A PROJECT OF HEALTH PROMOTION A PROJECT OF HEALTH PROMOTION AT - - PowerPoint PPT Presentation

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A PROJECT OF HEALTH PROMOTION A PROJECT OF HEALTH PROMOTION AT WORKPLACES IN VIETNAM: AT WORKPLACES IN VIETNAM: DEVELOPMENT AND EXPANSION DEVELOPMENT AND EXPANSION

Tran Dac Phu, MD. PhD Tran Dac Phu, MD. PhD Deputy Director Deputy Director Vietnam Administration of Preventive Medicine, Vietnam Administration of Preventive Medicine, Ministry of Health Ministry of Health

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• I. Background
• I. Background
• In the process of industrialization and modernization,

In the process of industrialization and modernization, workforce of small and medium workforce of small and medium-

• sized enterprises (SMEs)

sized enterprises (SMEs) plays an more and more important role. plays an more and more important role.

• The number of these enterprises has been increasing and

The number of these enterprises has been increasing and makes up 80 makes up 80-

• 90% of the total of

90% of the total of registed registed enterprises with enterprises with diverse industries. diverse industries.

• Developing SMEs doesn't only contribute to the growth

Developing SMEs doesn't only contribute to the growth rate of annual GDP, but also attracts a big amount of rate of annual GDP, but also attracts a big amount of workforce and takes part in the process of workforce workforce and takes part in the process of workforce redistribution and work distribution in the society. redistribution and work distribution in the society.

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• However, Vietnam is in the initial stage of market

However, Vietnam is in the initial stage of market economy development, the economic burst also economy development, the economic burst also means the non means the non-

• controlled development which

controlled development which causes work environment causes work environment-

• related problems

related problems

• A survey results in 135 small and medium

A survey results in 135 small and medium-

• sized

sized enterprises in Vietnam: the risk of exposures to enterprises in Vietnam: the risk of exposures to work hazards is high, for example: Dust work hazards is high, for example: Dust-

• 96%,

96%, noise noise-

• 29%, and adversed microclimate

29%, and adversed microclimate -

• 81%.

81%.

• The disease prevalence in SMEs is different, the

The disease prevalence in SMEs is different, the popular diseases are

• re

popular diseases are

• re-
• rhinolarynlogic

rhinolarynlogic, , gynaecologic gynaecologic diseases, headache, bronchitis, etc. diseases, headache, bronchitis, etc.

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• The SMEs managers' awareness of occupational

The SMEs managers' awareness of occupational health and safety is modest because they have not health and safety is modest because they have not accessed to the issued law documents. They are accessed to the issued law documents. They are therefore not aware of their responsibility therefore not aware of their responsibility

• Another case is that they are too busy with

Another case is that they are too busy with looking for market of their products as well as looking for market of their products as well as with their business activities. with their business activities.

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• In 1997, the MOH summed up

In 1997, the MOH summed up Ministrial Ministrial level level project of occupational health development in project of occupational health development in districts with the theme: "More productivity, better districts with the theme: "More productivity, better workplace" in small and medium sized enterprises. workplace" in small and medium sized enterprises.

• The report of the project was stated in the

The report of the project was stated in the conference:"Health conference:"Health Promotion in small and Promotion in small and medium sized enterprises" held in Shanghai in medium sized enterprises" held in Shanghai in September 1997. September 1997.

• Experts of WHO proposed to support Vietnam for

Experts of WHO proposed to support Vietnam for pilot implementation of this programme since pilot implementation of this programme since 1998. 1998.

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2.1. National

• ccupational

health network

675 District Preventive Medicine Centers Vietnam Administration of Preventive Medicine. MoH

• National Institute of Occupational

and Environmental Health.

• Nha trang Pasteur Institute.
• Ho Chi Minh City Hygiene and

Public Health Institute.

• Tay Nguyen Epidemiology Inst.

Provincial Health Bureau 64 provinces Ministries/Branches Personnel-Policy Dept. 64 Occupational Health Division–Preventive Medicine Centers 10275 COMMUNE HEALTH CENTER

• Cooperatives. small

and medium enterprise Factory. enterprise Communication.…) Health Center (Transportation. Con-

• truction. Industry.
• Agriculture. Railway
• Garment. Aviation.

