HIV & My Business

The Situation

Swaziland is currently at the epicenter of the global HIV/AIDS pandemic with 26% of adults being HIV positive (Swaziland Demographic Health Survey, NERCHA, 2006-2007). Contrary to previous association of HIV/AIDS with the unemployed, it is the higher income earning, who are more vulnerable to HIV, with this demonstrated when examining prevalence rate by employment status where reports show 36% of employed women and 27% of employed men are infected, while only 24% of unemployed women and 10% of men are infected (Modes Of Transmission Survey, NERCHA, 2009).

The TB incidence (1287 new cases per 100 000 people per year) and HIV-TB co-infection rates (80%) reported in the country are also among the highest in the world. (http://www.who.int/tb/publications/global_report/en/ : April 2012)

The affect of HIV/AIDS and TB on the country is great; social, human and economic development is negatively impacted, and with the disease debilitating citizens in their most productive age, both individual and business livelihoods are diminished.

Non Communicable Disease (NCD's) such as Heart Disease, Cancer and Diabetes are also on the increase in Swaziland, with the working population being highly vulnerable. According to a 2008 STEPS Survey conducted through support of the World Health Organisation, Swazi citizens in the 25-35 years age group had a 32% risk of NCDs and the age group of 45-55 years had a 50% risk. The survey also revealed blood pressure levels were rising in the younger population.

What Does This Mean For My Business?

Using the above statistical findings it can be projected between one and four, of every ten employees in the Private Sector in Swaziland are HIV positive. With the working population being highly vulnerable also to TB and Non Communicable Diseases, there is no doubt your business already is, or will be affected.

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How?

Expect direct impact through

  • Increased employee turnover rates, costing you business in recruitment and training procedures
  • Increased employee absenteeism rates, either for direct sickness or the ill health of a relative in which your employee must attend
  • Increased cost of Medical Aid and Insurance
"Peter Philip, Standard Bank's head of corporate health in South Africa estimates that for every year that a senior staff member remains productive, it saves about R300 000 and this rises to R750 000 for middle managers"

And indirect through

  • Decreased productivity of employees
  • Loss of skills base and institutional memory
  • Opportunity cost of management time spent on HIV/AIDS and wellness related issues

External Impact of HIV/AIDS and poor health on your business

  • Reduced quality of products and services
  • Negative impact on supply chain
  • Decreased health and increased morbidity and mortality
  • Market impact through changes in disposable income
  • Changes in dependency ratios
  • Increase or decrease in demand

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Which businesses are most at risk?

Any business with employees is at risk; however labour intensive industries, as well as those with a high mobility of labour are most likely to feel the effect of HIV/AIDS and the ill health of employees.

What should my business do?

The workplace has direct access to those most affected by HIV/AIDS-TB and our most productive population. Reaching these people with the information and services needed to empower positive health choices and to enrich and prolong lives is easily achieved through workplace wellness programming. This can be attributed to the structured communication channels found in, and systematic environment of, a workplace. Companies must realize their responsibility, and the great opportunity that is presented through workplace wellness programming and act.

Elements of a Workplace Wellness Program?

The SWABCHA Minimum Package identifies the recommended components of a workplace wellness program. This model can be used guide for the development of an effective Wellness program in a business of any size to mitigate the impact of poor health and HIV/AIDS.

Necessary Component

Description

Indicator

Tailored workplace policy

A policy developed in consultation with employees and employers endorsing the company’s commitment in respect to HIV/AIDS, TB and other chronic illnesses

Policy document available

Program focal person

A dedicated wellness program focal person with clear TOR and management support

Focal person available

Peer educator program

Peer educators who conduct informed dialogue to ensure there is clear understanding of HIV, TB and other health issues in the workplace (one peer educator for up to 50 employees)

Peer educators trained and active

Monthly HIV/AIDS and health education forums

Monthly health dialogues for both employers and employees are essential to the education process

Education dialogues conducted

Male and female condoms available and demonstrations conducted

Adequate male and female condom supply and dispensing system. Demonstrations must also be facilitated

Condoms available

Access to HRT, ART and primary health services

Access to safe, confident and confidential voluntary HTC and primary health care screening services
 

HTC/Primary health care screening and referral channels

What does each element involve?

See: Minimum Workplace Program Package Unpacked in Resources Section

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Getting Started!

Assessing the threat that HIV/AIDS and ill health poses to your business is often the first step in development of a workplace program as it identifies impact, which results in strong motivation. Indicators to examine include: the existing level of HIV/AIDS infection among employees (companies often do anonymous testing to gauge levels); absenteeism rates and the associated costs; staff turnover and associated retraining costs; morbidity rate; and medical aid costs.

