Iran Occupational Health Journal

fa وضعیت سلامت کارگران ایران و پیشنهاد مداخلات Health status of Iranian workers and proposed interventions مطالعات کمی و کیفی Qualitative and quantitative studies كاربردي Applicable   چکیده زمینه  و هدف: کارگران نیروی مولد جامعه بوده و تامین سلامت آنها ضروری است. هدف این مطالعه بررسی وضعیت سلامت نیروی کار در جامعه کار و تولید ایران و ارائه مدلی برای بهبود آن است.   روش بررسی: این مطالعه توصیفی و از نوع سیاست پژوهی است. گردآوری دادهها از طریق مرور اسناد و منابع و بحث گروهی متمرکز انجام شده است. پس از تحلیل مستندات و ترکیب یافته ها توسط تیم پژوهش، نتایج در دو بخش اصلی شناخت وضعیت موجود و جهتگیریهای آینده جمعبندی شده است.   یافته ها: به دلیل عدم وجود داده های نقطه ای در سال های گذشته نمی توان روند صعودی یا نزولی شاخص های سلامت کارگران را قضاوت کرد اما در کل جامعه وضعیت عوامل خطر بیماری های غیرواگیر، اختلالات روانی و آسیب های اجتماعی روند افزایشی داشته است که این موضوع احتمالا در مورد جمعیت کارگری نیز صادق است. مداخلات قبلی در حوزه سلامت کارگران متعدد بوده ولی در قالب برنامه ملی نظام مند نیست. گزارش پایش دوره ای برنامه ها  و ارزشیابی از مداخلات موجود به طور رسمی در دسترس نیست. اسناد بالادستی ارتقای سلامت کارگران را حمایت می کند. نیاز به ارتقاء و تمرکز در هر چهار حوزه تدوین، پایش و ارزشیابی برنامه ملی سلامت کارگران، ساختار و استانداردهای تدارک خدمات سلامت، بهبود رفتاری کارگران و کارفرمایان و تامین پایدار منابع (مالی، اطلاعات و نیروی انسانی ) وجود دارد.    نتیجه گیری: برنامه تدوین شده با نظرخواهی نهایی از کانون عالی کارفرمایان، کانون عالی کارگران و واحدهای تابعه وزارت تعاون کار و رفاه اجتماعی، وزارت بهداشت درمان و آموزش پزشکی و وزارت صنعت معدن تجارت در شورای هماهنگی خدمات بهداشتی بیمهشدگان تصویب شده و برای پایداری بیشتر برنامه به تصویب شورای عالی سلامت و امنیت  غذایی کشور برسد.   Abstract Background and aims: Workers are the productive force of the society and their health is essential. Safety and health at workplace are of great importance in terms of economic development as workers spend more than a third of their lives at work. The role of international organizations such as the World Health Organization and the International Labor Organization in dealing with workers' issues, including their health care needs, emphasizes the multifaceted nature of the field. The International Labor Organization has requirements such as ergonomic and occupational risk factors to protect work forces from physical and mental illness and injury from workplace hazards and accidents. These standards have a great impact on the laws and regulations of governments .One of these standards is the Occupational Health Services Contract, which cover musculoskeletal injuries, violence, stress, biological, chemical and physical hazards. This, plays an important role in the prevention, diagnosis, treatment and care of workers as well as the fight against discrimination. In Iran, the primary health care system has established a national model by providing health services, and the Ministry of Health's Environmental and Occupational Health Center is responsible for monitoring and implementing occupational health programs and projects in the country. The purpose of the study was to evaluate the health status of workforce in Iranian labor and production society and to present a model for its improvement.   Methods: This is a descriptive and policy research study. Data collection was conducted through a review of documents and resources and focus group discussions. In the firt phase, a diverse list of scientific documents and resources by searching Iranian and international databases including Iranmedex, Magiran, Medlib, Web of Science, Cochrane and Pubmed were identified and reviewed. The various keyword combinations such as health of workers, workforest health, human resource health, Iran, index, indicator, Intervention, plan, program and Policy both in Persian and English were searched. In addition, unpublished documents were received from relevant experts. The purpose of this phase was to determine the evaluation indicators and the health status of workers, the type and impact of interventions in the workplaces in recent years, as well as the recommended interventions for workers' health. A summary of the items obtained from the first phase, entitled "Recognition of the current situation in the framework of indicators, past interventions and challenges of the workers' health promotion system" was analyzed by the project team and then discussed in a focus group of stakeholders to determine the orientations. In order to apply the ideas and opinions of stakeholders related to this issue, Mendeleev's Intrest-Power analysis method was used. . First, the main stakeholders were listed, then the list was placed in the matrix of interest and power, and the items with high interest and high power were selected as the steering committee. After analyzing the documentation and combining the findings, the results were summarized in two main parts: recognizing the current situation and the future