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• II. Introduction of health promotion at
• II. Introduction of health promotion at

workplaces in vietnam workplaces in vietnam 1) 1996 1) 1996-

• 1997 period

1997 period

• The MOH pilot implemented a occupational

The MOH pilot implemented a occupational health model in SMEs with the theme:" More health model in SMEs with the theme:" More productivity, better workplace" which applied productivity, better workplace" which applied wise and enforcement of OHS legislation in 5 wise and enforcement of OHS legislation in 5 provinces and expanding to 9 others in 1997. provinces and expanding to 9 others in 1997.

• Its result was reported in the conference "Health

Its result was reported in the conference "Health promotion in small and medium promotion in small and medium-

• sized

sized enterprises" held in Shanghai, in 9/1997. enterprises" held in Shanghai, in 9/1997.

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Achievements Achievements: :

• Enthusiasm participation of enterprises

Enthusiasm participation of enterprises

• Initially implementing the improvement of

Initially implementing the improvement of working conditions. working conditions.

• Occupational

health and safety laws Occupational health and safety laws implemented by enterprises implemented by enterprises

• Good implementation of health

Good implementation of health personnels personnels at at district level in these activities. district level in these activities.

• Warm response of Ministries, Sectors and

Warm response of Ministries, Sectors and Technique Organs Technique Organs

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2) 2) 1998 1998-

• 1999

1999 period period

• Starting from 1999, with the help of WHO, MOH

Starting from 1999, with the help of WHO, MOH developed the project "Health promotion at developed the project "Health promotion at workplaces in SMEs workplaces in SMEs” ” following the guidelines of following the guidelines of WHO combining with wise and enforcement of WHO combining with wise and enforcement of OHS legislation. OHS legislation.

• Published by WHO as a case study document

Published by WHO as a case study document "evaluation a 1 "evaluation a 1-

• year implementation of the regional

year implementation of the regional guidelines for healthy workplaces in SMEs in Ngo guidelines for healthy workplaces in SMEs in Ngo Quyen district, Haiphong city and in Hue city Quyen district, Haiphong city and in Hue city -

• Healthy settings

Healthy settings -

• Case study Documents Series,

Case study Documents Series, No1". No1".

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Achievements Achievements: :

• Identifying the developing process of a health

Identifying the developing process of a health promotion at workplace program in SMEs in a district promotion at workplace program in SMEs in a district that is suitable with Vietnamese conditions. that is suitable with Vietnamese conditions.

• Publishing and distributing materials about hazardous

Publishing and distributing materials about hazardous factors at workplaces and prevention to enterprise factors at workplaces and prevention to enterprise managers and employees managers and employees

• Building health services for labourers in SMEs at the

Building health services for labourers in SMEs at the district level. district level.

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3) 2000 3) 2000-

• 2001 period

2001 period In Haiphong and Hue city: In Haiphong and Hue city:

• Expanding the project to 15 new enterprises in each

Expanding the project to 15 new enterprises in each city, Haiphong and Hue. city, Haiphong and Hue.

• Maintaining the activities of health promotion in 30

Maintaining the activities of health promotion in 30 enterprises having implemented the project since 1998. enterprises having implemented the project since 1998.

• Holding the competition for these enterprises.

Holding the competition for these enterprises.

• Integrating health promotion at workplace program

Integrating health promotion at workplace program into routine occupational health activities. into routine occupational health activities.

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Training courses conducted in Hue city in 2001 Training courses conducted in Hue city in 2001

Organizers Contents No of courses No of enterprises No of trainees Professional foster and plan implementation 01 9 districts, cities 34 Training on occupational health, prevention of

• ccupational diseases for local health workers

01 30 districts, cities 60 Health promotion at workplaces 03 30 districts, cities 195 Legislation enforcement in the S afety Week 01 50 enterprises 100 First aid and prevention of occupational diseases for enterprises 02 54 enterprises 62 Training for enterprises and companies on chemicals with strict requirements of occupational health and sterilization and insecticides permissibly used in households and the health sector 01 42 enterprises 62 Center of Preventive Medicine of Hue city Competition of first aid 02 50 enterprises 160 Occupational health - First aid and prevention of

