1. PROMOTING HEALTH IN THE WORKPLACE : Applying the WHO HPH tool in Public Hospitals in KwaZulu-Natal, South Africa PROMOTING HEALTH IN THE WORKPLACE : Applying the WHO HPH tool in Public Hospitals in KwaZulu-Natal, South Africa Ramdas P Geddes R Jinabhai C Cassimjee M Zungu S M KwaZulu-Natal HPH Committee-Department of Health; School of Public Health, University of KwaZulu-Natal.

2. Acknowledgement Dr S. Sirkar– Path Technical Co-ordinator Dr C. Bhagwandeen– Human Resource Support Unit Ms V. Moodley– Health Promotion Unit Mrs A. Khathi– Quality Assurance & Accreditation Unit Ms J. Maher – Quality Assurance & Accreditation Unit Mr C. Shawe – Quality Assurance & Accreditation Unit Dr V. Maistry – Edendale Hospital Ms H. Findlay – Greys Hospital Ms. V. Bawany– Lower Umfolozi War Memorial Hospital Ms R. Jele – Ngwelezana Hospital Ms U. Sooruth – Northdale Hospital Ms N. Mbambo – Inkosi Albert Luthuli Central Hospital

3. Background The Department of Health, KwaZulu-Natal, piloted the WHO Self-Assessment Tool (SAT), in six public hospitals, as part of an international collaboration with WHO, Barcelona Office.

4. 70% of global total SOUTH AFRICAN DEVELOPMENT COMMUNITY (SADC) KWAZULU -NATAL SOUTH AFRICA SUB – SAHARAN AFRICA SAHARA

6. Socio – Demographic Profile Of KwaZulu- Natal Socio – Demographic Profile Of KwaZulu- Natal KZN RSA TOTAL POPULATION 9.4m(20%) 44.8 POPULATION GROWTH RATE 2.8% 2.4% ADULT LITERACY RATES 84% 82% UMEMPLOYMENT RATE 39% 33% PER CAPITA INCOMER1910 R2566 ACCESS TO SAFE DRINKING WATER 50%

7. Epidemiological Profile Triple burden of disease HIV sero-prevalence –32% KZNRSA NEONATAL MORTALITY23.219.8 INFANT MORTALITY52.145.4 <5 MORTALITY74.559.4 MATERNAL MORTALITY170150

8. Background Dept of Health KZN Hospitals83 Clinics434 Community Health Centres 14 Health Budget 2005/2006 R 10.3 billion (US$ 1.7 billion)

9. Background Dept of Health KZN Total staff number65 000 CategoryPercentage Managers, Administrators & Logistical Support Staff 49% Nurses38% Allied Health Professionals & Technical Staff 8% Doctors and Pharmacists5%

10. Aims This study assessed staff health, staff development and their involvement in hospital management.

11. Methods Cross sectional descriptive study Six selected hospitals – all 3 levels of care Sample of all health workers – sample size of 2105 Data source : Self administered questionnaires Hospital staff records Hospital financial records Authorisation to undertake the study

12. Results & Discussion Total staff 6905 2105 administered 1610 staff questionnaires analysed response rate 76%. First study conducted in DOH No provincial standards or norms

13. A : Staff Health CRITERIAPERCENTCOMMENTS smokers9%Legislation, sin taxes, awareness campaigns Knowledge of own HIV sero status 66%Epicentre of epidemic VCT, ARV’s, PEP policies & programes Workplace based response Absenteeism: nursing staff 2.1%Malingering Burn-out Needle stick injuries4.2%Policies, procedures- Universal precautions High risk for sero- conversion

14. B: Staff Development CRITERIAPERCENTCOMMENTS Job descriptions on commencement 61%Impact on stds setting,personal development, performance Aware of performance appraisal system 51%Impact on performance and moral Participation in CPD programme 78%Enforced through professional bodies

15. C: Hospital Management CRITERIAPERCENTCOMMENTS Involvement in hospital policy-making 38%Democratization of the workplace Awareness of risk management procedures 79%20% pose a hazard Estimated budget for staff Health Promotion R111,70 per employee per year No dedicated budget for HP or EAP

16. Conclusion & Recommendation HPH tool contextualised for South Africa Policy implications Improvements at hospital level Deepened staff involvement in Health Promotion Created awareness of own health status Management areas for concerned Improved relationships between management and staff Expansion of projects to all hospitals