Occupational health care services for informal workers. From public policy to real practice
Authors: Luis Carlos Betancourt Sanchez, Vladimir Cuenca Cuellar
Abstract: Informal workers make up the majority of active workers in the world; However, actual access to occupational health services is limited, precarious, and of minimal relevance for health promotion in the workplace. Occupational health programs have a strong emphasis on accidents and to a lesser extent on disease prevention. However, this approach is based on a deterministic vision that does not correspond to the real needs of workers with respect to their health.Some countries establish in their regulatory frameworks that occupational health and safety services are the responsibility of the employer; in other cases, the services are administered by a public regulatory framework that allows access to a greater number of workers without considering the characteristics of insertion into employment. In the case of informal workers, although they have access to some primary health care services that constitute the first contact with the health system, there is little recognition of the health problems derived from work at this level.In some sectors, such as agriculture and mining, public policies have been implemented to promote health care for informal workers. However, multiple problems hinder the continuity of the programs and the quality of care for workers. The training of health professionals to integrate actions on occupational health in primary health care is scarce. The development of competencies for health professionals and community agents is timely and necessary, not only for the identification and analysis of work-related problems but also for the promotion of health in the workplace. On the other hand, financing of health care programs is scarce, sometimes it depends on political agreements that do not materialize in public programs that are sustained over time.It is necessary to emphasize that a combined action is required between the state and institutions, which allows establishing conditions for comprehensive care from the promotion of health in the workplace. All of the above are under a vision that goes beyond the notion of accidents and occupational diseases as central axes of workers' health.
Keywords: occupational health, basic occupational health services, informal workers
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