• ccupational diseases

21 125 enterprises 216 District Health Centers Guidelines for use, preservation of pesticides and prevention of pesticide poisonings for commune health workers 08 8 districts, cities 165 Health promotion at workplaces in small and medium enterprises 01 9 districts, cities 34 DoPM-MOH, NIOEH , PPMC Health promotion at workplaces in small and medium enterprises 01 30 enterprises 30 Total 42 1166

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Training Material

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IEC’s Material

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The jury of HPW Competition in Hue City

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Inspection in Hue city Inspection in Hue city

• Pre

Pre-

• test and post

test and post-

• test were conducted in the above

test were conducted in the above

• courses. In the end of the courses, all of trainees
• courses. In the end of the courses, all of trainees

received the certificate of participation. Therefore, received the certificate of participation. Therefore, all of trainees seriously followed the courses and all of trainees seriously followed the courses and post post-

• test results were very good.

test results were very good.

• To prepare for the annual Safety Week, Center of

To prepare for the annual Safety Week, Center of Preventive Medicine of Hue city actively plans Preventive Medicine of Hue city actively plans intersectoral inspection and then hold a meeting, in intersectoral inspection and then hold a meeting, in which all members of the inspection group are which all members of the inspection group are invited, to inform the inspection contents and invited, to inform the inspection contents and select enterprises for inspection. select enterprises for inspection.

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• The inspection is also done in enterprises having not

The inspection is also done in enterprises having not conducted periodic health check for workers and conducted periodic health check for workers and anual anual measurement of environment factors and being slow in measurement of environment factors and being slow in report. report.

• Contents of OH legislation and of the health promotion at

Contents of OH legislation and of the health promotion at workplace project are integrated into the inspection. workplace project are integrated into the inspection.

• In the end of the inspection, all enterprises are obligated to

In the end of the inspection, all enterprises are obligated to propose the schedule time to complete unimplemented propose the schedule time to complete unimplemented activities. activities.

• The inspection group also gives measures of penalization

The inspection group also gives measures of penalization for administrative violations of the stipulation on OHS for administrative violations of the stipulation on OHS legislation. legislation.

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• Occupational health is now actively implemented

Occupational health is now actively implemented in enterprises. Most of enterprises asked the Center in enterprises. Most of enterprises asked the Center

• f PM for health examination and measurement of
• f PM for health examination and measurement of

environment factors in the beginning of the year. environment factors in the beginning of the year.

• Center of PM annually conducts training courses

Center of PM annually conducts training courses

• n OH for district PM Groups. Then, district PM
• n OH for district PM Groups. Then, district PM

Groups actively work with enterprises. There are Groups actively work with enterprises. There are now 110 enterprises having healthy corners with now 110 enterprises having healthy corners with booklets and leaflets about improvements of booklets and leaflets about improvements of working conditions, workers' health protection, and working conditions, workers' health protection, and first aid. Etc. first aid. Etc.

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• In Hue city, there is not only a health station,

In Hue city, there is not only a health station, but also a network of concurrently health but also a network of concurrently health personnel in each production group in large personnel in each production group in large firms and in small enterprises, there are at firms and in small enterprises, there are at least 2 concurrently health personnel, who least 2 concurrently health personnel, who are trained annually. are trained annually.

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Health coner at canteen of My Huong enterprise in Hai phong

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In other provinces: In other provinces:

• Conducting pilot training courses about workplace health

Conducting pilot training courses about workplace health promotion for district health workers, enterprise managers promotion for district health workers, enterprise managers and workers of 4 localities. and workers of 4 localities.

• Then providing training courses for health

Then providing training courses for health personnels personnels of 30

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provinces/cities and Ministries, Sectors. provinces/cities and Ministries, Sectors.

• Publishing propaganda and training documents about

Publishing propaganda and training documents about workplace health promotion and providing them for all workplace health promotion and providing them for all localities, related localities, related-

• Institutes and Ministries, Sectors in the

Institutes and Ministries, Sectors in the country. country.

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Evaluation meeting 2000-2001 on HPW Teacher group disscusion With C. Chu in Hue city

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• Issuing guideline documents about health care

Issuing guideline documents about health care for laborers in small and medium sized for laborers in small and medium sized enterprises (Circular 09/2000/TT enterprises (Circular 09/2000/TT-

• BYT
• f

BYT

• f

Ministry of Health on 28/4/2000) Ministry of Health on 28/4/2000) 4) From 2002: 4) From 2002:

• To continue expanding the workplace health

To continue expanding the workplace health promotion programme in SMEs over the promotion programme in SMEs over the country. country.

