Practical guide · 20 countries · updated 1 October 2026
Occupational health in French-speaking Africa
Who must arrange a medical visit, how often, with which physician, and how to protect employees’ health data. A clear summary, country by country, for executives, HR and HSE managers.
A documentary summary, not legal advice. Each country sheet gives a reliability level and its sources. Check with the labour inspectorate before any decision.
Key points
The six notions to know
Pre-employment visit
Before starting the job or in the following days. The physician checks that the employee can hold the intended position.
Periodic visit
Usually every 12 months. More often for under-18s, pregnant women and exposed jobs.
Return-to-work visit
After a workplace accident, an occupational disease, maternity leave or a long absence (15 to 30 days depending on the country).
Fitness certificate
Fit, fit with restrictions or unfit. Never a diagnosis. One copy for the employee, one for the employer.
Medical record
Opened at hiring and confidential. The employer has no access; only the occupational physician and authorised physicians do.
Accredited physician
In almost every country, the occupational physician is accredited by the Ministry of Labour. The Congo publishes an official list.
Comparison
Comparison table of the 20 countries
| Country | Periodic visit | Return after absence | Organisation | Health data |
|---|---|---|---|---|
| Congo | Yearly in practice (to be confirmed in the texts) | Compulsory (circular 478/2024), time limit to be confirmed | Company or inter-company health centre, depending on the company’s class | Law 29-2019 |
| Gabon | To be confirmed | To be confirmed | To be confirmed | Law 001/2011 amended in 2023 |
| Cameroon | Yearly; every six months for under-18s | After an illness of more than 3 weeks | In-house service, inter-company service or agreement with a physician or hospital, with prior approval | Law 2024/017 |
| Chad | Regular, frequency to be confirmed | To be confirmed | To be confirmed | Law 007/PR/2015 |
| Central African Republic | To be confirmed | To be confirmed | To be confirmed | Law 24 |
| Equatorial Guinea | At most every 3 months for dangerous, unhealthy or food-handling work | Not specified | Medical or paramedical service suited to the risk | Ley 1/2016 |
| DR Congo | Yearly, with screening for contagious diseases | Compulsory, time limit to be confirmed | Company medical service | Digital Code (2023) |
| Burundi | To be confirmed | To be confirmed | To be confirmed | Law 1/03 of 10/03/2026 |
| Senegal | Yearly: clinical examination, chest X-ray, urine test | After more than 21 days of absence, an accident, occupational disease or maternity, within 8 days | Company service from 400 employees, inter-company below | Law 2008-12 |
| Côte d’Ivoire | Yearly | After more than 30 days of absence, an accident, occupational disease or maternity | In-house service, inter-company service or approved external provider | Law 2013-450 |
| Burkina Faso | Yearly; every 3 to 6 months for high-risk jobs | Compulsory | Membership of the OHS service or an approved body | Law 001-2021 |
| Benin | To be confirmed | To be confirmed | To be confirmed | Digital Code (2017) |
| Togo | To be confirmed | To be confirmed | To be confirmed | Law 2019-014 |
| Mali | To be confirmed | To be confirmed | Compulsory medical service; inter-company centres and INPS | Law 2013-015 |
| Niger | To be confirmed | To be confirmed | Compulsory service; official medical centre possible under 1,000 employees | Law 2022-59 |
| Guinea | Periodic surveillance provided for | To be confirmed | To be confirmed | Law L/2016/037 |
| Mauritania | To be confirmed | To be confirmed | To be confirmed | Law 2017-020 |
| Madagascar | Yearly; twice a year for 15-18-year-olds | After more than 15 days of absence | Inter-company service; in-house service only for isolated sites | Law 2014-038 |
| Djibouti | Yearly | To be confirmed | Company service or shared service | 2025 Digital Code |
| Comoros | Provided for, frequency to be confirmed | To be confirmed | Compulsory service; official centres possible under 300 employees | Law 14-029 |
Country sheets
The details, country by country
Click on a country to open its sheet.
Congo · CEMAC High reliability
The country has only 14 occupational health specialists (ILO, 2025). A new labour code is under discussion.
| Labour code | Law 45-75 of 15/03/1975, amended (laws 22-88 and 6-96) |
|---|---|
| Implementing texts | Orders 9033, 9034 and 9035 of 10/12/1986 (company and inter-company centres, classification); order 21400 of 16/08/2021 (list of referenced occupational physicians); circulars 477 and 478 of 22/11/2024 (visit register, pre-employment and return-to-work visits) |
| Organisation | Company or inter-company health centre, depending on the company’s class |
| Periodic visit | Yearly in practice (to be confirmed in the texts) |
| Return-to-work visit | Compulsory (circular 478/2024), time limit to be confirmed |
| Authorised physician | Accreditation by the Minister of Labour; official list of referenced physicians |
| Key points | Visit register compulsory. Health and safety committee from 20 employees. Workplace accidents reported to the CNSS within 48 hours. |
| Health data | Law 29-2019. Commission (CNPD) created in 2025, not yet operational. Transfers abroad: countries with adequate protection and prior information. |
To check: Full text of the 1986 orders and the 2024 circulars.
