Health status of Iranian workers and proposed interventions

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 workerschr('39') 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 Healthchr('39')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. 

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 In addition, unpublished documents were received from relevant experts.The purpose of this phase was to determine the evaluation indicators and the health status of workers, the type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 workerschr('39') 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 workerschr('39') 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, Mendeleevchr('39')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.

Due to the lack of point data in previous years, it is not possible to judge the ascending or descending trend of workerschr('39') 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 workerschr('39') 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 workerchr('39')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%

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 Workerschr('39') 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.