Revival , sustaining and strengthening of

implementing Workplace Wellness and

HIV/AIDS programs in Health Sector

facilities in Lesotho through an innovative

interactive 3 D virtual media clusters

By ; Sejojo Phaaroe

Principal Medical Technologist/Scientist

Health Research and Laboratory Services- MOH

LESOTHO

BACKGROUND

• The MOHSW had anecdotal information about the

impact of HIV and AIDS on the Health Workforce:

– High rates of absenteeism

– Low morale

– Stigma and Discrimination

– High levels of attrition

BACKGROUND

• SAHCD undertook an HR assessment of MOHSW

• Need for HIV/AIDS workplace policy was identified

• Dialogue between SAHCD and Directorate HR, and HIV and AIDS was made

• Held consultations with ILO, NAC and Public Service

• In consultation with MOHSW, a formative study was undertaken in 4 districts; Berea, Leribe, Maseru, Quiting in Sept 2007

• Selection of 4 districts was based HIV prevalence and rural & urban balance

BACKGROUND

• Formative assessment

• Facilities

• Quthing (Quthing Hospital & Villa Maria Health Centre)

• Maseru (Scott Hospital & St. Barnabas Health Centre)

• Berea (Maloti Adventist Hospital & Mapheleng Health

Centre)

• Leribe ( Motebang Hospital & Maputsoe Filter Clinic)

– Methodology

• Desk reviews, FGDs (284), Key Informant Interviews

(KII)(150) & stakeholder consultations

• Data analysis – SPSS, Thematic analysis (manual)

• Documentation

• Findings have been disseminated in several forums

BACKGROUND

• Findings – Overall shortage of HIV and AIDS programming, services

and activities targeting Health Care Workers

– High HIV infection vulnerability at work place

– Negative and unsupportive attitudes from workers (Stigma/discrimination)

– Lack of care & support services

– Inadequate info/knowledge on HIV and AIDS latest trends and developments in terms of service & equipment

HIV and AIDS Work Place Policy

• A draft Work place policy has been developed under the leadership of MOHSW with participation of CHAL, Mental Hosp, Wellness Centre, ILO, NAC and other partners.

• A draft strategic plan and operational plan have also been developed and disseminated for comments.

POLICY PROVISIONS

National Health Policy provides for

• commitment to regional and international conventions of HIV and AIDS

• formation of sector work place policy and programmes

• protection of PLWHAs as employees in the workplace

Policy statements

The MOHSW and CHAL acknowledge the seriousness of the impact of HIV and AIDS and is committed through workplace policy to reducing the magnitude of the pandemic establishing programmes that will ensure the provision of quality services targeted at Health Sector employees and their immediate family

POLICY PROVISIONS

• Scope of the policy

– The policy applies to all employees of the Health Sector and their immediate(direct dependents) families

– Immediate family: or direct dependants of a health worker.

• Policy Goal

– To manage HIV and AIDS and other related illnesses among all employees of the Health Sector in order to have a healthy and productive workforce.

POLICY OBJECTIVES (1)

• Strengthen preventive interventions against the

transmission of HIV and AIDS and opportunistic

infections

• Enhance provision and maintenance of an

effective delivery system of treatment, care and

support

• Improve and provide interventions targeted at

mitigating long and short term effects of the

epidemic

• Reduce stigma, discrimination and victimization

of infected and affected employees

POLICY OBJECTIVES (2)

• Increase knowledge of Health Sector employees on employee rights based on Human Rights Approach

• Improve the total well being of a health worker in line with the definition of health according to the World Health Organization.

• Strengthen M & E Framework to ensure the effective and sustained implementation of HIV and AIDS programmes

10 Key principles

No discrimination

Confidentiality

Prevention

Gender equality

No screening

Healthy work environment Continuation of

employment

A workplace issue

Social dialogue

Care and support

POLICY PRINCIPLES (2)

• The policy shall be informed and updated by

regular infection, prevention, control,

assessments and other emerging issues

• Management commitment and role is paramount

to providing an enabling environment for

implementation of HIV and AIDS workplace

policy and programmes

LEGAL FRAMEWORK

The policy is in compliance with all relevant legislation, civil

service regulations and international codes of practice Health, Safety and Welfare at Work

• The Policy will be implemented in line with the Labour

Code Order 1992, part VII.

Workman’s Compensation

• The Policy will make reference of what is provided in the

Workman’s Compensation act of 1977 and Section 101-

116 of Labour Code Order, 1992.