Source: National OSH profile, ILO 2025
Gabon · CEMAC To be confirmed
New labour code of 2021. Gabon has ratified ILO Convention 161 on occupational health services.
| Labour code | Law 022/2021 of 19/11/2021 |
|---|---|
| Implementing texts | Implementing decrees to be identified |
| Organisation | To be confirmed |
| Periodic visit | To be confirmed |
| Return-to-work visit | To be confirmed |
| Authorised physician | To be confirmed |
| Key points | Medical certificate required at hiring (art. 20). CNSS for occupational risks, CNAMGS for health insurance. |
| Health data | Law 001/2011 amended in 2023. APDPVP authority operational. Transfers subject to authorisation. |
To check: Health and safety title of the 2021 code and its decrees.
Source: Official Journal of Gabon
Cameroon · CEMAC Medium reliability
About 35 specialists for 5.1 million workers.
| Labour code | Law 92/007 of 14/08/1992, arts. 95 to 103 |
|---|---|
| Implementing texts | Decree 79/096; order 015/MTPS/IMT of 15/10/1979 (occupational medical services); order 039/MTPS/IMT of 1984 (health and safety) |
| Organisation | In-house service, inter-company service or agreement with a physician or hospital, with prior approval |
| Periodic visit | Yearly; every six months for under-18s |
| Return-to-work visit | After an illness of more than 3 weeks |
| Authorised physician | Occupational medicine specialist or accredited physician |
| Key points | Visits during working hours, paid by the employer. CNPS for occupational risks. |
| Health data | Law 2024/017. Prior authorisation to process and to transfer health data. Authority not yet in place. |
Source: Camerlex
Chad · CEMAC Medium reliability
The code provides for visits “at hiring and regularly”.
| Labour code | Law 038/PR/96 of 11/12/1996, arts. 239 to 244 |
|---|---|
| Implementing texts | Decrees to be identified |
| Organisation | To be confirmed |
| Periodic visit | Regular, frequency to be confirmed |
| Return-to-work visit | To be confirmed |
| Authorised physician | To be confirmed |
| Key points | CNPS Chad for occupational risks. |
| Health data | Law 007/PR/2015. ANSICE operational. Transfers outside CEMAC/ECCAS: adequate protection and notification. |
To check: Full reading of the code and decrees.
Source: Thomas D. Avocats
Central African Republic · CEMAC To be confirmed
2009 labour code; medical provisions to be consulted.
| Labour code | Law 09.004 of 29/01/2009 |
|---|---|
| Implementing texts | To be identified |
| Organisation | To be confirmed |
| Periodic visit | To be confirmed |
| Return-to-work visit | To be confirmed |
| Authorised physician | To be confirmed |
| Key points | ILO Convention 155 ratified in 2006. |
| Health data | Law 24.001 (2024). Authority not yet created. |
To check: Text of the code.
Source: CNSS RCA
Equatorial Guinea · CEMAC Medium reliability
Spanish-speaking country: certificates and registers in Spanish.
| Labour code | Ley 4/2021 of 03/12/2021 |
|---|---|
| Implementing texts | Arts. 49, 54 to 63 |
| Organisation | Medical or paramedical service suited to the risk |
| Periodic visit | At most every 3 months for dangerous, unhealthy or food-handling work |
| Return-to-work visit | Not specified |
| Authorised physician | Not specified |
| Key points | Random alcohol and drug testing permitted. |
| Health data | Ley 1/2016. Supervisory body not operational. Transfers subject to authorisation. |
Source: NATLEX
DR Congo · Central Africa and Great Lakes Medium reliability
The employer also owes medical care to the employee and their family.
| Labour code | Law 015/2002 amended by law 16/010 of 15/07/2016 |
|---|---|
| Implementing texts | Order 01/76 of 21/01/1976 (medical service); order 28/75 of 30/10/1975 (pre-employment and return-to-work examinations) |
| Organisation | Company medical service |
| Periodic visit | Yearly, with screening for contagious diseases |
| Return-to-work visit | Compulsory, time limit to be confirmed |
| Authorised physician | To be confirmed |
| Key points | CNSS for occupational risks. |
| Health data | Digital Code (2023). Prior authorisation for medical data and transfers. Authority not yet constituted. |
Source: Leganet
Burundi · Central Africa and Great Lakes To be confirmed
2020 labour code; provisions to be consulted.
| Labour code | Law 1/11 of 24/11/2020 |
|---|---|
| Implementing texts | To be identified |
| Organisation | To be confirmed |
| Periodic visit | To be confirmed |
| Return-to-work visit | To be confirmed |
| Authorised physician | To be confirmed |
| Health data | Law 1/03 of 10/03/2026. Agency not yet created. |
To check: Text of the code.
