The Role of Government in Occupational Health Effort Program

in Medan

Isyatun Mardhiyah Syahri

, Badaruddin

, Surya Utama

and Zulfendri

Faculty of Public Health, Universitas Sumatera Utara, Jl. Universitas No. 21 Kampus USU, Medan, Indonesia

Faculty of Social and Political Science,Universitas Sumatera Utara, Jl. Dr. A. Sofian No. 1 Kampus USU,

Medan, Indonesia

Keywords: The Role of Government, Occupational Safety and Health.

Abstract: Occupational health effort in Medan need to be increased, because accidents and occupational diseases still

occur.This condition shows workers are still very vulnerable, especially the informal sector that does not yet

have access to occupational health services, so that the implementation is integrated in the health center. A

study is required to analyze the role of government in occupational health effort. This study was qualitative

research by conducting in-depth interviews with managers of the occupational safety and health (OSH) at

health center, staf of labor department, OSH center, and the employment BPJS.Data were analyzed using

thematic analysis. The results showed that the government had a role in supervision, cooperation, providing

budget and training, but the role played was not optimal. Not all OSH managers in health center have been

trained and there is still little OSH training for workers. It is recommended that cooperation, budget and

OSH training be improved so that the implementation of the occupational health effort program is better.

1 INTRODUCTION

Occupational health effortsare urgently needed to

improve workers' health, prevent the emergence of

health problems, protect workers from possible

dangers in the workplace (Kementerian Kesehatan

RI, 2010). Based on the report of the Directorate of

Occupational Health and Sports, in 2016, there were

144,062 occupational accidents and 61,234

occupational diseases in Indonesia, while in North

Sumatra there were 6,473 occupational diseases and

1,479 occupational accidents (Kementerian

Kesehatan RI, 2016). In addition, Syahri & Fitria's

research (2018) shows that as many as 65.5% of

informal workers who are members of five

occupational health posts in Medan have

experienced work accidents. It needs stakeholder

support to overcome this, especially the government.

Regional Regulation of Medan City no. 4 of

2012 concerning the Medan City Health System,

section 10 regarding occupational health efforts

article 18 paragraph 5 which states that the Office

together with the Regional Work Unit in charge of

manpower and other relevant agencies carry out

coaching towards the implementation of fostering

occupational health efforts both in the formal sector

and informal.

The government, in this case, the Medan city

health office and other agencies involved in

occupational health are the Department of Labor, the

employment BPJS and Occupational Safety and

Health Center also play a role in the health effort in

Medan City. Rantanen (2005) also emphasized that

the government involved in occupational health

services is an institution in charge of safety and

health for workers and health institutions as well as

related institutions that are competent in the

occupational safety and health field. Thus, the

synergy of the role carried out by the government

can improve the work health program.

Research on the role of government in health

services already exists, but few focus on occupational

health effort. Research by Tang, Eisenberg, and

Meyer (2004); Straube (2013) focus on the role of

government in improving the quality of health and

safety services, namely by improving service quality,

strengthening regulation, increasing knowledge and

developing health technologies and practices,

collaborating with all parties , making regulations so

that health services can be affordable improving the

quality of health services and increasing prevention

Syahri, I., Badaruddin, ., Utama, S. and Zulfendri, .

The Role of Government in Occupational Health Effort Program in Medan.

DOI: 10.5220/0010013501710175

In Proceedings of the 3rd International Conference on Social and Political Development (ICOSOP 3 2019) - Social Engineering Governance for the People, Technology and Infrastructure in

Revolution Industry 4.0, pages 171-175

ISBN: 978-989-758-472-5

171

and health promotion efforts. Research by Wade and

Francisco (1982) and Frieden (2013) examines the

role of government in occupational health with the

results that need to increase resources, distribution of

technical information, consultation and improvement

of regulations, but have not been linked to basic

health services.

The limited study of the role of the government

in occupational health efforts, as well as the high

number of occupational accidents and suspected

occupational diseases that occur, it is necessary to

conduct a study of the government's role in

occupational health effort in Medan.

