Impact and Effectiveness on Basic Occupational Health Interventions for the Informal Sector in Indonesia - A Qualitative Study

BACKGROUND: 70% of Indonesia's 240 million people depend on informal work. The "Occupational Health for Informal Sector" (OHIS) program of Directorate of Occupational Health (Ministry of Health, Indonesia) trained more than 2300 health officers in 'Basic Occupational Health' from provincial, district health offices, and community health center. OHIS established "Occupational Health Posts" in villages (PUSKESMAS; 4644 in 2005, and 5107 in 2007) and basic occupational health services in Community Health Centers. We report on a qualitative study of OHIS's impact in 2010.

METHOD: Researchers interviewed 31 respondents in Java Island, selected a-priori, in charge of OHIS from national, province, district, community and village levels.

RESULTS: 70% concluded that the establishment of "Centers for Occupational Health" and "Occupational Health Post" had been important for implementing OHIS. 50% of PUSKESMAS delivered OHIS services during study period. However, on district level, 90% respondents reported insecure funding as main barrier to continue. 80% identified long-term funding and training as most needed resources. 50% reported that sustainability depended currently on voluntary action of health officers. 60% explained that OHIS only worked if central supervisors visited often, regular training and funding was provided and officers on district level openly supported OHIS. 80% suggested that OHIS be included in “Minimum Service Standard" for Community Health Centers. Several informal sectors demanded increasingly more information on safe working methods.

CONCLUSION: Indonesia's model of integrating Basic Occupational Health services into Primary Care is moderately successful. Sustained funding and training seem the most important factors of future success.