Source: NATLEX
Senegal · West Africa High reliability
The most detailed framework in the region. Dakar hosts the World Congress on Safety and Health at Work in April 2027.
| Labour code | Law 97-17 of 01/12/1997 |
|---|---|
| Implementing texts | Decree 2006-1258 (organisation of services); decree 2006-1253 (medical labour inspection) |
| Organisation | Company service from 400 employees, inter-company below |
| Periodic visit | Yearly: clinical examination, chest X-ray, urine test |
| Return-to-work visit | After more than 21 days of absence, an accident, occupational disease or maternity, within 8 days |
| Authorised physician | Holder of the occupational medicine specialist diploma (CES) |
| Key points | Enhanced surveillance: high-risk jobs, pregnant women, under-18s. Fitness certificate in 2 copies. |
| Health data | Law 2008-12. CDP operational. Transfers: adequate protection and prior information. |
Source: Decree 2006-1258
Côte d’Ivoire · West Africa Medium reliability
Eleven implementing decrees adopted in April 2026, including one on occupational health services.
| Labour code | Law 2015-532 of 20/07/2015, arts. 43.1 to 43.4 |
|---|---|
| Implementing texts | Decree 67-321 (amended); decree 2008-1715 (accreditation); April 2026 decrees |
| Organisation | In-house service, inter-company service or approved external provider |
| Periodic visit | Yearly |
| Return-to-work visit | After more than 30 days of absence, an accident, occupational disease or maternity |
| Authorised physician | Physicians and nurses accredited by the ministry |
| Key points | CNPS for workplace accidents. Annual report to the authorities. |
| Health data | Law 2013-450. Authority operational. Transfers outside ECOWAS: prior authorisation. |
To check: Content of the April 2026 decrees.
Source: National OSH profile, ILO
Burkina Faso · West Africa Medium reliability
New labour code adopted in May 2026.
| Labour code | Law 013-2026/ALP of 06/05/2026 (replaces law 028-2008) |
|---|---|
| Implementing texts | Decree 429/1987 (Workers’ Health Office); decree 2012-099 (medical inspection) |
| Organisation | Membership of the OHS service or an approved body |
| Periodic visit | Yearly; every 3 to 6 months for high-risk jobs |
| Return-to-work visit | Compulsory |
| Authorised physician | To be confirmed |
| Key points | End-of-contract visit. OSH committee from 25 employees. |
| Health data | Law 001-2021. CIL operational. Transfers on authorisation, encryption required. |
To check: Provisions of the 2026 code.
Source: Agence Ecofin
Benin · West Africa To be confirmed
The code refers to the “accredited physician”; the OSH decrees remain to be consulted.
| Labour code | Law 98-004 of 27/01/1998 |
|---|---|
| Implementing texts | To be identified |
| Organisation | To be confirmed |
| Periodic visit | To be confirmed |
| Return-to-work visit | To be confirmed |
| Authorised physician | Accredited physician |
| Key points | Fitness visit for fixed-term contracts of more than one month. |
| Health data | Digital Code (2017). APDP active. Transfers on prior authorisation. |
To check: OSH decrees.
Source: NATLEX
Togo · West Africa Medium reliability
Strict accreditation: the occupational physician must specialise in occupational health.
| Labour code | Law 2021-012 of 18/06/2021 |
|---|---|
| Implementing texts | Order 006/2011 (accreditation of OSH staff); order 3131/2024 (high-risk sectors) |
| Organisation | To be confirmed |
| Periodic visit | To be confirmed |
| Return-to-work visit | To be confirmed |
| Authorised physician | Doctor of medicine specialised in OSH; contract sent to the inspectorate within one month |
| Key points | Construction, mining, energy, healthcare and chemicals classified as high risk. |
| Health data | Law 2019-014. IPDCP operational since March 2025. |
To check: Visit frequency.
Source: Order 006/2011
Mali · West Africa Medium reliability
The INPS employs most occupational physicians.
| Labour code | Law 92-020 of 23/09/1992, arts. L171 to L177 |
|---|---|
| Implementing texts | Social Security Code (law 99-041) |
| Organisation | Compulsory medical service; inter-company centres and INPS |
| Periodic visit | To be confirmed |
| Return-to-work visit | To be confirmed |
| Authorised physician | To be confirmed |
| Health data | Law 2013-015. APDP active (sanctions already imposed on a clinic). |
To check: Implementing texts.
