New concept in basic occupational health services – BOHS: Lessons learned

New concept in basic occupational health services – BOHS

Introduction
One of the widest impacts of globalization is the growing inequity in the conditions of work between industrialized and developing world. A vast majority of workers of the world (80-90%) do not have access to occupational health services, OHS. Many of existing services are outsourced and often downsized to the minimum. There is challenge to provide and modify OHS to meet the needs of particularly underserved and vulnerable groups of workers.

Method
A The new approach proposed by joint action of the ILO, WHO and ICOH on basic occupational health services, BOHS, provides a new approach for meeting the occupational health needs of the workers who at the moment do not have access to services.
The method is guided by a general and several specific guidelines and representing good but simple PHS practices. Many lessons have been learned form the completed and ongoing pilots which are used for further development of the BOHS approach.

Results
Several countries South-Eastern and Eastern and Northern Europe, in Asia, in East Africa and South America have undertaken pilot projects for adjustment of BOHS into their national and local circumstances. Evaluations of a number of BOHS pilot projects find them feasible, effective both in expanding the coverage and improving the content of services. A special training programme is a part of BOHS implementation, starting from Training of Trainers (ToT) programmes for pilot leaders. A special e-learning platform has also been developed for BOHS.

Discussion
The BOHS pilots have given suggestive evidence on feasibility of the approach and on its positive impact on extension of coverage as well as on systematization of the existing OHS practice. Much development is also needed. Requests for more guidelines and training and on-site training have been presented.