2 METHOD

This research is a qualitative research, in-depth

interviews are used for data collection. Source

triangulation is used to maintain the quality of

research results. Informants in this study were

Occupational Safety and Health (OSH) managers in

health centers, staf of labor department, OSH center,

and the employmentBPJS. Thematic analysis is used

to analyze the data that has been collected. The

focus of this research is the role of government in

occupational health effort in Medan.

3 RESULTS AND DISCUSSION

According to the informant, the role carried out by

the government in the occupational health effort

program according to the informant includes

supervision, facilitators in occupational safety and

health training, budgeting, collaboration and roles in

producing OSH policies.

3.1 Supervision

Supervision is an effort to pay attention, observe and

control the ongoing activities. Supervision is carried

out on officers who are carrying out work health

efforts programs, supervision is also carried out on

the industry, where workers carry out their activities

to avoid accidents and occupational diseases.

According to the informant, the government,

through the health office, has supervised the

implementation of the occupational health efforts

program in relation to activities carried out at the

target workplaces, this was stated by the

informantbelow:

"Health services have been involved in monitoring

and supervising OSH activities." (01)

Supervision is carried out to the manager of the

occupational health efforts in health center, namely

during the implementation of a routine OSH officer

meeting which is held once a month at

the health department, as the following informant

stated:

"Health services have been reminded during

routine meetings to provide guidance in the

workplace." (02)

In addition to the supervision that has been

carried out by the health department, it is also

expected that the labor department can jointly

conduct supervision, this was conveyed by

informant, including:

"In addition to the health office, it is very

necessary for the role of the labor office to provide

recommendations for the conditions for issuing

work permits and workplace requirements.” (02)

The employment BPJShas a role to protect

workers, so it should supervise every industry

whether all workers are protected with employment

guarantees, as revealed by informant :

" Role of the employment BPJS, to protect

workers, because many workers have had work

accidents, but there is no guarantee so it is

necessary to socialize the employment guarantee

program."(03)

Supervision is carried out by the government in

accordance with their respective duties, as conveyed

by informant :

"The government carries out its respective duties,

like supervision at work. The employment

BPJSperforms the function of protecting workers.

For the health department to carry out

occupational health effort as stated in the Health

Act."(04)

This condition shows that the supervision has

been carried out by the government but is still

running independently, it is expected that in the

future, to increase the role in terms of supervision

should be carried out collaboratively, integrated,

carried out dynamically and continuously. Good

supervision is dynamically, by adopting a positive

attitude, namely providing guidance and direction

Omisore (2014) According to Mor, Travis, Pyun,

and Xie (2014) the results of supervision as input or

advice should be utilized for the progress of

workers. The research of Henry, Nantongo, Wagner,

Embrey, and Trap (2017) shows that the power of

supervision lies in the feedback producing OSH

policies.

3.2 Training

The government is expected to provide OSH

training, both for OSH managers, industry and

ICOSOP 3 2019 - International Conference on Social Political Development (ICOSOP) 3

172

workers, to increase knowledge in the OSH field.

During this time, the government through the Medan

City Health Office has provided OSH training,

especially for OSH managers in the health center,

but the training provided has been unstructured,

because it was given during the monthly staff

meeting, as the following informants said:

"The government in this case the health office has

provided training related OSH." (05)

Not only the health department, OSH centers

have also held training for small and medium

enterprises in the working area of the health center,

but not all industries in the health center work area

have been trained.

"For training alone, we often collaborate with

health center, and have already been there for

friends at the health center, there have also been

for friends at small and medium enterprises." (06)

In addition the employmentBPJS has also

conducted OSH training, but it is still temporary, as

revealed by the following informant:

"Preventive promotive efforts have been given,

then training in OSH basic training, but it is

temporary." (07)

OSH training should be carried out in a

collaborative manner. Research by Mahan et al.

(2013) shows that OHS training is carried out in a

collaborative way to improve a healthy and safe

work environment. Siriruttanapruk, Wada and

Kawakami's study (2009) explains that OSH training

for officers at basic service centers is carried out by

the Bureau of Occupational Health and Environment

in collaboration with the Department of Public

Health in Thailand.