Source: Maliweb
Niger · West Africa Medium reliability
Medical equipment required according to headcount.
| Labour code | Law 2012-45 of 25/09/2012, arts. 145 to 154 |
|---|---|
| Implementing texts | Decree 2017-682 of 10/08/2017 |
| Organisation | Compulsory service; official medical centre possible under 1,000 employees |
| Periodic visit | To be confirmed |
| Return-to-work visit | To be confirmed |
| Authorised physician | Accreditation by the Minister of Labour |
| Key points | Infirmary above 100 employees. OSH committee from 50. |
| Health data | Law 2022-59. HAPDP operational. Transfers on authorisation. |
Source: Code (CNSS Niger)
Guinea · West Africa Medium reliability
A National Occupational Health Service exists, but many implementing texts are missing.
| Labour code | Law L/2014/072/CNT of 10/01/2014 |
|---|---|
| Implementing texts | Decree D/2022/0260 (SNST) |
| Organisation | To be confirmed |
| Periodic visit | Periodic surveillance provided for |
| Return-to-work visit | To be confirmed |
| Authorised physician | To be confirmed |
| Key points | The CNSS leads prevention. |
| Health data | Law L/2016/037. Authority never created. |
Source: National OSH profile, ILO
Mauritania · West Africa To be confirmed
Company medical services provided for in articles 254 to 263 of the code.
| Labour code | Law 2004-017 (updated 2009) |
|---|---|
| Implementing texts | Title VI of the code |
| Organisation | To be confirmed |
| Periodic visit | To be confirmed |
| Return-to-work visit | To be confirmed |
| Authorised physician | Accredited physician |
| Key points | Visit before approval of fixed-term contracts of more than 3 months. |
| Health data | Law 2017-020. APD operational. |
To check: Content of articles 254 to 263.
Source: Droit-Afrique
Madagascar · Indian Ocean and Horn of Africa High reliability
Inter-company services (SMIE) as a general rule.
| Labour code | Law 2024-014 of 14/08/2024 |
|---|---|
| Implementing texts | Decree 2003-1162 (company medicine) |
| Organisation | Inter-company service; in-house service only for isolated sites |
| Periodic visit | Yearly; twice a year for 15-18-year-olds |
| Return-to-work visit | After more than 15 days of absence |
| Authorised physician | Accreditation by the Minister of Labour |
| Key points | Annual report compulsory. Record accessible to the CNaPS medical adviser. |
| Health data | Law 2014-038. Commission not yet operational. |
To check: Compatibility of the 2003 decree with the 2024 code.
Source: Decree 2003-1162
Djibouti · Indian Ocean and Horn of Africa Medium reliability
Examination within 8 days of hiring.
| Labour code | Law 133/AN/05 of 28/01/2006, arts. 122 to 135 |
|---|---|
| Implementing texts | Order 63/69/SPCG (shared services) |
| Organisation | Company service or shared service |
| Periodic visit | Yearly |
| Return-to-work visit | To be confirmed |
| Authorised physician | To be confirmed |
| Key points | Workplace accident reported within 48 hours. |
| Health data | 2025 Digital Code. Commission not yet operational. |
Source: Droit-Afrique
Comoros · Indian Ocean and Horn of Africa Medium reliability
Medical equipment required according to headcount.
| Labour code | Law 12-012/AU of 28/06/2012 (arts. 158 to 164) |
|---|---|
| Organisation | Compulsory service; official centres possible under 300 employees |
| Periodic visit | Provided for, frequency to be confirmed |
| Return-to-work visit | To be confirmed |
| Authorised physician | Accredited physicians and nurses |
| Key points | Infirmary above 100 employees. |
| Health data | Law 14-029. Authority never constituted. |
Source: Africa-laws
Frequently asked questions
FAQ
My company has 30 employees. Do I need my own physician?
Generally not. SMEs join an inter-company service or sign an agreement with an accredited physician or clinic. An in-house service is only required above a threshold, for example 400 employees in Senegal.
Can I see my employees’ medical results?
No. The employer receives the fitness conclusion and any job restrictions. Blood pressure, glucose, serology and diagnoses remain covered by medical confidentiality.
What happens in the event of a workplace accident?
It must be reported to the social security fund within a short time, often 48 hours (CNSS in the Congo). The employee then has a return-to-work visit.
Can medical records be hosted in the cloud, outside the country?
Yes, but it is regulated. Several countries (Cameroon, DRC, Benin, Burkina Faso, Gabon, Mali, Niger) require prior authorisation from the data protection authority for any transfer abroad.
Does OHADA harmonise occupational health?
No. The draft Uniform Act on labour law was never adopted. Each country applies its own labour code.
Apply these rules without thinking about them
The Santé DIAC application automatically sets visits according to country and job.
Sources: ILO national OSH profiles, NATLEX, official journals, research.lawlab.africa (September 2026).