The World Health Organization (WHO) is calling on governments and health care leaders to address persistent threats to the health and safety of health workers and patients.

“The COVID-19 pandemic has reminded all of us of the vital role health workers play to relieve suffering and save lives,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “No country, hospital or clinic can keep its patients
safe unless it keeps its health workers safe. WHO’s Health Worker Safety Charter is a step towards ensuring that health workers have the safe working conditions, the training, the pay and the respect they deserve.”

The pandemic has also highlighted the extent to which protecting health workers is key to ensuring a functioning health system and a functioning society.

The Charter, released today for World Patient Safety Day, calls on governments
and those running health services at local levels to take five actions to better protect health workers. These include steps to protect health workers from violence; to improve their mental health; to protect them from physical and biological hazards;
to advance national programmes for health worker safety, and to connect health worker safety policies to existing patient safety policies.

Mounting reports of infections, illness and attacks among health workers fighting COVID-19

COVID-19 has exposed health workers and their families to unprecedented levels of risk. Although not representative, data from many countries across WHO regions indicate that COVID-19 infections among health workers are far greater than those in the general
population.

While health workers represent less than 3% of the population in the large majority of countries and less than 2% in almost all low- and middle-income countries, around 14% of COVID-19 cases reported to WHO are among health workers. In some countries,
the proportion can be as high as 35%.  However, data availability and quality are limited, and it is not possible to establish whether health workers were infected in the work place or in community settings. Thousands of health workers infected
with COVID-19 have lost their lives worldwide.

In addition to physical risks, the pandemic has placed extraordinary levels of psychological stress on health workers exposed to high-demand settings for long hours, living in constant fear of disease exposure while separated from family and facing social
stigmatization. Before COVID-19 hit, medical professionals were already at higher risk of suicide in all parts of the world. A recent review of health care professionals found one in four reported depression and anxiety, and one in three suffered insomnia during
COVID-19[1].
 WHO recently highlighted an alarming rise in reports of verbal harassment, discrimination and physical violence among health workers in the wake of COVID-19.

5 steps to improve health worker safety and patient safety

On World Patient Safety Day, WHO reminds governments that they have a legal and moral responsibility to ensure the health, safety and wellbeing of health workers. The Organization’s health worker charter  calls on all Member States and relevant
stakeholders to take steps to:

Establish synergies between health worker safety and patient safety policies and strategies:

  • Develop linkages between occupational health and safety, patient safety, quality improvement, and infection prevention and control programmes.
  • Include health and safety skills in personal and patient safety into education and training programmes for health workers at all levels.
  • Incorporate requirements for health worker and patient safety in health care licensing and accreditation standards.
  • Integrate staff safety and patient safety incident reporting and learning systems.
  • Develop integrated metrics of patient safety, health worker safety and quality of care indicators, and integrate with health information system.  

Develop and implement national programmes for occupational health and safety of health workers:

  • Develop and implement national programmes for occupational health for health workers in line with national occupational health and safety policies.
  • Review and upgrade, where necessary, national regulations and laws for occupational health and safety to ensure that all health workers have regulatory protection of their health and safety at work.
  • Appoint responsible officers with authority for occupational health and safety for health workers at both the national and facility levels.
  • Develop standards, guidelines, and codes of practice on occupational health and safety.
  • Strengthen intersectoral collaboration on health worker and patient safety, with appropriate worker and management representation, including gender, diversity and all occupational groups.

Protect health workers from violence in the workplace

  • Adopt and implement in accordance with national law, relevant policies and mechanisms to prevent and eliminate violence in the health sector.
  • Promote a culture of zero tolerance to violence against health workers
  • Review labour laws and other legislation, and where appropriate the introduction of specific legislation, to prevent violence against health workers.
  • Ensure that policies and regulations are implemented effectively to prevent violence and protect health workers.
  • Establish relevant implementation mechanisms, such ombudspersons and helplines to enable free and confidential reporting and support for any health worker facing violence.

