Some Issues of Occupational Health of Health Care Workers in Central Asia (Review)

Abstract

Introduction: In the Global Strategy on Human Resources for Health: Workforce 2030, the World Health Organization (WHO) called for the promotion of decent working conditions for health care workers (HCWs) in all settings. The Central Asian countries (CACs) are low- and middle-income countries with economies past transition and with implemented health care reforms that touch HCWs and occupational health and safety (OHS) at large. The aim: of the present article is to highlight some challenges in OHS regulation and to highlight some of the latest studies on biological health risks to HCWs in CACs. Materials and methods: The article reviews 18 journal articles in Russian and 3 journal articles in English published since 2004, 3 dissertations, 10 national statistical sources and profiles, and 5 books. Results: OHS management systems in CACs are built on the principle of responding to insurance cases, not their prevention. Most labor law standards are declarative in nature because many employers ignore labor protection requirements. There has been no study since 2000 on the working conditions, the physical and chemical health risks or the effects of working conditions, mental and physical loads on the health of HCWs. A few studies were found on work-related infectious diseases (viral hepatitis, HIV and tuberculosis) of HCWs in Kyrgyzstan and Kazakhstan. The latest studies showed a high prevalence of viral hepatitis B, C and G and of HIV infection in HCWs in Kyrgyzstan, with much lower rates in Kazakhstan. Conclusions: The traditional OHS approach used in soviet times has proven insufficient in CACs with developing market economies. OHS and the health of HCWs in Central Asia is insufficiently studied. The available data indicate a low level of attention to the health of HCWs. Serious studies on OHS in health care settings in this region are needed.