Employment and sociodemographic characteristics: a study of increasing precarity in the health districts of Belo Horizonte, Brazil

<p>Abstract</p> <p>Background</p> <p>The fundamental importance of human resources for the development of health care systems is recognized the world over. Health districts, which constitute the middle level of the municipal health care system in the city of Belo Horizonte, Brazil, deal with demands from all parts of the system. This research seeks to provide the essential features required in order to understand the phenomenon of increase in precarity of employment in these health districts.</p> <p>Methods</p> <p>The legal and human resource management documents used by the Municipal Health Secretariat of the City of Belo Horizonte were adopted as the corpus for this research. In order to analyse the changes in employment (2002–2006), the data were collected from ArteRH, a computerized database dealing specifically with data related to human resources, which began operating in 2001. The workers were classified into permanent and non-permanent groups, and their contractual rights were described. Employment dynamics and changes were examined, concentrating on the incorporation of workers and on their social and employment rights during the period under study. The comparative data for the two groups obtained were presented in frequency distribution tables according to type of employment, sex, age group, level of education and wages from 2002 to 2006.</p> <p>Results</p> <p>There was a clear difference between the permanent worker and non-permanent worker groups as regards existing guaranteed employment rights and social security. The increase in the number of non-permanent workers in the workforce, the growing proportion of older workers among the permanently employed and the real wage reductions during the period from 2002 to 2006 are indicative of the process of growing precarity of employment in the group studied.</p> <p>Conclusion</p> <p>It is a plausible supposition that the demand for health reforms, along with the legal limits imposed on financial expenditure, gave rise to the new types of contract and the present employment situation in the health districts in Belo Horizonte.</p

Occupational Health Care in Small and Medium-Sized Enterprises - Introduction of Services to Craftsmen by Using Their Professional Networks

In order to ensure equality of occupational health care among employees of small and medium-sized enterprises (SMEs) and of larger companies, amendments in the regulations of the numerous German accident insurance funds had to be made to provide for full availability of services, as requested by German and European law. According to these amendments, sectors formerly exempted due to small size and due to lack of an adequate number of qualified personnel, had to be covered by occupational health care. In order to reach this target group new strategies of care delivery had to be developed, making use of pre-existing infrastructure and networks. In Germany, district trade association (Kreishandwerkerschaften) have proved to be very effective for introducing occupational safety and health care into SMEs by either hiring external multidisciplinary services or by establishing a common service to be used by all associated crafts establishments. In a study conducted by the Federal Office for Health and Safety at Work in 1996 (Boldt, Gille, &Grahl, 1997), 7 district trade association were looked at in detail for their strategies. The results were discussed and supplemented in a 2-day workshop

Occupational Health Care in Small and Medium-Sized Enterprises—Introduction of Services to Craftsmen by Using Their Professional Networks

In order to ensure equality of occupational health care among employees of small and medium-sized enterprises (SMEs) and of larger companies, amendments in the regulations of the numerous German accident insurance funds had to be made to provide for full availability of services, as requested by German and European law. According to these amendments, sectors formerly exempted due to small size and due to lack of an adequate number of qualified personnel, had to be covered by occupational health care. In order to reach this target group new strategies of care delivery had to be developed, making use of pre-existing infrastructure and networks. In Germany, district trade association (Kreishandwerkerschaften) have proved to be very effective for introducing occupational safety and health care into SMEs by either hiring external multidisciplinary services or by establishing a common service to be used by all associated crafts establishments. In a study conducted by the Federal Office for Health and Safety at Work in 1996 (Boldt, Gille, &Grahl, 1997), 7 district trade association were looked at in detail for their strategies. The results were discussed and supplemented in a 2-day workshop

Occupational Health Care in Small and Medium-Sized Enterprises - How Many Doctors Do We Need and How Do We Ensure Good Care?

The translation of the framework directive 89/391/EEC (Council Directive 89/391/EEC) into national law aims at supplying occupational protection and health care to all employees of large, small, and medium-sized enterprises (SMEs) likewise, depending on assessed exposure. Prior incomplete protection of the German workforce with bias against the SMEs requires an assessment of quantitative and qualitative adequacy of present occupational health care practice and also of future needs. Therefore, the Federal Institute for Occupational Safety and Health of Germany initiated a study to evaluate the present state of occupational health care in 4 regions with different geographic and economic structure. Based on these data the future demand for adequately trained occupational physicians will be estimated by employing a statistical method that allows for including a large number of modifying variables (economic development, demographic change, etc.). Expected result of the applied technique are the estimated minimal and maximal number of occupational physicians that have to be trained to meet future demand. In the same study models of best practice will be identified and evaluated for general application. The project started in October 1997 and will be finished by January 2000