SPECIFIC POLICIES STATEMENTS (1) Prevention

• Awareness and Education

– Treatment of STIs and TB and other OIs

– Appropriate awareness and education

programmes

– Promotion of a healthy lifestyle

– Training in BCC targeted to Peer Educators,

Support Groups and Committees

• Condoms

– Regular supply of condoms in all health

facilities and workplaces

SPECIFIC POLICIES STATEMENTS (2) Universal Precautions and Workplace Safety

– Appropriate Infection Prevention and Control measures

– Develop and avail protocols and guidelines for handling

hazardous materials to HCW

– Provide education on occupation hazards in Universal

precautions

– Provision of adequate essential medical supplies and

personal protective clothing

– Supervision of appropriate medical waste disposal at

workplace.

– Increase access to Post Exposure Prophylaxis to HCW

SPECIFIC POLICIES STATEMENTS (3)

Preventive Medical Services – Avail to Health Facilities, the following:

– Vaccines

– TB Screening

– PMTCT

– HTC

– STI, Universal Precaution and prevention of infection

SPECIFIC POLICIES STATEMENTS (4)

Social Vulnerability – Consideration of family stability in relation to deployment

and transfer of employees where necessary.

• Treatment, Care and Support

– Provision of ART

– Education and advice on healthy lifestyles including

nutritional education and stress management

– Home Based Care

– Appropriate psychosocial support

SPECIFIC POLICIES STATEMENTS (5)

Stigma and Discrimination

• Practicing non discrimination, victimization and harassment

• Create a conducive environment for HTC and disclosure of

status

• Reasonable accommodation of special needs for staff living

with HIV and AIDS

Impact Mitigation

• Empowerment of orphans on their inheritance

• Provision for contacts for referral services

ROLES AND RESPONSIBILITIES

Employee rights and obligations • HIV Testing and Counseling

– Pre-employment test is not a precondition for employment

– Access to counseling and referral services

– Provision of supportive work environment

– Education and awareness programmes

– MOHSW and CHAL will adhere to the Public Service HIV and AIDS Policy and guidelines

– HIV and AIDS shall not be used a criterion for denying promotion, training or development of an employee

– HIV and AIDS shall not be used a criterion for retirement during downsizing and restructuring programme

ROLES AND RESPONSIBILITIES

Employee rights and obligations Work performance and Reasonable Accommodation

• Refusal to work with an employee that is HIV/AIDS positive shall be regarded as disciplinary offence

• Suitable alternatives shall be sought for employees living with HIV and AIDS that cannot cope with their current jobs

• Confidentiality

– Confidentiality of an employee shall be maintained at all times, breach of which will call for disciplinary measures

• Gender and Sexuality

– Reduction in Gender Based Violence

– Provision of PEP to the sexually assaulted

ROLES AND RESPONSIBILITIES

Employees rights and Obligations

• Incentives

– Inclusion of participation in HIV and AIDS work place

policy in staff performance appraisal.

• Grievance and Disciplinary Procedures

– Handled according to the relevant civil service

disciplinary procedures

ROLES AND RESPONSIBILITIES OF

MANAGEMENT • Principal Secretary

– Chief Accounting Officer

– Make finances and resources available for programme implementation

– Commission baseline study to assess the impact of HIV and AIDS in the Ministry.

• Human Resource Department

– Facilitate the dissemination of the policy to all employees

– Facilitate the implementation of all programmes relating to the policy

– Develop structures necessary for implementation of the policy

ROLES AND RESPONSIBILITIES OF

MANAGEMENT

• Managers and Heads of departments

– Ensure employees in their departments are aware and

understand the policy

– Policy implementation and compliance

– Open and maintain communication channels

– Provide support to peer education programme

– Protect confidentiality regarding employees’ health

condition.

– Protect employees against infection

– Refer employees to counseling services where necessary

ROLES AND RESPONSIBILITIES OF

EMPLOYEES

– Acknowledge that fellow employees’ health condition is

private and confidential and he/she is under no obligation

to disclose

– Shall not discriminate against employees living with HIV

and AIDS

– Play a supportive role to fellow employees with HIV and

AIDS

– Take precaution not to accidentally or intentionally infect a

fellow employee

ROLES AND RESPONSIBILITIES

Associations affiliated to MOHSW

– Show commitment to implementing the Policy and

Programme

– Encourage members to be involved in the programmes

from inception.

IMPLEMENTATION Coordination

– Responsibility of the steering Committee under the

leadership of a champion/coordinator who reports to the

Director Human Resources

– Facility based Steering Committees will be formed for

implementation at facility level.

– National Steering Committee should strengthen partnerships

with CHAL, Staff Association, local government structures,

donor agencies, business institutions

Resource Mobilization

• The MOHSW will

– Avail 2% of the annual recurrent budget for HIV and AIDS

funding as per government directive

– Prepare and submit proposals to bilateral agencies

.

IMPLEMENTATION

• Monitoring and Evaluation

– Undertake anonymous baseline survey to assess the prevalence of HIV and AIDS among Health Workers

– Development an M & E framework

• Policy Review

– Reviews will be informed by regular infection, prevention, control, assessments

– Findings of surveys and overall changing environment

.

Thank You