Introduction to OH&S profiles and indicators Kari Kurppa, M.D. Finnish Institute of Occupational Health Workshop to Establish The Estonian Network on OH&S in Agriculture 9 – 10 June 2003 Tartu, Estonia

STANDARD EMPLOYMENT NON-STANDARD EMPLOYMENT - Big enterprises - Other RURAL AGRICULTURE & INFORMAL SECTOR Farmers micro-enterprises cottage industries entrepreneurs own-account …. Inspections Law Labor unions Research Social security OH&S services (some coverage) Precarious work WORLD LABOR FORCE

FOCUS ON THE LOCAL LEVEL Thus far, information has been given mainly a "central" connotation. Even the collection of information at the peripheral level is done with the needs of the central level in mind. One has to get away from such thinking. (Health For All by the year 2000)

COMMUNITY MEDICINE The study of health and disease in the population of a specified community. The goal is to identify health problems and needs, to identify means by which these needs may be met, and to evaluate the extent to which health services meet these needs.

COMMUNITY DIAGNOSIS The process of appraising the health status of a community, including determinants of health, such as socioeconomic conditions, prevalence of tobacco smoking. Community diagnosis may attempt to be comprehensive or may be restricted to specific health conditions, determinants, or subgroups.

INDICATOR Indicators are pointers that simplify phenomena and help to understand and monitor complex realities. to simplify to understand to monitor

HEALTH INDICATOR A variable, susceptible to direct measurement, that reflects the state of health of persons in a community. Examples include injury rates, incidence rates based on notified cases of disease, disability days, prevalence of exposure, etc.

INDICATOR A thing that serves to give an indication or suggestion of something else. A variable linked to the variable, which itself cannot be directly observed. A "tool" for measurement, not necessarily equal to the phenomenon under scrutiny. Not a true measure of the phenomenon for which it was chosen.

PROFILE A sketchy description of situation, a concise analysis. An profile includes indicators, if available. An overview about the landscape for indicators. Provides background for the state of affairs, including causes for ill-health.

OH&S PROFILE An OH&S profile is a structured description of a situation on OH&S in specific context. structured overview sector of economy, county, community light description (not scientific)

PURPOSE OF A PROFILE To understand OH&S in local context, and from the perspective of stakeholders To provide a written summary that documents a state of affairs

Model development: Sectoral Profile on OH&S in Agriculture County OH&S Profile Rural Community OH&S Profile PROFILES

SUBNATIONAL PROFILES - province, district, subdistrict, village - benchmarking within a country - tools for local empowerment - relatively new ideas in most countries

COMMUNITY OH&S PROFILE ÜLENURME COMMUNE (COUNTY OF TARTU, ESTONIA) Name and affilities of the community: Ylenurme (Ülenurme); Tartu county; Estonia Contact Information: Ülenurme Vallavalitsus Tõrvandi, Tartu Maakond fax Municipal council chairman Aavo Lang Municipal director Aivar Aleksejev, tel , Municipal secretary Reet Sakk, tel , Geography: Ülenurme is a community situating in Southeastern Estonia, just south of Tartu (a university town with inhabitants). The distance from the community center to Tartu is 6 km. The total area is 8634,9 ha. 73,8% of the territory is in agricultural use ha cultivable land and 1128 ha forests. Average temperature in summer (May-Aug) is +15º C and in winter (Dec-March) -2ºC. Villages/other divisions: There are two centers with more than one thousand inhabitants ( Ülenurme (1034) and Tõrvandi (1578), 12 villages (Soinaste (275), Räni (473), Külitse (329), Lepiku (88), Laane (61), Reola (149), Uhti (293), Läti (12), Täsvere (15), Õssu (28), Soosilla (37) and Lemmatsi (106)). Community centers (both administrative and commercial) are Ülenurme and Tõrvandi. Administration: There is a community development plan for years , prepared together with Tartu University (to be found at commune's internet site Commune office employs 14 persons. There is no-one responsible for work, health or occupational health and safety matters. Health matters belong in priciple to financial and social councillor. Commune does not arrange work for unemployed. (continued… 1/7)

