National Occupational Health Policy for the Informal Mining, Transport and Agricultural Sectors

June 13, 2013

DOH ADMINISTRATIVE ORDER NO. 2013-0018

 

I. Rationale

The Joint Safety and Health Committee of the International Labour Organization (ILO) and World Health Organization (WHO) has defined occupational safety and health as the "the promotion and maintenance of the highest degree of physical, mental and social well-being of all workers in all occupations, the prevention among workers in the employment from risks resulting from factors adverse to health; the placing and maintenance of the worker in an occupational environment adapted to his physiological and psychological equipment and, to summarize, the adaptation of work to man and each of each man to his job."

It is the thrust of the occupational health program to cover the prevention of injuries and illnesses among the workers. In line with this, identification, assessment, evaluation, and control of hazards that the workers are exposed to are important steps to undertake. Another major aspect of this program is to promote physical and psychological well-being, including the social and mental components, among the workforce, the business and other stakeholders.

In our country's Constitution, the State Policies on Section 15 promulgates that the State shall protect and promote the right to health of the people and instill health consciousness among them. In Section 18, the State affirms labor to be a primary social economic force. It shall protect the rights of workers and promote their welfare. However, since the Occupational Health and Safety Standards exclude workers in the informal sector, it is but fitting to formulate a set of guidelines to protect the workers under these sectors.

In the formal or organized workers' sector in the country, systems are in place governing the health assessment and monitoring of its individual health status. However, it is apparent that in the informal sector, it is still neglected or has been given low priority. It has been noted that there is very low awareness level on access to social and health insurance among these workers in the informal sector especially among the group of agricultural workers, small-scale miners and land transport drivers. SDEHCc

Under Administrative Order No. 2010-0035 the Aquino Health Agenda (AHA): Achieving Universal Health Care was approved and launched to improve, streamline and scale up reform interventions for low income vulnerable groups such as the informal sector workers.

The National Government has a crucial role in reducing poverty, increasing access of the workers to education, health and other social services so that the transition from the informal to formal sector employment will be in place. The informal sector workers are considered a part of the general population in terms of access to health services and health insurance coverage. Thus, the health program for these sectors should be embodied in the public health system of the country. It is foreseen that special occupational health services should be made available at the local levels, and that local health offices should be able to respond to the demands for these services.

II. Objectives

This Order shall (a) provide a comprehensive policy direction in the development of an occupational health program relevant to workers in the informal sectors of mining, transport, and agricultural groups; (b) create an enabling environment for strengthening the capacity of health systems, collaborate with key partners in supporting the delivery of appropriate health services for the informal workers including recommended surveillance systems and, (c) develop a mechanism to ensure enrollment of the informal workers in the National Health Insurance system.

III. Scope

This issuance shall apply to all units and instrumentalities, including attached agencies of the Department of Health (DOH). It also applies to local government units (LGUs), non-government organizations, professional organizations, private sector, workers in the informal sector primarily those engaged in the Mining, Transport, and Agricultural Sectors and other relevant partners and government agencies involved in providing health and welfare services and programs. ISEHTa

IV. Definition of Terms

A. Informal Sector — sector consisting of units engaged in the production of goods and services with the preliminary objective of generating employment and incomes to the persons concerned, particularly unincorporated household enterprises that are market and non-market producers of goods as well as market producers of services

B. Occupational health — the promotion and maintenance of the highest degree of physical, mental and social well-being of all workers in all occupations, the prevention among workers in the employment from risks resulting from factors adverse to health; the placing and maintenance of the worker in an occupational environment adapted to his physiological and psychological equipment and, to summarize, the adaptation of work to man and each of each man to his job.

V. Guiding Principles

The program shall be guided by the following principles:

A. Prevention. Importance of precautionary measures in avoiding human health and environmental impacts.

B. Equity and Social Protection. Health in the context of social protection and human security to improve their livelihoods and create opportunities to build a better life for themselves and their families.