orientations. Results: Due to the lack of point data in previous years, it is not possible to judge the ascending or descending trend of workers' health indicators; but, in general population, the status of risk factors for noncommunicable diseases, mental disorders and social injuries has been increased and is probably true for the labor population. Although, numerous interventions have been previously conducted in the workers' health area, they are not systematic and not included in a national program framework. The periodic monitoring report of the program and evaluation of the existing interventions are formally unavailable. Upstream documents supports every aspect of promoting worker's health. There is a need to improve and focus on all four areas of formulating, monitoring and evaluating the National Worker Health Plan, the structure and standards of health service provision, improving behaviors of workers and employers, and providing sustainable resources (financial, information and human resources).   The optimal point for the health of workers is that the Ministry of Cooperatives, Labour, and Social Welfare reduce the prevalence of work-related accidents and diseases for 15 years by attracting international sites and the participation of the working community and employers. To achieve this vision, at least three strategic goals must be considered; Including improving the score of health behaviors of workers in the production community by 30%, improving the score of suitable environment to reduce risk and increase protective factors (depending on the type of residence) by 30% and also improving the benefit of screening services, intervention And follow up to 50% Conclusion: The findings of this study show that despite the numerous national trustees and the packaging of various health, social and safety services, as well as the support of upstream documents, the health of workers has not improved considerably and there are various gaps in the operational levels. There is a need to improve and focus on the development, monitoring and evaluation of the National Workers' Health Plan, the structure and standards of health service provision, improving the behavior of workers and employers and the provision of sustainable resources (finance, information and workforce). The program should be approved by Insured Health Services Coordination Council after final opinion of the Employers Association, the Labors Association and the subsidiary units of the Ministry of cooperation, Labor and Social Welfare, the Ministry of Health and Medical Education and the Ministry of industry, mine and Trade in the. The plan is to be approved by the Supreme council for Health and Food Security for further sustainability.   سلامت کارگران, برنامه ملی, , محیط کار, ارتقای سلامت Keywords: Workers' Health, National Program, Workplace, Health Promotion 475 488 http://ioh.iums.ac.ir/browse.php?a_code=A-10-3360-1&slc_lang=fa&sid=1 behzad damari بهزاد دماری bdamari@gmail.com 13600319475328460038103 13600319475328460038103 Yes 1 Associate Professor, community Medicine Specialist, Department of Governance and Health, Neuroscience Research Institute, Tehran University of Medical Sciences, Tehran, Iran دپارتمان حکمرانی و سلامت،پژوهشکده علوم اعصاب،دانشگاه علوم پزشکی تهران،ایران ebrahim sadeghifar ابراهیم صادقی فر esadeghifa@yahoo.com 13600319475328460038104 13600319475328460038104 No PhD in Economic and social Development,Islamic Azad University دانشگاه آزاد اسلامی، ایران aliasghar farshad علی اصغر فرشاد fdgir@yahoo.com 13600319475328460038105 13600319475328460038105 No Professor, Occupational Health Reseach Center, Iran University of Medical Sciences, Tehran, Iran مرکز تحیقات بهداشت کار، گروه بهداشت حرفه ای، دانشکده بهداشت،دانشگاه علوم پزشکی و خدمات بهداشتی درمانی ایران، تهران،ایران hasan mohamadsadeghian حسن محمدصادقیان sadegh425@yahoo.com 13600319475328460038106 13600319475328460038106 No PhD Candidate in Psychology, Ahvaz University دانشگاه اهواز،ایران hosein almadani حسین المدنی hosseinalmadani@yahoo.com 13600319475328460038107 13600319475328460038107 No PhD of Psychology, Researchr, Department of Governance and Health, Neuroscience Research Center, Tehran University of Medical Sciences, Tehran, Iran دپارتمان حکمرانی و سلامت ، پژوهشکده علوم اعصاب،دانشگاه علوم پزشکی تهران،ایران abbas vosoogh moghadam عباس وثوق مقدم a_vosoogh@yahoo.com 13600319475328460038108 13600319475328460038108 No Assistant Professor of Research in Commuity Medicine,Secretariat of Supreme Council for HealthandFoodSecurity,Ministry of Health and Medical Education, Tehran, Iran. دبیرخانه شورای عالی سلامت و امنیت غذایی، وزارت بهداشت درمان و آموزش، تهران،ایران Fereshteh Taheri فرشته طاهری fereshtehtaheri61@gmail.com 13600319475328460038109 13600319475328460038109 No PhD Student of Cognitive Psychology, Occupational Health Research Center, Iran University of Medical Sciences, Tehran, Iran. مرکز تحقیقات بهداشت کار،دانشگاه علوم پزشکی ایران، تهران،ایران