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South Africa: Lessons Learned from Private Sector Initiatives Regional Videoconference: Addressing Stigma and Discrimination of HIV/AIDS in Africa Pretoria,

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Presentation on theme: "South Africa: Lessons Learned from Private Sector Initiatives Regional Videoconference: Addressing Stigma and Discrimination of HIV/AIDS in Africa Pretoria,"— Presentation transcript:

1 South Africa: Lessons Learned from Private Sector Initiatives Regional Videoconference: Addressing Stigma and Discrimination of HIV/AIDS in Africa Pretoria, South Africa April 2, 2009

2 Country Context and Status Source: www.unaids.org

3 Country Context and Status HIV prevalence amongst public antenatal clinic attendees (DOH) 2000200120022003200420052006 2007 Eastern Cape 20.221.723.627.128.029.528.6 26.0 Free State 27.930.128.830.129.530.331.1 33.5 Gauteng 29.429.831.629.633.132.430.8 30.3 KwaZulu Natal 36.233.536.537.540.739.139.1 37.4 Limpopo 13.214.515.617.519.321.520.6 18.5 Mpumalanga 29.729.228.632.630.834.832.1 32.0 Northern Cape 11.215.915.116.717.618.515.6 16.1 North West 22.925.226.229.926.731.829.0 29.0 Western Cape 8.78.612.413.115.415.715.1 12.6 RSA24.524.826.527.929.530.229.1 28.0 Current national prevalence: 18.8% Source: NATIONAL HIV AND SYPHILIS PREVALENCE SURVEY SOUTH AFRICA 2007 © National Department of Health 2008

4 Country Context and Status April 1994 1 st democratic elections held in South Africa. October 1998 Deputy President Thabo Mbeki makes the Declaration of Partnership Against AIDS, in which he calls for an end to discrimination against people living with HIV. Less than 2 months later Gugu Dlamini, an AIDS activist in Durban, is beaten to death by her neighbors after declaring that she is HIV- positive on World AIDS Day. From: http://www.avert.org/aidssouthafrica.htm

5 Country Context and Status 2002 A study reveals that only one third of respondents who had revealed their HIV-positive status were met with a positive response in their communities. One in ten say that they had been met with outright hostility and rejection. 2005 "Let us give publicity to HIV/AIDS and not hide it, because [that is] the only way to make it appear like a normal illness. Nelson Mandela after the death of his son due to AIDS.

6 Policy Framework for Responding to Stigma and Discrimination Legislation Labour Relations Act (No.66 of 1995) The Labour Relations Act protects employees against unfair dismissal. Employment Equity Act (No.55 of 1998) This Act ensures that all employees are treated equally and that there is no discrimination in the workplace. Basic Conditions of Employment Act (No.75 of 1997) This Act sets standards for employers on how many hours an employee may work in a week and how much leave they are allowed to have.

7 Policy Framework for Responding to Stigma and Discrimination Promotion of Equality and Prevention of Unfair Discrimination (No.4 of 2000) The Promotion of Equality and Prevention of Unfair Discrimination Act also sees to it that there is no unfair discrimination in the workplace. Occupational Health and Safety Act ( No. 85 of 1993) An employer is obliged to ensure that the risk of occupational exposure to HIV is minimized as far as is possible. Compensation for Occupational Injuries and Disease Act (No.130 of 1993)

8 Policy Framework for Responding to Stigma and Discrimination Department of Health: Comprehensive HIV and AIDS Care, Management and Treatment Plan for South Africa Training manual - Operational plan for comprehensive HIV and AIDS care, management and treatment for South Africa HIV and AIDS and STI Strategic Plan for South Africa, 2007-2011 Operational Plan for Comprehensive HIV and AIDS Care, Management and Treatment for South Africa National Antiretroviral Treatment Guidelines Monitoring and Evaluation Framework

9 Policy Framework for Responding to Stigma and Discrimination Department of Labour: Code of Good Practice on Aspects of HIV/AIDS Employment HIV/AIDS Technical Assistance Guidelines Private Sector: Global Business Coalition on HIV/AIDS, Tuberculosis and Malaria South African Business Coalition on HIV/AIDS Sector initiatives

10 Intro to CareWorks The CareWorks Group: HIV Management Workplace programs (private sector) Focus predominantly on mobile males (construction, transport, mining) Treatment programs PEPFAR partner Focus CareWorks Training Change management specialists Diversity CareWorks Africa 15 countries industrialization funds (EFP) as partners Objective: Deliver all CareWorks solutions into Africa

11 Enrol HIV + ARV adherence Keep the positives healthy and productive Keep the negatives negative

12 Objectives Of HIV Management in the Private Sector Reduce Stigma & Discrimination Prevent Transmission (Prevention strategy) Prolong Productivity (Treatment strategy)

13 What makes our approach work? Passion Plan Objectives driven and aligned Measured (good data) Involvement of HIV Positive People Multi-disciplinary approach Business experience … BUT… CARE WORKS!

14 Can it be achieved in the Private Sector? % HIV Prevalence 15.5%8.5% % Staff trained in HIV 100% % staff tested 91%88% % of HIV+ on Treatment Program 99%90% % of those on ARVs that are adherent 90%80% % disclosed to company 100%+80% Change in prevalence over 4 years.08%Data NA

15 Programs and Interventions to address Stigma and Discrimination Key approaches/strategies used to implement program/intervention? Broad strategy (long term) Create reasonable, deliverable expectations – align objectives Leadership active commitment (CEO, Unions, managers) Policy (formulation, promotion and implementation / adherence management) KAPB surveys (baseline and focus) Good knowledge and understanding for all (combat myths and ignorance) Process vs. events Ongoing focus… (WPEs / steer com / reporting / communications / support and involvement of HIV+ (PLWHAs) etc.)

16 Programs and Interventions to address Stigma and Discrimination Episodes (short term) Focus groups Organizational culture Counseling Diversity (racism / gender…) Disciplinary action

17 Programs and Interventions to address Stigma and Discrimination Who are the target groups? All employees Communities Who are the key partners? Senior management Unions Line management WPEs PLWHAs

18 Programs and Interventions to address Stigma and Discrimination Response from a client? We embarked on an intensive HIV/AIDS program nine years ago with the assistance of CareWorks. It definitely was not an easy task, but today we are very thankful that we went that route. Our employees share our dream: stopping new infections, encouraging all staff members to know their status and to encourage infected employees to receive the treatment offered. Marlene Cronje, Human Resources Director, Power Construction

19 Challenges and Gaps Challenges and gaps Syndromic – finding the problem through WPEs KAP Results! Understanding Change Management process

20 Lessons learnt in the private sector Remain focused on program objectives Managements active commitment is imperative Always include Trade Unions (where represented) HIV/AIDS should be a strategic priority Education and focus must be ongoing. This provides the platform to address stigma and discrimination within the content of the intervention Involve a PLWHA (not at the beginning of the program, rather towards the Testing phase) Aim for disclosure in a secure environment

21 Lessons learnt in the private sector Establish an effective Steering Committee to manage and oversee the program Ensure senior management and union representation Train the Steering Committee members in policy matters and how to deal with stigma and discrimination issues Address any form of stigma and discrimination immediately and seriously. If not, it could lead to failure of program and even labor unrest

22 The Way Forward Develop standard measurement criteria and tools Continue learning, recording and sharing Thank you! www.careworks.co.za info@careworks.co.za +27 21 673-5300


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