SAHR 2007 - Health Systems Trust

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Health and Health Care in the Workplace 7 In the non-mining sector occupational injuries account for close to 99% of all claims submitted under COIDA with a total of 219 399 in 2006 (excludes injuries reported by exempted employers). 17 This represents a reported injury rate of 42 per 1 000 workers for 2006, which is 27% higher than the rate of 33 per 1 000 workers in 1994. This suggests a worsening of occupational health and safety standards from data reported previously by Jeebhay et al. 1 This is corroborated by reports of an increase in the awards for occupational injuries in 2006 which amounted to R1.311 billion representing an increase of close to 30% on the previous year’s expenditure. In the mining sector there were 4 158 occupational injuries reported in 2006, which represents an injury rate of 4.13 per million hours worked. Gold mines accounted for 56% of all reported injuries. During the same period 199 fatalities were reported which translates to a fatality rate of 0.20 per million hours worked. The gold mining sector appeared to be the most hazardous contributing 57% of all fatalities. Both injury and fatality rates in mines have indicated a downward trend from 1984 to the present (see Figure 2). This is probably related to the contraction of the mining industry as well as improved safety measures in mines due to improved regulation of mine health and safety since the early 1990’s. 20 In recognition that the safety standards in South African mines are still not in line with international standards, the Mine Health and Safety Council (MHSC) in South Africa has set itself the goal of achieving safety levels equivalent to international benchmarks by 2013 in all underground metalliferous mines. 21 HIV and AIDS Although no reliable data of HIV infection per sector or per skills category is available, it is generally believed that the HIV prevalence is significantly higher among semi- and unskilled workers than among highly skilled and white-collar workers. The mining, transport, building and construction and manufacturing sectors are particularly vulnerable to the AIDS epidemic, as a large proportion of their workforce falls within the semi- and unskilled categories with two large mining companies reporting an HIV prevalence of 30% among their workforce. 22 With over 5 million of the population estimated to be infected with HIV, South African workplaces have had to develop an organised and formalised response in dealing with the HIV epidemic. A recent survey by the South African Business Coalition on HIV/AIDS (SABCOHA) evaluated the HIV workplace strategies of 1 032 companies and found that 81% of the financial services companies, 60% of the mines and around 50% of the companies in the manufacturing and transport sectors had an HIV and AIDS policy. 22 However, less than a third of the retailers, wholesalers, vehicle dealers and building and construction companies implemented an HIV and AIDS policy. There appears to be a relationship between size and skill level in the company and the implementation of HIV programmes. The financial, mining, transport and manufacturing sectors appear to be the most advanced in the provision Figure 2: Annual fatality and injury rates for South African mines, 1984-2004 0.6 12 Fatality rate (million hours) 0.5 0.4 0.3 0.2 0.1 10 8 6 4 2 Injury rate (million hours) 0 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 0 Fatality rate Injury rate Source: Department of Minerals and Energy, 2005. 21 109 Department of Minerals and Energy, South Africa. Fatality and injury rates per commodity (rates per million hours worked) – SAMRASS. Data base (provisional figures).
of HIV awareness programmes, voluntary counselling and testing (VCT) programmes, HIV and AIDS care, support and treatment programmes and the provision of antiretrovirals (Figure 3). In contrast, smaller companies (employing less than 100 employees) lag behind in the provision of HIV programmes due to financial constraints and lack of perceived long-term risk to business operations. 22 Figure 3: Percentage of companies that have implemented HIV/AIDS programmes – sectoral breakdown, 2005 HIV/AIDS workplace awareness programme Financial Services Manufacturing Mining Transport Motor Wholesale Building & Construction Retail Voluntary counselling and testing Financial Services Mining Transport Manufacturing Wholesale Motor Building & Construction Retail HIV/AIDS care, support and treatment Financial Services Mining Transport Manufacturing Motor Building & Construction Retail Wholesale Provision of antiretroviral therapy Financial Services Mining Transport Manufacturing Motor Retail Building & Construction Wholesale 3 3 4 15 13 10 10 8 15 11 9 44 40 31 27 34 34 23 21 40 32 28 24 38 26 65 61 61 60 57 76 79 0 15 30 45 60 75 90 Source: SABCOHA survey, 2005. 22 110
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South African Health Review 2007 LI
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Foreword The 12th edition of South
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12 Traditional and Complementary Me
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Other Funders for the Health System
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This response raises a number of qu
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ucts are currently sold without reg
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The authors conclude that mandatory
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servicing and inappropriate hospita
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systems is also critical; worrying
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Authors: Laetitia Rispel i Geoffrey
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Stewardship: Protecting the Public
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Introduction The importance of the
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diseases such as tuberculosis and t
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17 of 2002). This Act entirely repl
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(d) and any other matter relating t
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Year Act No. Title Objects 1997 90
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References 1 Department of Health.
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Purchasing of Health Care 33Pooling
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Introduction This chapter presents
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Medical schemes are the largest fin
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per person dependent on the public
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An increase in hospital expenditure
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private pharmacy do so for self-tre
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References 1 McIntyre D, Thiede M,
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Policy and legislative framework In
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Medical schemes and revenue collect
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There is evidence that when faced w
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are thus contributing factors to th
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Figure 2: Historic membership of me
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Page 91 and 92: Introduction There has long been co
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Page 103 and 104: Current debates A key area of ongoi
Page 105 and 106: References 1 Gluckman H. The Provis
Page 108 and 109: Authors: Patrick Matshidze i Lyn Ha
Page 110 and 111: Health Information Systems in the P
Page 122 and 123: Authors: Shahieda Adams i Reno Mora
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Page 142 and 143: Author: Bettina Taylor i 8 Rationin
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Page 160 and 161: Authors: Haroon Wadee i Farzana Kha
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Authors: Thulani Matsebula i Michae
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Private Hospitals 11 Table 1: Priva
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Private Hospitals 11 Table 3: Distr
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Private Hospitals 11 Human resource
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Private Hospitals 11 Figure 3: 16 T
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Private Hospitals 11 Figure 4: 2 50
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Private Hospitals 11 Monitoring qua
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Private Hospitals 11 Recommendation
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Authors: Nceba Gqaleni i Indres Moo
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Traditional and Complementary Medic
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Authors: Myles Mander i Lungile Ntu
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Economics of the Traditional Medici
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Authors: Marion Stevens i Edina Sin
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HIV and AIDS, STI and TB in the Pri
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Indicators 213
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Authors: Candy Day i Andy Gray ii 1
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Health and Related Indicators 15
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Health and Related Indicators 15 St
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Glossary AFA AIDS ALP AMA ANC ART A
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Glossary KZN LFS LIMS LP LPP MAR MC
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Glossary SAPC SARS SASIM SASSA SEP
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Index A Acts (Legislation and Bills
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Index N and O National Health Refer
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SAHR 2007 - Health Systems Trust

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