Assessment of Tuberculosis Prevention and Care Measures in Mining Industries of Malawi, 2019

Abstract Setting Karonga, Rumphi, Kasungu and Lilongwe districts of Malawi in 2019. Objectives To determine the availability and utilization of TB preventive and care services in fifteen licensed mining industries in four selected districts in Malawi in 2019. Design We conducted a cross-sectional study using mixed-methods. Qualitative data were analysed using content analysis and thematic approach. We calculated the frequencies, proportions, median and interquartile range in STATA v16.0. Qualitative data was analysed using content analysis. We triangulated the qualitative and quantitative results. Results Of the 373 miners, 215 (58%) indicated that they were provided with annual TB screening while 43 (12%) had TB screened before being recruited in the mine, 171 (46%) were provided with masks, and 25 (7%) were aware of compensation after being sick while working in a mine. Of the 171 miners that indicated that masks were provided, 110 (64%) cited N95, 55 (32%) cited surgical mask, and 6 (4%) cited cotton wasters. The common OHS measures at the mines were banning of smoking within the mining site, sensitization of the miners on TB and adequate ventilation. The key challenges were the absence of the national Occupational Health and Safety Policy (OHSP), limited financial resources to consistently procure the PPE, and poor coordination between the mines, labour and health offices at district level. Conclusion The mining industries of Malawi have implemented an array of the expected measures however most of these are available at a sub-optimal level. The absence of the national OHSP has provided a loophole for non-adherence of the mining industries to providing OHS to the miners. Therefore, Malawi should put in place OHSP to safeguard the health and social protection as well as compensation of the miners and ex-miners.