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BOHS in Transitional

Economy: Nepal Experience


Dr. Sunil Kumar Joshi
MD, MPhil (Occup. Medicine), PhD (Public Health),
PG Dip Diabetology

Professor of Community Medicine


Kathmandu Medical College
Email: drsunilkj@gmail.com

Political Transition in Nepal


Up until 1990, Nepal was a monarchy

under executive control of the King.


The movement in April 2006 brought a
change in the nation's governance: an
interim constitution was promulgated,
with the King giving up power
In December 2007, the interim
parliament passed a bill making Nepal a
federal republic, with a president as
head of state and monarchy was
abolished.
King left Royal Palace on 11 June 2008

Post Democracy OSH Related


Policies in Nepal
Labour Act 1992,
Labour Regulation 1993,
Labour and Employment Policy 2005,
No separate act on Occupational

Safety and Health (OSH) yet


National Health Program: Essential
Health Care Services on
Occupational Health

ILO Conventions Endorsed


Nepal has endorsed all together 11

ILO Conventions
Nepal has not yet ratified ILO
Conventions No. 155 on
Occupational Safety and Health,
161 on Occupational Health
Services, 187 on Promotional
Framework for Occupational Safety
and Health

Why BOHS
Economic structures and conditions of

work have changed substantially in each


workplace
The workplaces are more unstable and
the jobs have become more precarious
and temporary
Big industries are doing well with
occupational health services (OHS)
Main concerns are SME, SSE, House Hold
Enterprises and informal sectors

Some Photos on OSH in Small


Scale Enterprises and
Informal Sectors in Nepal

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11

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Policy Implications and OHS


The Labour Act of Nepal ensures the provision
of:
First aid facility in industrial enterprises with
more than 50 employees,
Academically trained medical assistant in the
case of industrial enterprises with more than 400
workers,
A medical doctor and a medical assistant if an
industrial enterprise has more than 1,000
employees.
Occupational diseases are required to be
reported, but the mechanism is not clear

Policy Implications and OHS


Essential Health Care Services on

Occupational Health mention briefly


about the interventions required to
improve workers' health in term of
Chronic Respiratory Disease,
Accident, Cancers, Eye and Skin
Diseases, Hearing Loss,
No specific policy, strategy and plan
of action are developed by the
Ministry of Health, neither, it has
identified the appropriate focal point

Policy Implications and OHS


Compensation for injuries:

accident insurance is required in


accident prone industries such as
construction, transport, hotel,
travel, trekking, adventure, rafting,
jungle safari and other enterprises
Informal sectors are not included in
this scheme

Obstacles in BOHS
Practices
Nation
Lack of adequate qualified and
skilled manpower
Lack of National strategy for BOHS
Management
Lack of commitment, effort & less
attention from concern authorities
(Government, WHO, ILO)
Lack of legal back up mechanisms
(ILO Convention C155, C161)

Obstacles in BOHS Practices


Employers
Isolation and overlooking of BOSH
issues by formal and informal
sectors/ given low priority
Poor institutionalization, lack of
ripple effect of good OHS practices
in some industries
Lack of awareness, commitment and
effort

Obstacles in BOHS Practices


Employees
The labour forces are guided by their
political affiliations, lack effective
coordination and unity on OHS issues.
The workers have still been collectively
bargaining for issues relating to
minimum wages, equal remuneration
etc. thereby, overshadowing issues
pertaining to OHS.

BOHS Opportunities
OSH issues are considered as an

integral part of workers right


Different stakeholders have
realised the importance of OHS for
better health of the workers
International donors stipulates for
stringent OHS provision in the multi
national projects.

Models of BOHS Provision


High priority models
Primary health care model: Primary
health centres, health posts and sub
health posts as starting level OHS
to ensure the availability of
Occupational Health services to all
people specifically living in rural,
remote area, poor and disadvantaged
population
Train the auxiliary health workers on
basic occupational health, accident

Models of BOHS Provision


High priority models
District hospitals: as an unit of
Basic Occupational Health Services;
a doctor and a nurse from a specific
department to undergo a short
training on occupational health.
EHCS: District hospitals should
provide care to the workers

Models of BOHS Provision


High priority models
Tertiary Level Teaching Hospital :
as an International Standard
Occupational Health Service Centre
BPKIHS, a Tertiary Level Teaching
Hospital in Eastern Nepal has taken
that initiative.

Models of BOHS Provision


Other Models
Big Company Model

Company

OHS

Group services
OHS

Social security model


Private physician
Private health centre

BOHS Improvement Strategy


Political Commitment
Legislations
Leadership
Role, Responsibility &

Accountability
Information, Education &
Communication
Monitoring
Reporting

Effective BOHS Promotional


Strategy
Policy formation
Standard set up
Technical & financial assistance

Cooperation on Program
Technical & Financial
Assistance

Donors

Government

Safe & Healthy


Work environment

Employee &
Trade union
Cooperation at workplace
Catalyst for implementation

Implementation of BOHS
Catalyst for implementation

Employer &
Employer Federation

My Goals
Occupational Safety and Health

international network building


Pressure building at local, national and
regional level
Proper implementation of existing
legislations
National Policy Development on
Occupational Health Services/BOHS
implementation
Capacity building

Few Photos on OSH


Awareness Arising and
Capacity Building Activities in
Nepal

ThankYou