Improve mental health and psychological well-being

  • Establish policies to ensure appropriate and fair duration of deployments, working hours, rest break and minimizing the administrative burden on health workers.
  • Define and maintain appropriate safe staffing levels within health care facilities.
  • Provide insurance coverage for work-related risk, especially those working in high-risk areas.
  • Establish a ‘blame-free’ and just working culture through open communication and including legal and administrative protection from punitive action on reporting adverse safety events.
  • Provide access to mental well-being and social support services for health workers, including advice on work-life balance and risk assessment and mitigation.

Protect health workers from physical and biological hazards

  • Ensure the implementation of minimum patient safety, infection prevention and control, and occupational safety standards in all health care facilities across the health system.
  • Ensure availability of personal protective equipment (PPE) at all times, as relevant to the roles and tasks performed, in adequate quantity and appropriate fit and of acceptable quality. Ensure an adequate, locally held, buffer stock of
    PPE. Ensure adequate training on the appropriate use of PPE and safety precautions.
  • Ensure adequate environmental services such as water, sanitation and hygiene, disinfection and adequate ventilation at all health care facilities.
  • Ensure vaccination of all health workers at risk against all vaccine-preventable infections, including Hepatitis B and seasonal influenza, in accordance with the national immunization policy, and in the context of emergency response, priority
    access for health workers to newly licenced and available vaccines.
  • Provide adequate resources to prevent health workers from injuries, and harmful exposure to chemicals and radiations; provide functioning and ergonomically designed equipment and work stations to minimize musculoskeletal injuries and falls.

In addition to the Health Worker Safety Charter, WHO has also outlined specific World Patient Safety Day 2020 Goals for health care leaders to invest in, measure, and improve health worker safety over the next year. The goals are intended
for health care facilities to address five areas:  preventing sharps injuries; reducing work-related stress and burnout; improving the use of personal protective equipment; promoting zero tolerance to violence against health workers,
and reporting and analyzing serious safety related incidents.  

For more information on World Patient Safety Day Campaign

 

[1] Pappa, S., Ntella, V., Giannakas, T., Giannakoulis, V. G., Papoutsi, E., & Katsaounou, P. (2020). Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. Brain, behavior, and immunity, S0889-1591(20)30845-X. Advance online publication. https://doi.org/10.1016/j.bbi.2020.05.026

 

 

 

 

 

 

 

 

 

 

Twenty-five speakers, including Ministers and senior officials from Member States, WHO Director-General Dr Tedros Adhanom Ghebreyesus and Principals of the signatory agencies, participated in an online launch event to release the first progress report of Stronger
Collaboration, Better Health: The Global Action Plan for Healthy Lives and Well-being for All (GAP), following the launch of the GAP at the United Nations General Assembly in September 2019.

This marks a strong engagement towards the implementation of GAP and an important step towards accelerating country progress on the health-related Sustainable Development Goals (SDGs).

Following the opening remarks by the WHO Director-General, key statements were made by the principals of signatory agencies at the event including:

  • Henrietta H. Fore, Executive Director of UNICEF
  • Peter Sands, Executive Director of The Global Fund
  • Winnie Byanyima, Executive Director of UNAIDS
  • Dr Seth Berkley, CEO of Gavi, the Vaccine Alliance
  • Dr Natalia Kanem, Executive Director of United Nations Population Fund (UNFPA)
  • Dr Muhammad Pate, Director of the Global Financing Facility for Women, Children and Adolescents and Senior Director of Health and Nutrition at the World Bank
  • Phumzile Mlambo-Ngcuka, Executive Director of UN Women
  • Dr Philippe Duneton, Executive Director a.i. of Unitaid
  • Amir Abdulla, Deputy Executive Director of World Food Programme

In the face of the many challenges that countries face from the COVID-19 pandemic, our shared vision of coherent and coordinated support from the multilateral system is more important than ever. Strong, sustained leadership and the support of Member
States and partners are critical to achieving this ambitious goal.

– Dr Tedros Adhanom Ghebreyesus,
WHO Director-General

The SDG3 GAP progress report presents early evidence of progress achieved and challenges faced during “learning-by-doing-approach” and covers the first 8 months of implementation since its launch and outlines progress made by partner agencies
in moving from the key commitments made in the GAP – Engage, Accelerate, Align, Account – to action.