C. Promotion. Improved opportunities and livelihoods, notably through 'connecting' to better jobs and opportunities.

D. Workers' Right to Know. Information on the hazards in their workplaces, confidentiality (privacy) of health information, access to training and education and maintenance of a healthy and safe workplace. DCSTAH

E. Consistency. Need to build on and leverage existing policy commitments, engagements and processes at the international, national, regional and local levels in a practical and achievable way.

F. Coherence/Integrated. Importance of encouraging closer coordination and cooperation among stakeholders on a shared framework of action.

G. Synergies. Need to explore and exploit synergies and untapped potential that may exist in the shared agendas of various stakeholders and between sectors.

H. Private-Public Partnership. Cooperative venture between the public and private sectors, built on the expertise of each partner, that best meet clearly defined public needs through allocation of resources, risks and rewards.

VI. General Guidelines

Cognizant of the reality that workers in the informal sector are particularly vulnerable due to the nature of their work since they are exposed to a more hazardous environment than the general public, have access to fewer risk management services and have less opportunity to obtain permanent jobs and engage in productive work. Thus, workers in the informal sector are striving to improve their livelihoods, while addressing risks, social protection and equity enables them to manage these risks and have the opportunity to build a better life for themselves and their families and contribute to growth and productivity in the society.

A. Policy, Plans and Partnerships

1. Health policy, plans and programs shall be formulated (e.g., guidelines, strategic approaches and partnerships) to effectively carry-out set objectives.

2. Service Provision, Capacity and Systems Development:

a. Health Services — Appropriate preventive and promotive health services/packages shall be developed for the specific risk exposure scenarios for the sector. TcEaDS

b. Training — Workers in the informal sector shall be given training on health and safety aspects of the job. Technical skills shall be improved through collaboration with the Department of Labor and Employment, TESDA and other institutions. It is also important that the leaders and administrators of the program shall be trained in Basic Course on Occupational Health and Safety.

c. Facilities Enhancement — Upgrading of manpower, laboratory, hospitals and other health facilities shall be undertaken to conform to the specific health needs and concerns for these sectors.

d. Systems Development — Referral and Networks with private/public hospitals and health centers for emergency treatment shall be established especially for those engaged in mining operations.

3. Risk Assessment and Management. Thorough assessment and evaluation of the working environment including hazard exposure shall be conducted in order to establish correlation between the worker and his/her exposure. Likewise the use of the applicable personal protective equipment (PPE) including comprehensive training on its use and maintenance shall be incorporated into the occupational health programs of the sector.

4. Health promotion/healthy lifestyle program:

a. Advocacy — Health promotion on the major contributing factor in disease causation including set of lifestyle habits that the individual worker indulges in shall be conducted and programs shall be implemented among the workers in the informal sector, such as nutrition, smoking cessation, alcohol intake, etc.

b. Psychosocial support and counseling services. Since the workers in the informal sector are subjected to a variety of stressors, a comprehensive system of psychological counseling services shall be made available. Post-traumatic stress debriefing shall be recommended. aESHDA

5. Collaboration/Networking/Partnerships:

Appropriate networking with existing government agencies responsible for the various workers' benefits and privileges shall be conducted in the following concerns:

a. Registration of the trade or industry as part of securing the license for operation;

b. Ensuring the compliance of the requirements including the provision of the minimum health programs as outlined in the Order;

c. Conducting a comprehensive information dissemination campaign to include health and safety and workers' benefits and privileges;

d. Setting up of health services dedicated to the informal sectors identified;

e. Exploring the services by Government Financial Institutions (GFIs) that offer related services to the informal sectors such as the Land Bank of the Philippines, Development Bank of the Philippines.

f. Utilization of the LGUs

i. Registration of the trade or industry in the local government unit thru the assistance of associations/cooperatives;

ii. Implementation of the Interconnectivity Caravan thru strengthening and empowering of the League of Municipalities of the Philippines (LMP) and strengthening local actions through community organizing, etc.

iii. Monitoring and tracking of program progress and developments related to the health and welfare of the workers. ICTacD

iv. Setting up a mechanism in each LGU where permit/license to operate, may it be in the transport, small-scale mining, and farming, shall be granted only for workers under the informal sector who comply with the necessary requirements. Implementation of the various financing options on the different health programs and benefits, depending on the needs and capabilities of the cities and municipalities: (i) full payment by the LGU; (ii) subsidized scheme; (iii) salary deduction; and (iv) combination.

