH committee. 6. Minutes of meeting held 7. Quarterly reports of workplace incidents and events in the HSD

I wish you success as you undertake this assignment Sincerely, ………………………………………………….. HEALTH SUB DISTRICT IN CHARGE CC DISTRICT HEALTH OFFICER

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Annex 14: TOR members of HSD OSH Committee




…………………………………………….. 2011

Dear ……………………………………………………… RE: NOMINATION AS MEMBER HSD OSH COMMITTEE The MOH developed an Occupational Safety and Health policy to promote safe and healthy work practices within the sector. In line with this every workplace within the sector is expected to implement an OSH program to ensure safety and health at the workplace starting with the formation of an OSH committee. The purpose of this letter is to nominate you as the member of the HSD OSH committee. As a member of this committee you shall activity participate in OSH activities in the HSD. Specifically you shall work with other committee members to:

6. Coordinate capacity building activities as well as provide regular support supervision to the health unit committees.

7. Receive reports from the health units on workplace incidents and events and give timely feedback.

8. Receive and discuss OSH issues from the health units at least every quarter. 9. Compile HSD workplace accidents and incidents for submission to the district OSH

committee. You will report to the chairperson of the HSD OSH committee. The following deliverables are expected from you:


5. Quarterly reports of workplace incidents and events in the HSD 6. Reports of HSD workplace accidents and incidents


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Annex 15: TOR Chairperson health unit OSH Committee




…………………………………………….. 2011

Dear ……………………………………………………… RE: NOMINATION AS CHAIRPERSON HEALTH UNIT OSH COMMITTEE The MOH developed an Occupational Safety and Health policy to promote safe and healthy work practices within the sector. In line with this every workplace within the sector is expected to implement an OSH program to ensure safety and health at the workplace starting with the formation of an OSH committee. The purpose of this letter is to nominate you as the chairperson of the health unit OSH committee. As the chairperson of this committee you shall be responsible for the overall implementation of the OSH program in the health unit. Specifically you shall be responsible for:

12. Ensure that an OS&H Committee is in place and facilitated to meet regularly. 13. Mobilize and avail the resources for the workplace program. 14. Ensure that there are viable operational policies and procedures to manage

Workplace Safety and Health in the health unit. 15. Disseminate the national Workplace Safety and Health Guidelines within the facility

and ensure that all health workers are knowledgeable. 16. Identify training needs and ensure that all staff members are appropriately trained in

Workplace Safety and Health. 17. Support consultations and worker participation in facility workplace program. 18. Ensure that steps are taken to correct deficiencies in the workplace program,

including investigation of incidents and accidents as well as taking corrective action. 19. Ensure undertaking of regular risk management activities and maintenance of

effective risk controls. 20. Ensure that injury management procedures, including HIV Workplace post‐ exposure

prophylaxis and workplace reinsertion are followed. 21. Review OSH activities and report progress and issues to the district OSH committee

and other relevant authorities. 22. Include Workplace Safety and Health responsibilities in the job descriptions of all

health workers in the facility. You will report to the chairperson of the HSD OSH committee. The following deliverables are expected from you:

5. Lists of members of health unit and health unit OSH committees. 6. Quarterly reports of workplace incidents and events in the health unit

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I wish you success as you undertake this assignment Sincerely, ……………………………………………… HSD IN CHARGE CC CAO

Annex 16: TOR Secretary health unit OSH Committee




…………………………………………….. 2011

Dear ……………………………………………………… RE: NOMINATION AS SECRETARY HEALTH UNIT OSH COMMITTEE The MOH developed an Occupational Safety and Health policy to promote safe and healthy work practices within the sector. In line with this every workplace within the sector is expected to implement an OSH program to ensure safety and health at the workplace starting with the formation of an OSH committee. The purpose of this letter is to nominate you as the secretary of the health unit OSH committee. As the secretary of this committee you shall act as a link between the Health unit OSH committee and the health workers. You shall be specifically responsible for:

5. Receiving and compiling on a regular basis, reports of workplace accidents and incidents from the health workers

6. Preparation and presentation on a regular basis, OSH issues from the health workers for discussion by the health unit committee

7. Coordinating the provision of regular OSH training and capacity building for the health workers

8. Following up with relevant offices and authorities, all issues of compensation for workers from the health unit with permanent disability arising from workplace exposure to hazards.

You will report to the chairperson of the health unit OSH committee. The following deliverables are expected from you:

8. Lists of members of health unit and health unit OSH committee. 9. Minutes of meeting held 10. Quarterly reports of workplace incidents and events in the health unit

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I wish you success as you undertake this assignment Sincerely, ………………………………………………….. HEALTH UNIT IN CHARGE CC HEALTH SUB DISTRICT IN CHARGE

Annex 17: TOR members of health unit OSH Committee




…………………………………………….. 2011

Dear ……………………………………………………… RE: NOMINATION AS MEMBER HEALTH UNIT OSH COMMITTEE The MOH developed an Occupational Safety and Health policy to promote safe and healthy work practices within the sector. In line with this every workplace within the sector is expected to implement an OSH program to ensure safety and health at the workplace starting with the formation of an OSH committee. The purpose of this letter is to nominate you as the member of the health unit OSH committee. As a member of this committee you shall activity participate in OSH activities in the health unit. Specifically you shall work with other committee members to:

10. Coordinate capacity building activities as well as provide regular support supervision to the health unit committees.

11. Receive reports from the health units on workplace incidents and events and give timely feedback.

12. Receive and discuss OSH issues from the health units at least every quarter. 13. Compile health unit workplace accidents and incidents for submission to the district OSH

committee. You will report to the chairperson of the health unit OSH committee. The following deliverables are expected from you:


8. Quarterly reports of workplace incidents and events in the health unit 9. Reports of health unit workplace accidents and incidents

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OCCUPATIONAL SAFETY AND HEALTH IMPLEMENTATION STRATEGY

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Transcript of OCCUPATIONAL SAFETY AND HEALTH IMPLEMENTATION STRATEGY