• To set up Video tape about the project of health

To set up Video tape about the project of health promotion at workplaces in SMEs which was promotion at workplaces in SMEs which was pilot implemented in Haiphong city and Hue pilot implemented in Haiphong city and Hue city: its steps and achievements. city: its steps and achievements.

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Training course in Ho Chi Minh city on HPW, Sep 2001

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• To set up CD disk including the contents of training

To set up CD disk including the contents of training documents about workplace health promotion for documents about workplace health promotion for district health workers, enterprise managers and district health workers, enterprise managers and workers. workers.

• To publish training documents for trainers about

To publish training documents for trainers about workplace health promotion and conduct pilot training workplace health promotion and conduct pilot training courses: one class in the north and the other in the courses: one class in the north and the other in the south. south.

• To establish health promotion model for labourers in

To establish health promotion model for labourers in large firms, join large firms, join-

• ventures foreign capital enterprises,

ventures foreign capital enterprises, village enterprises and for agricultural workers. village enterprises and for agricultural workers.

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+ + Since 2000, MOH has started activities of health Since 2000, MOH has started activities of health promotion for agricultural workers promotion for agricultural workers

• To investigate working conditions and health

To investigate working conditions and health

• f the female employees in agriculture in 8
• f the female employees in agriculture in 8

agricultural typical provinces. agricultural typical provinces.

• To set up a health care model for female

To set up a health care model for female employees in agriculture. employees in agriculture.

• To publish training and propaganda documents

To publish training and propaganda documents about health care and promotion in agriculture about health care and promotion in agriculture for health, intersectoral personnel, and farmers. for health, intersectoral personnel, and farmers.

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Initiative activities HPW in agriculture

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Training course for farmers

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• To carry out some researches about the health

To carry out some researches about the health situation of the female employees in agriculture, situation of the female employees in agriculture, risks caused by agriculture production. risks caused by agriculture production.

• To continue developing the health care model

To continue developing the health care model for female employees for female employees.

.

+ + Recently, the MOH has pilot implemented health

Recently, the MOH has pilot implemented health promotion models for large firms, join promotion models for large firms, join-

• ventures,

ventures, foreign capital enterprises and village enterprises: foreign capital enterprises and village enterprises:

• Carry out investigating working conditions and

Carry out investigating working conditions and the health of employees. the health of employees.

• Start implementing the model of workplace

Start implementing the model of workplace health promotion in Vietnamese railway sector. health promotion in Vietnamese railway sector.

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• Set up national guidelines of workplace health

Set up national guidelines of workplace health promotion for all vary types of businesses. promotion for all vary types of businesses.

• In corporation with the MOLISA to hold a

In corporation with the MOLISA to hold a workshop on workplace health promotion for workshop on workplace health promotion for SMEs. SMEs.

• After 2 years of being issued, the Circular that

After 2 years of being issued, the Circular that guides health care for workers in SMEs has been guides health care for workers in SMEs has been implemented in nearly implemented in nearly 70% of localities at 70% of localities at district level district level (in 573 districts in all) and in (in 573 districts in all) and in approximately 2000 SMEs approximately 2000 SMEs. .

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No Contents 2001 The first 6 months of 2002 1 Number of the provinces disseminated the Circular 32 42 2 Number of the districts disseminated the Circular 305 268 3 Number of the workplaces trained on the Circular implementation 1645 2533 4 Number of the workplaces implemented 928 1042

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• 5. Integrated activities:
• 5. Integrated activities:

a) a) All the activities/steps require

All the activities/steps require multisectoral multisectoral and and multidisciplinary cooperation multidisciplinary cooperation: :

• The Central Steering Committee includes:

The Central Steering Committee includes: representatives from the MOH, the MOLISA, representatives from the MOH, the MOLISA, The NIOEH, Hanoi Medical School, etc. The NIOEH, Hanoi Medical School, etc.

