The construction industry is one of the largest sectors in Malaysia. This industry has become one of the main contributors
for national economic development and consistently contributes 3% to 5% to the national Gross Domestic Product (GDP). This
sector has also opened up job opportunities for various levels of employment. High demands and rapid urbanization offer huge
opportunities for registered contractors. Despite contributing in enhancing national economics, this sector has been regarded as one
of the most dangerous and hazardous workplaces due to the type of nature and the job activities at construction sites. According to
the International Labour Organization (ILO), 2.3 million fatalities related to occupational accidents and illnesses are estimated to
occur each year. Furthermore, 4 percent of world GDP is estimated to be lost due to occupational accidents and illnesses. The number
of fatality accidents in the construction industry was the highest with 652 cases of non-permanent disability (NPD) and permanent
disability (PD) accidents in the period 2007 to 2015, equivalent to 72.44 cases per year and representing 48.77% of the construction
industry. The huge gap between the number of accidents reported to SOCSO and DOSH becomes a major concern due to a rising
number of underreported cases of fatalities and injury in the construction sector, especially those involving foreign labour. The margin
between accidents reported to SOCSO and DOSH is 97.49%. Regards to rapid developments, safety measures to improve performance
management of OSH should be emphasized to reduce losses of life, property and productivity.
The objectives of occupational health services (OHS) are to create a healthy and safe working environment, prevent work-related diseases, optimise employees' functional capacity and promote health. According to the literature, global accessibility to OHS has not shown much improvement and even worsened in certain countries. The main challenges come from the small and medium enterprises (SMEs). To respond to these global challenges, the basic occupational health services (BOHS) guideline was published under the purview of the World Health Organization and the International Labour Organization. The guideline describes BOHS as part of the infrastructure called the occupational safety and health system, an essential element that ensures the high service coverage and sustainability of the programme. The BOHS guideline was introduced in Malaysia by the Department of Occupational Safety and Health with a focus on SMEs, but its accessibility is low. A gap analysis was conducted between the current BOHS in Malaysia and the published international guideline. The important challenges identified that contributes to the low BOHS accessibility in Malaysia is the weakness in the BOHS infrastructure and OHS system provision. The proposed BOHS infrastructure model is meant to increase accessibility and to provide fair and equitable health services for Malaysians.