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The majority of workers worldwide remain without adequate access to Occupational Health Services (OHS), particularly with regard to gaps in implementation, coverage, content, and capacity building. Yet access to OHS is an essential element of the right to health and is recognised in numerous global human rights agreements as being a fundamental human right. Even in situations of resource scarcity, states have obligations to formulate, implement, monitor and evaluate occupational health laws and policies, and to facilitate the participation of workers in these activities. Rather than counting OHS as a cost to production, it is important to frame OHS as a value-driven enterprise which can benefit all stakeholders, both employers and employees and provide a fair and accepted framework for managing conflicting interests. More importantly, OHS as a rights-based activity will reach beyond the traditional formal sector and challenge governments to address the OH needs of informal sector workers and other working populations currently lying outside of traditional regulatory perspectives – a particularly important requirement for Low and Middle-Income countries. Not all countries will enjoy the same resources to implement OHS’s and rationing decisions may result in different levels of OHS provision. However, a Rights-based approach to OHS provision will identify basic OHS standards consistent with core obligations on states, will impose constitutional limits on the extent to which rationing decisions adversely impact on OHS provision, will force stakeholders to pursue equity-related policies and will open participatory spaces for citizens and communities to assert rights to workplace health and safety, across formal and informal sectors. This approach provides a huge opportunity for leverage for OHS in the developing world which OH practitioners should support through their research, service and advocacy.