Building on existing collaborations, the agencies are committed to leveraging the Global Action Plan to fill in gaps and add value to existing global, regional and national coordination mechanisms in the response to help countries protect health gains
achieved so far, recover from COVID-19 pandemic with more resilient health systems and continue efforts towards achieving of the SDGs.

The report also captures and highlights case studies from five countries and some of the challenges encountered to date, such as the need to further institutionalize the GAP approach to collaboration among the agencies.

Interventions from Member States

Minister of Public Health of Afghanistan, Hon. Dr Ahmad Jawad Osmani 

Afghanistan in the last 2 decades has witnessed significant gains in health outcomes by improving access to health services. Equity and social justice were the guiding principles. In today’s Afghanistan, we are facing an increasing burden of communicable
and non-communicable diseases. A majority of women are dying from both maternal and non-maternal related causes. Although more children now are celebrating their 5th birthday, many are critically malnourished. And this year, Afghanistan has the
highest number of polio cases. My team and I are working to increase the resilience of our health system and incorporate lessons learned from the pandemic response to meet the needs of the people. Primary health care is the backbone of an essential,
responsive and resilient health system and my team is working to improving the implementation of primary healthcare services.

Federal Minister of Health of Germany, Hon. Mr Jens Spahn

Germany very much appreciates the leading role of the WHO within the Global Action Plan and throughout its first implementation phase. This plan is a remarkable example of multilateral cooperation. However, the current pandemic is threatening hard-won
improvements towards reaching SDG 3 and could set us back by years. Thus, the Global Action Plan is more important than ever in order to bundle our efforts and face this challenge together. Lessons learned from the first phase of the Global Action
Plan can be used to adjust and further support its objectives. The progress report reflects the strong collaboration and coordination of the 12 signatory agencies to support short, medium- and long-term actions in response to COVID-19. Germany is
convinced that the Global Action Plan will play an important role in achieving progress towards the health-related SDGs. It also signals strong support of the WHO and other Global Action Plan partners in this joint commitment.

Minister of Health of Ghana, Hon. Mr Kwaku Agyemang-Manu

Ghana is strongly committed to universal health coverage as evidence in the ambitious UHC roadmap that we have prepared to guide our journey towards our UHC goals. Expanding our positive approach to primary health care and strengthening our national health
insurance scheme are key pullers of these efforts. Funding is key to our success, hence the need to mobilize new resources for health. The GAP play a key role as we look to operationalize, fund our UHC roadmap and update our health finances strategy.
The GAP brings in the coherence, coordination and collaboration that we need and expect from the multilateral system. As we tackle the immediate crisis of COVID-19, the Global Action Plan is critical to ensuring that we do not lose track of our journey
towards health-related Sustainable Development Goals.

Minister of Health of Norway, Hon. Mr Bent Høie

With today’s launch of the progress report, we are reminded that the deadline for the SDGs is only ten years away. The Global Action Plan is more important than ever.  The message today is clear: we must step up action on the targets where
we are furthest behind. We must remain focused on this important instrument for working together to ensure healthy lives and well-being for all. Building strong primary health care systems that include everyone, is absolutely crucial. Not only for
the individual person or a country’s preparedness, but also for the world’s security. Because no-one is safe until everyone is safe. Norway remains a consistent partner for our common future. We are determined to continue working with others to ensure
health for all by 2030. The Global Action Plan is the much-needed tool that will help us get there. We will leave no one behind.

Minister of Health and Social Protection of Somalia, Hon. Ms Fawziya Abikar Nur

I am representing Somalia today, a country which has suffered and is continuing to suffer from protracted crises and complex humanitarian emergencies. The profound effects of these crises have weakened and fragmented our health systems, creating a huge
loss of human capital and these have been reflected in our health indicators such as high maternal and child deaths, low immunization coverage and depleted access to healthcare. As we recover from COVID-19 and rebuilt our system, I urge our development
partners especially the GAP signatories to understand more than ever our local context, health priorities, and the value of having a strong collaborative and cohesive partnership that’s led by the government. And the shared responsibility and
commitment to monitor and evaluate the result of financing in the health sector. More than ever, we need to act together and push for universal health coverage using evidence and data on what works in fragile and vulnerable settings and what are the
low cost but high impact interventions. We need to rebuild our systems and ensure services are accessible, affordable and equitable to all.