The SATBHSS Project, Occupational Health and Safety, mid-term review, key achievements and recommendations (29 April-8 May 2019)



The aim of the Southern Africa Tuberculosis and Health Systems Support (SATBHSS) Project mid-term evaluation was to provide an opportunity for key partners to reflect on implementation progress and fix bottlenecks that might impact negatively on project results.

The African Union Development Agency-New Partnership for Africa’s Development (AUDA-NEPAD) undertook a self-assessment to evaluate its contribution, focusing on understanding and documenting progress in the first two years (2017-2018). The overall purpose was to improve implementation efficiency and effectiveness for positive impact in the region. This report provides an overview of the outcomes of the self-assessment, including key recommendations presented by project partners during the mid-term review (MTR) Regional Advisory Committee (RAC) meeting in Maputo, Mozambique.

Members of the Regional Advisory Committee (RAC) gather in Maputo, Mozambique 
Photograph: Norman Khoza



1. On rolling out a standardised package for OH ­services and mining safety standards across the four countries

To ensure harmonisation, and benefit from the economies of scale, the project adopted a regional approach which resulted in the development of a regional occupational health and safety inspection equipment guideline to be utilised by countries during the procurement of equipment. Through a partnership between AUDA-NEPAD, the International Labour Organization (ILO) and the National Institute for Occupational Health (NIOH), HealthWISE has been rolled out in hospitals in Lesotho as a step towards strengthening occupational health and safety of healthcare ­workers. HealthWISE lessons learned in Lesotho will be incorporated into the roll-out into the other three project countries. Capacity building has been undertaken in support of screening and treatment interventions of occupational lung diseases.

Present at the RAC mid-term review meeting (L-R) –  Dr Ronald Mutasa: Technical Team Leader (World Bank); Mr. Barnaby Mulenga: Permanent Secretary of the Ministry of Labour and Social Security, Zambia; and Her Excellency Dr Nazira Karim Vali Abdula, Honourable Minister of Health, Mozambique 
Photograph: Norman Khoza


2. Improving the quality and availability of human resources in the targeted areas

One hundred and twenty-one regional experts have been trained in occupational health and safety (OHS), including medical doctors, occupational health nurses, occupational hygienists, occupational health and safety inspectors, radiologists, environmental health practitioners, and  academics. A regional occupational health and safety inspector’s training manual, incorporating local, regional and international best practice, has been developed. Practical training on airborne dust measurements, for occupational hygienists who passed the International Occupational Hygiene Association-recognised international exams, is building a cadre of internationally-recognised experts in the region. Contributing partners are listed in Table 1.

Table 1. Training partners

3. Strengthening mine health regulation

All countries are reviewing their mine health and safety policies and legal frameworks. The code of practice on mine health regulation and occupational health was established in 2017, and provides a platform for peer learning in these reviews. Regional harmonised guidelines on mine health inspection were adopted in 2018 and have been used to update country guidelines. A pool of experts was established in 2019 to support the reviews. In 2018, an agreement was signed with the NIOH for support of the development of a standardised innovative information technology system for compliance monitoring and mine health surveillance data management.


4. Operational research and knowledge sharing

Two regional  studies are being conducted on mine health regulation, and occupational health and safety services in southern Africa. The first study comprises: i) a desktop evaluation of the status of OHS regulatory frameworks, and ii) dust exposure measurements in a sample of mines in order to understand worker exposure to crystalline silica and airborne dust levels in different commodities and workforce sizes. Preliminary results showed high silica dust exposure in some of the mines, which triggered interventions to be implemented by the respective ministries. The second study is the ‘Opportunities for private sector participation in TB control’. It is being undertaken to understand the level of engagement of the private sector in tuberculosis (TB) control, and to identify opportunities, risks, challenges, and key strategic priorities to expand private sector support for prevention and care. 

The results of both studies will support the development, in the four study countries, of targeted policies and regulations that protect mine workers from exposure to harmful dusts that can lead to occupational lung disease, including TB. Conclusions and recommendations from the studies will strengthen legislation in study countries and provide spill-over benefits across the Southern African Development Community (SADC) region.



The regional project component on OHS is on track: 80% of planned activities in the first half of the project were achieved, with a 70% absorption rate of project funds. Communities of Practice and Centres of Excellence have added value to knowledge sharing and learning. The regional multi-sectoral approach used in project implementation has facilitated learning and has spearheaded a comprehensive response to TB and occupational lung diseases. Training of experts from the government on OHS is improving the quality and quantity of human resources for OHS. There is a need to focus on country-specific and ­tailored OHS primary preventions to reduce exposure to airborne dust such as crystalline silica, and coal dust.


Resources for updates on project activities

• Website:

• Twitter:

• Facebook:

• YouTube:


Report by:
Norman Khoza: OHS Specialist: SAIOH Member
Chimwemwe Chamdimba: Policy Specialist
Buhle Hlatshwayo: Communication Specialist
 e-mail: buhleh@ 
African Union Development Agency (AUDA-NEPAD)

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