Many services providers in the country, including SWABCHA are able to assist in kick starting a workplace wellness program (see useful links page). Although it is always best for a program to be allocated a specific budget, don't be discouraged if this is not feasible in your company, there are many of the package activities that can be implemented at no cost or little cost, through either coordinating in-house or finding an appropriate low cost provider.

For example, policy development is aided through investigating relevant websites and online documents or through contacting SWABCHA for advice. Possible topics and delivery models for Awareness Sessions can be found on line, including in the Resources section of this site. Condoms are available free of charge through the Swaziland Government, and can be collected from the Ministry of Health or delivered by SWABCHA.

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What benefits can a business expect to see?

"RSSC MD Nick Jackson, attributes their HIV/AIDS and Wellness program from shifting HIV/AIDS as the number one risk to their business, a position which it held for the five years previous, to number three in 2012" In consultation with SWABCHA 2012

There are scores of benefits to be seen from implementing a workplace wellness program, some immediate and others taking a little while to be evident, but there is no doubt investing time and resources in a program, can expect a return on investment. Benefits include:

Workplace wellness programs allow for a more empowered staff member, who is able to make positive health choices, whether that is in exercising preventative measures and/or engaging the necessary medical advice or treatment to control a health condition, such as ARV's for AIDS. And although there are health risks, such as hereditary diseases that cannot be modified, information education programming is proven to affect many others including smoking, physical inactivity, weight gain, sexual behavior and alcohol use, and, by extension, hypertension and high cholesterol (Patel, Daily Maverick, 2012). Taking this into account, through programming your business should experience a decreased level of staff absenteeism and less staff turnover, as more employees remain healthy, which will definitely positively impact the bottom line of your business.

Furthermore through bringing health conditions to the forefront of employee activities and communications, they are de-stigmatized. Not only is this beneficial to increasing the uptake and effectiveness of program activities such as HIV Testing and Counseling, it also creates an environment where a health conditions can be freely conversed upon, enabling a community of care between employees, and employees and management.

A company displaying care and support for their employees through a workplace programming is also known to experience improved employee/management relations and a boost in staff morale.

HIV/AIDS and the poor health of a nation indisputably have an effect on markets and on consumer behavior. A healthy workforce has more purchasing power and creates stronger economy; therefore looking after your employees and their dependants not only benefits your business but the wider economic environment.

Through being proactive in this area, your company positions itself as a socially responsible with a holistic approach to achieving objectives and sustainability, which in today's world often influences if a customer or potential partner engages your business.

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What are other companies in the country doing?

Companies within industries that have been hardest hit by HIV/AIDS, such as Sugar Cane, Construction, Milling and Manufacturing are leaders in Wellness Programming in Swaziland. RSSC, Illovo, SAPPI and Inyatsi Construction implement comprehensive programs which reach employees and also the communities in which the businesses interact with targeted education, social and treatment services. Government Parastatals and the Financial Institutions in the country are also highly active in ensuring employees are presented with every opportunity in the workplace to allow good health.

Small, micro and medium size businesses (SMMEs) have been slower in initiating Workplace Programs, although there are many that have effective programs like KOBWA and Ingwe Mills. In consultation with SWABCHA, SMME's site challenges in locating the human or financial resources for a program as the reason for inactivity. As mentioned previously many activities can be implemented on little or no budget and as this becomes increasingly known a greater number of SMME's are conducting activities. Although maximum impact of a program will be seen when all components of the Minimum Package are enacted, many benefits can be derived from the implementation of just one activity, making this approach by SMME's a great option.

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Community Outreach

Most successful workplace Programs have an outreach component providing education, medical and/or support services to external groups of people, such as: employee dependents, the surrounding community to the business and the most at risk populations within the country, e.g. Orphaned and Vulnerable Children (OVC's) in Swaziland. Not only a corporate social responsibility exercise, outreach initiatives contribute directly to the success of company programs, as the employees dependants/surrounding community can frequently influence their health and wellbeing.

It is seen that reaching an employees dependents/surrounding community with the same targeted health messages which are promoted at work, gives a stronger platform for an employee to change behavior after hours as suggestions are supported. Furthermore, increasing access to medical services for dependants of employees minimizes the possibility of a dependent unknowingly transmitting a virus or infection to an employee, while also reducing the chance of an employee having to care for unwell relative, which may result in the employee being absent from work, stressed and/or losing productivity.

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