6. Formation of cooperatives/strengthening workers' and operators' associations for the following:

a. For the administration of the SSS and PhilHealth coverage, farmers', and miners', drivers', associations and cooperatives shall be established.

b. Associations with the cooperative concept of 'bayanihan' especially in raising common funds from individual members for the benefit members shall be instituted.

7. Mechanism for the full coverage of health and social insurance integrated through the National Health Insurance System, and the Social Security System. Guidelines for the strategic approach for the implementation of the full coverage of health insurance of the informal sector workers shall be developed considering existing platforms whereby this can be strengthened/enhanced through:

a. Membership to the Individual Paying Program

b. Kasapi Program of PhilHealth for medical and hospitalization benefits as well as access to outpatient care and special packages and through the self-employed membership to SSS for medical, retirement and burial benefits. DIAcTE

B. Strengthening Operational Structure for Occupational Health for the Informal Sector at different levels of governance

The proposed framework shows the operational concept on the development of policies and occupational health and safety standards, the implementation of comprehensive health program, and the mechanism for coverage of health insurance of the workers in the informal sector.

Through Executive Order No. 489 signed 22 November 1991, the Inter-Agency Committee on Environmental Health (IACEH) was established with the Secretary of Health designated as Chair and the Secretary of the Environment and Natural Resources as the Vice-Chair. The Environmental and Occupational Health Office of the National Center for Disease Prevention and Control under the Support to Service Delivery Team II serves as the Secretariat for the IACEH.

The IACEH sub-sector on Occupational Health shall serve as the main coordinating body for the implementation of an integrated and multi-sectoral program for the informal sector which shall be composed of the following Core Agencies:

1. The Department of Health (DOH) shall continue to provide the policy-making body relevant to the protection and promotion of health to the workers in the informal sector in collaboration with other government agencies and concerned stakeholders.

2. The Department of Labor and Employment (DOLE) shall collaborate with the DOH in the development of policies relevant to the protection and promotion of health to the workers in the informal sector.

3. The Mines and Geo-Sciences Bureau of the Department of Environment and Natural Resources (MGB-DENR), the Land Transportation Office of the Department of Transportation and Communications (LTO-DOTC) and the Department of Agriculture (DA) shall provide specific technical assistance to the DOH and DOLE in the development and in planning the implementation strategy of these occupational health guidelines.

4. The Department of Interior and Local Government (DILG) shall serve as the oversight body to the LGU particularly in the implementation of the occupational health program and guidelines, and as such shall be responsible in monitoring compliance of LGUs to DILG administrative order pertinent to the subject matter. cEAIHa

5. The SSS and PhilHealth shall continue to have a direct link with the LGUs and the informal sector workers in matters related to expanding health insurance coverage and more extensive information campaign about the benefits of enrolment or membership, either through cooperatives or associations or through voluntary membership to SSS or through the individual paying program of PhilHealth.

VII. Budget and Financing

The Department of Health shall allocate a corresponding yearly budget based on the implementation of the National Occupational Health Program for the Informal Sector. Likewise, the DOH shall encourage other national government agencies and the local government units to fund their local NOHP programs to implement their respective thrusts and concerns at the local level.

VIII. Separability Clause

In the event that any provision or part of this order is declared unauthorized or rendered invalid by any court of law or competent authority, those provisions not affected by such declaration shall remain valid and effective.

IX. Effectivity

This Order shall take effect immediately.

(SGD.) ENRIQUE T. ONA, MDSecretary of Health