+ + The roles of the Central Steering Committee:

The roles of the Central Steering Committee:

• To draft

To draft stratergies stratergies, objectives, policies, and , objectives, policies, and plan of action for the project plan of action for the project

• To guide and publicize all the steps in the

To guide and publicize all the steps in the project project

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• Hold seminars and meetings to introduce the

Hold seminars and meetings to introduce the meaning and the roles of healthy workplace meaning and the roles of healthy workplace promotion as well as the results of the project. promotion as well as the results of the project.

• Supervise and investigate the need of health

Supervise and investigate the need of health promotion. promotion.

• Develop propaganda and training documents and

Develop propaganda and training documents and references for district health personnel, references for district health personnel, enterprises' managers and workers. enterprises' managers and workers.

• Train for trainers about HWP.

Train for trainers about HWP.

• Supervise and evaluate project activities through

Supervise and evaluate project activities through monthly, 6 month reports, healthy workplace monthly, 6 month reports, healthy workplace evaluation checklist, field visits. evaluation checklist, field visits.

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• Provincial and local Steering Committee (ST)

Provincial and local Steering Committee (ST)

• The roles of the provincial and local Steering

The roles of the provincial and local Steering Committee: Committee:

• To establish provincial and local plan of action.

To establish provincial and local plan of action.

• To conduct investigation on the demand of health

To conduct investigation on the demand of health promotion. promotion.

• monthly visit enterprises to collect data and

monthly visit enterprises to collect data and information following the monthly and 6month information following the monthly and 6month reports reports;

;

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• urge the progress of the project; take

urge the progress of the project; take documentary photographs

• f

technical documentary photographs

• f

technical improvement; improvement;

• discuss with the enterprise leaders about the

discuss with the enterprise leaders about the development as well as the difficulties that they development as well as the difficulties that they need to get over; need to get over;

• guide enterprises in establishing the healthy

guide enterprises in establishing the healthy corner. corner.

• Report to the Central Steering Committee the

Report to the Central Steering Committee the results of the project activities, difficulties and results of the project activities, difficulties and suggestions suggestions

• Take part in evaluating the project activities

Take part in evaluating the project activities

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b) Beside the HPW Project in SMEs headed by the b) Beside the HPW Project in SMEs headed by the MOH MOH, , there are some similar activities initiated there are some similar activities initiated and implemented by VCCI named Vietnam and implemented by VCCI named Vietnam Footwear Industry Footwear Industry -

• Business Links Initiative. In

Business Links Initiative. In the programme, the MOH is a member of the the programme, the MOH is a member of the Steering Board. The Programme has been Steering Board. The Programme has been achieving positive results as follows: achieving positive results as follows:

• To create a Management Support System including

To create a Management Support System including books, CD with the aim to assist managers in books, CD with the aim to assist managers in reviewing current working conditions, practices reviewing current working conditions, practices and procedures in their workplaces and in and procedures in their workplaces and in developing action plans for improvement of developing action plans for improvement of working condition for the employees. working condition for the employees.

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• To train on OHS management and chemical safety

To train on OHS management and chemical safety management. management.

• To conduct a research on the current monitoring

To conduct a research on the current monitoring and inspection work of OHS in footwear and inspection work of OHS in footwear businesses. businesses.

• To implement a pilot project in 5 selected trial

To implement a pilot project in 5 selected trial shoes and footwear factories. shoes and footwear factories.

• However, the activities of the project are still

However, the activities of the project are still fragmental, the outcome of the activities has not fragmental, the outcome of the activities has not frequently been evaluated, the results of the frequently been evaluated, the results of the project are not persuasive. project are not persuasive.

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• 6. Support provided by the Government
• 6. Support provided by the Government includes

includes support on human resource, equipment, issuing support on human resource, equipment, issuing related legislation. related legislation.

• Intersectoral participation at local and central level.

Intersectoral participation at local and central level. Especially, local authorities take part in and Especially, local authorities take part in and

• rganize HPW competitions, training courses and
• rganize HPW competitions, training courses and

enterprise inspection. enterprise inspection.

• Only in 2001, Center of PM of provinces/cities

Only in 2001, Center of PM of provinces/cities bought 52 equipment for measuring environmental bought 52 equipment for measuring environmental factors. factors.

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• 7. Resources,
• 7. Resources, maintainance

maintainance and development: and development:

• Human resources: from Center of PM, DHC, the

Human resources: from Center of PM, DHC, the Central and local agencies. To enforce the human Central and local agencies. To enforce the human resource for the project and the ability to complete resource for the project and the ability to complete the project it's necessary to strengthen the the project it's necessary to strengthen the partnership with other sectors at all levels. partnership with other sectors at all levels.