3.3 Financing

The Occupational Health Effort Program requires a

financial to run well, this budget can be used for

promotive, preventive, curative and rehabilitative

efforts, but not yet available to the fullest. According

to informant that OSH training and testing of the

work environment can be budgeted so that it can be

utilized by small and medium industries.

"...can be used for training and testing every year

should be budgeted for activities for industries that

are considered lacking ability or small and

medium enterprises designated by the health

center, ...." (06)

The financefor occupational health effort

activities is still very minimal, this was disclosed by

informants so it needs to be included in the health

operational assistancebudget for each health center,

following the statement:

"Hm... for the implementation, it seems that the

finance is however small, so the health department

informs them to budget for activities in health

operational assistance from their respective health

center." (05)

During this time, the existing finance is only in

the form of transportation to the field, for the OSH

socialization to industry has not yet exist, the

following quote:

"The funds available from health operational

assistance are only in the form of transport to the

field..." (01)

Based on the conditions, the finance available for

implementing occupational health effort in Medan is

still very small, that is only for the transportation of

managers to the industry being fostered. According

to Rantanen (2005) In Finland, the cost for

occupational health services provided by the city

health center is USD 25 for prevention activities and

USD 49.2 for curative activities per protected

worker per year, In developing countries it may be

around 20 USD per year, and for prevention

activities only around USD 5 per year. This should

be considered by the Medan City Health Office to

provide a budget for activities, because the

government is the most responsible authority.

According to Pellicer, Carvajal, Rubio, and

Catalá (2014) the average value of prevention costs

reaches 1.54% of the total project budget, overall

costs for occupational safety and health are around

5% of the total development project budget that

needs to be provided for company. This can be

stated in the form of an OSH policy from the local

government to cover the costs of each workplace.

3.4 Policy

Occupational safety and health policies are very

important as a basis for the implementation of the

occupational health efforts in Medan City.The role

played by the government in relation to policies is

still not maximal, there are no local regulations

governing OSH specifically, besides the government

through the health department needs to make

operational standards for safety and health

implementation procedures in health center. The

following are the opinions of the informants

regarding this matter:

"The Health Office needs to make a procedure for

preparing program targets for health center." (03)

"To be effective there should be integrated

regulations." (06)

According to Mandal (2009) the government

thinks deeply and reviews existing legislative steps,

to improve the occupational health situation in its

area. In the Rantanen, Lehtinen, and Iavicoli study

(2013) in countries that are members of the

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173

international commission for occupational health,

most of the respondents have OSH policies adopted

in many cases, the majority of respondent countries

stipulate, through law, employers' obligations to

regulate OSH to their workers in some countries, the

public sector is responsible for providing OSH. In

line with this, Dwomoh, Owusu, and Addo, (2013)

explained that with the policy issued by the

government, all those involved in occupational

health can interpret and carry out their duties.

3.5 Cooperation

The activities will work better if it is carried out in

collaboration, as stated by informants, the following

excerpt:

" We are in the service of health, social security of

workers engaged in promotion and prevention,

labor in licensing, so collaboration.” (08).

"For self-training, we often collaborate with health

center and have already been there for friends at

the health center, there have also been friends for

small and medium enterprises." (06).

Cooperation between the health department and

the OSH center already exists, namely by providing

training for workers, but has not run routinely.

Likewise, cooperation with the employment

BPJSalready exists, but it has been maximally

unimplemented.

Based on the conditions above, cooperation

needs to be improved by involving all parties. It is

expected that government institutions should further

improve communication, because according to

Halonen, Atkins, Hakulinen, Pesonen, and Uitti

(2017) dialogue and contacts are often seen as

necessary to increase trust, so as to form

cooperation.

4 CONCLUSIONS

The roles that have been carried out by the

government include as supervisors, providers of

OSH training, budgeting, cooperation and OSH

policy makers. The role of the government in the

occupational health effort program is still running on

its own and has been unmaximized. Communication

and dialogue between the health department, the

department of labor, the employmentBPJS and the

OSH center need to be improved, so that cooperation

and collaboration occur. Revitalization of the role of

the government is very much expected so that the

occupational health effort program in Medan is

better.

ACKNOWLEDGEMENTS

The author thanks to all informants who participated

in this study.

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