Ndione Ida, Aerts Ann, Barshilia Asha, Boch Johannes, Rosiers Sarah Des, Ferrer Jose M E, Saric Jasmina, Seck Karim, Sene Bernard N, Steinmann Peter, Venkitachalam Lakshmi, Shellaby Jason T
PATH, Dakar-Fann, Dakar, Senegal.
Novartis Foundation, Basel, Switzerland.
BMC Public Health. 2021 Jun 10;21(1):1108. doi: 10.1186/s12889-021-11109-9.
Of the 15 million annual premature deaths from non-communicable diseases (NCDs), 85% occur in low- and middle-income countries (LMICs). Affecting individuals in the prime of their lives, NCDs impose severe economic damage to economies and businesses, owing to the high mortality and morbidity within the workforce. The Novartis Foundation urban health initiative, Better Hearts Better Cities, was designed to improve cardiovascular health in Dakar, Senegal through a combination of interventions including a workplace health program. In this study, we describe the labor policy environment in Senegal and the outcomes of a Novartis Foundation-supported multisector workplace health coalition bringing together volunteering private companies.
A mixed method design was applied between April 2018 and February 2020 to evaluate the workplace health program as a case study. Qualitative methods included a desk review of documents relevant to the Senegalese employment context and work environment and in-depth interviews with eight key informants including human resource representatives and physicians working in the participating companies. Quantitative methods involved an analysis of workplace health program indicators, including data on diagnosis, treatment and control of hypertension in employees, provided by the coalition companies, and a cost estimate of NCD-related ill-health as compared to the investment needed for hypertension screening and awareness raising events.
Senegal has a legal and regulatory system that ensures employee protection, supports social security benefits, and promotes health and hygiene in companies. The Dakar Workplace Health Coalition comprised 18 companies, with a range of staff between 300 and 4'220, covering 36'268 employees in total. Interviews suggested that the main enablers for workplace program success were strong leadership support within the company and a central coordination mechanism for the program. The main barrier to monitor progress and outcomes was the reluctance of companies to share data. Four companies provided aggregated anonymized cohort data, documenting a total of 21'392 hypertension screenings and an increasing trend in blood pressure control (from 34% in Q4 2018 to 39% in Q2 2019) in employees who received antihypertensive treatment.
Evidence on workplace health and wellness programs in Africa is scarce. This study highlights how private sector companies can play a significant role in improving cardiovascular population health in LMICs.
在每年因非传染性疾病（NCDs）导致的1500万过早死亡中，85%发生在低收入和中等收入国家（LMICs）。非传染性疾病影响处于黄金工作年龄的人群，由于劳动力中的高死亡率和高发病率，给经济和企业带来了严重的经济损失。诺华基金会城市健康倡议“更健康的心，更美好的城市”旨在通过包括工作场所健康计划在内的一系列干预措施，改善塞内加尔达喀尔的心血管健康。在本研究中，我们描述了塞内加尔的劳动政策环境以及诺华基金会支持的多部门工作场所健康联盟（该联盟汇聚了志愿参与的私营公司）的成果。
2018年4月至2020年2月期间采用混合方法设计，将工作场所健康计划作为案例研究进行评估。定性方法包括对与塞内加尔就业背景和工作环境相关的文件进行案头审查，以及对八名关键信息提供者进行深入访谈，这些信息提供者包括参与公司的人力资源代表和医生。定量方法涉及对工作场所健康计划指标的分析，包括联盟公司提供的员工高血压诊断、治疗和控制数据，以及与高血压筛查和提高认识活动所需投资相比，非传染性疾病相关健康不佳的成本估计。
塞内加尔拥有一个法律和监管体系，可确保员工得到保护、支持社会保障福利，并促进公司的健康和卫生。达喀尔工作场所健康联盟由18家公司组成，员工人数在300至4220人之间，总共覆盖36268名员工。访谈表明，工作场所计划成功的主要推动因素是公司内部强有力的领导支持以及该计划的中央协调机制。监测进展和成果的主要障碍是公司不愿分享数据。四家公司提供了汇总的匿名队列数据，记录了总共21392次高血压筛查，以及接受抗高血压治疗的员工中血压控制呈上升趋势（从2018年第四季度的34%升至2019年第二季度的39%）。
关于非洲工作场所健康与福祉计划的证据很少。本研究强调了私营部门公司在改善低收入和中等收入国家心血管人群健康方面如何能够发挥重要作用。