• Financial resource: basically depends on local

Financial resource: basically depends on local budgets, makes the best use of support from other budgets, makes the best use of support from other agencies and sectors as well as from project agencies and sectors as well as from project implementing enterprises and the international implementing enterprises and the international

• rganizations.
• rganizations.
• At enterprises: budget for HPW activities is put into

At enterprises: budget for HPW activities is put into the labour protection plan. the labour protection plan.

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• 8. The successes of the project
• 8. The successes of the project
• Lift up the position and roles of enterprise

Lift up the position and roles of enterprise managers in the market, this is also an indirect managers in the market, this is also an indirect way to attract more contracts for the enterprises. way to attract more contracts for the enterprises.

• Have an overall review about relevant matters at

Have an overall review about relevant matters at enterprises in order to reach the such goals of enterprises in order to reach the such goals of health promotion as: revenue, production capacity, health promotion as: revenue, production capacity, employer's points of view, employees' opinions, employer's points of view, employees' opinions, working conditions and health, etc. working conditions and health, etc.

• Integrate and combine many different sectors,

Integrate and combine many different sectors, agencies, and organs: in each working groups the agencies, and organs: in each working groups the health agencies play the key role to give useful health agencies play the key role to give useful consultation to the local governments consultation to the local governments

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• Systematically manage: the strict control comes

Systematically manage: the strict control comes from all levels from national to provincial and from all levels from national to provincial and local, and feedback from level workplaces are local, and feedback from level workplaces are reported to relevant agencies. reported to relevant agencies.

• Interventions are mapped out masterly for

Interventions are mapped out masterly for different subjects with many different strategies of different subjects with many different strategies of prevention on labour organization, individual prevention on labour organization, individual habbit habbit and practice changes, environment change, and practice changes, environment change, upgrading and reinforcing employees' knowledge, upgrading and reinforcing employees' knowledge, etc. etc.

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• 9. The failures and reasons:
• 9. The failures and reasons:
• Slowly improving working conditions especially

Slowly improving working conditions especially when the matter relates to such factors as toxic when the matter relates to such factors as toxic gases, dust, noise, and waste water. The reason is gases, dust, noise, and waste water. The reason is from limited budget spent on the matter. from limited budget spent on the matter.

• Occupational diseases are possibly diagnosed but

Occupational diseases are possibly diagnosed but there has not been any official document regulating there has not been any official document regulating policies for employees suffering from those policies for employees suffering from those diseases. diseases.

• As workers are usually changed, training and

As workers are usually changed, training and information updating need to be strengthened. information updating need to be strengthened.

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• 10. Lessons learned from the implementation of
• 10. Lessons learned from the implementation of

the project: the project:

• To use WHO and ILO modern approaches of

To use WHO and ILO modern approaches of health promotion and working condition health promotion and working condition improvement. improvement.

• It's necessary to do a pilot programme before

It's necessary to do a pilot programme before implementing and developing a implementing and developing a stratergy stratergy. .

• During the implementation it's essential to mobilize

During the implementation it's essential to mobilize leading experts on the field and on management in leading experts on the field and on management in

• rder to combine technique with management
• rder to combine technique with management
• There should be consultancy given by either

There should be consultancy given by either foreign or domestic experts who visit enterprises foreign or domestic experts who visit enterprises and suggest solutions to obstacles in each stage. and suggest solutions to obstacles in each stage.

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• Evaluation process must be taken with seminars.

Evaluation process must be taken with seminars. The seminars should be attended by various The seminars should be attended by various

• participants. In the seminars, localities implementing
• participants. In the seminars, localities implementing

the pilot programme should report their experiences the pilot programme should report their experiences and the chairman board should introduce the and the chairman board should introduce the program and steps of building relevant legislation. program and steps of building relevant legislation.

• Development
• f

documents (training and Development

• f

documents (training and propagandating propagandating documents) need being carefully documents) need being carefully prepared at all levels from national, provincial, local prepared at all levels from national, provincial, local to workplace. to workplace.

• To do the activities, it's essential to build legislation.

To do the activities, it's essential to build legislation.