SECTORAL PROFILES Sector of economy (agriculture,...) Practical instruments for labour inspectors, employers, managers, trade unions, … Benchmarking

Sri Choom village Baanklang Lamphun Thailand = Village health volunteer

A VILLAGE OH&S PROFILE MAY CONSIST OF  Geography and culture  Administration and resources  Village economy  Village labor force demography  Income generating sources  Basic minimum need indicators  Health problems and management  Social and societal problems  OH&S problems (materialized, potential)  Awareness, perceptions and attitudes

VILLAGE OH&S PROFILE Village memory/ overview Local context Qualitative indicators Needs and existing resources Summary on OH&S issues Available at village health post Regularly updated

Things to find out - geographic boundaries - how long the community has existed - general history - key people and leaders - demographics - expenses and income - important issues - morale & involvement levels - resources

Why write a community description? To capture unspoken rules and norms To gain understanding To get a feel for attitudes and opinions To take stock of strengths and shortcomings

Why should you identify local needs and resources? To understand the environment To understand public opinion To make decisions about priorities Who benefits from identifying needs and resources? Those experiencing the problem Service providers Community leaders Others

How to write a community description Draft your initial description. Share draft with key community members; get their feedback on correct understanding. Consider results so far. Get feedback from varied sources before completing final description and analysis.

How can you use a community description? To share with others who do work in your community To present as background information to administrators and leaders To activate the community … To use as the basis for a grant proposal

Community OH&S Profile More than a set of indicators A concise account of OH&S in a community. Provides understanding that cannot be given by a list of indicators. Textual description puts facts into proper context. Its main purpose is describe OH&S in context. Gives structure to OH&S related matters in a community. Even a sketchy profile on OH&S issues in a community is helpful.

USES OF A COMMUNITY OH&S PROFILE  Understanding OH&S in a local context  Empowering local action  Summary of community OH&S  Prioritization  Follow-up tool  Comparison with similar communities  Collaboration between communities  Community memory on OH&S

 Action oriented  NOT research oriented ! An approach for developing a reasonable understanding of a situation as a basis for action. An approach which provides information but which in the very process of acquiring information can alter the situation. RAPID ASSESSMENT PROCEDURE

RAPID ASSESSMENT improvisation, iteration, cross- checking concerns and priorities seeking variability rather than averages

RAP TECHNIQUES  Formal interviews  Informal interviews  Conversations with well informed individuals or groups  Focus group discussions  Observations  Walk-throughs  Case-studies  ‘Community studies’  Minisurveys  Use of secondary data sources (reports documents statistics)  Other

WALK-THROUGH OBSERVATIONS In Sri Choom village unhealthy, unsafe, and unergonomic working conditions and practices are common: - Worksite housekeeping generally requires improvement - laying things on floor and walkways (accident risk) - unsafe use of pesticides - circular saws and other power equipment without safeguards - exposed and unclean live electrical lines and plugs - exposure to organic solvents in furniture manufacturing - exposure to allergenic and carcinogenic wood dust - frequent complaints about musculoskeletal pains - inadequate illumination in furniture manufacturing - unergonomic work postures - unsafe use of handtools - unsafe way to lift and carry heavy objects - eating in chemically contaminated areas - noise that can cause hearing loss - nonexistence, poor maintenance, or lack of use of personal protective equipment.

TOP-DOWN-BOTTOM-UP TOP-DOWN Cannot force a change  Bottom may not respond (if they don't agree) BOTTOM-UP Bottom needs guidance/encouragement  Bottom needs political support TOP-DOWN-BOTTOM-UP Top-down combined with Bottom-up

TOP-DOWN & BOTTOM-UP "The more the top-down and bottom-up forces are coordinated the more likely that complex systems will move toward greater effectiveness."

A recipe for generating an imperfect but sufficiently accurate solution Worked by first obtaining a rough-and-ready result which could be fed back into the algorithm to generate a more refined result. This refined result could then be fed back into the algorithm to generate an even more accurate result and so on. Euler was able to provide a position for the moon which was accurate enough for the purposes of the navy. EULER'S ALGORITHMIC METHOD