07 july 2011 effective employee health and wellness programme- hct service delivery model sabcoha...
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07 July 2011
EFFECTIVE EMPLOYEE HEALTH AND WELLNESS PROGRAMME-
HCT Service Delivery Model
SABCOHA CONFERENCESun City –N.West
Ms Morero E. Leseka
Introduction
DPSA context for the HIV&AIDS response and HCT
• Coordination of HIV&AIDS and TB response
DPSA is responsible for the coordination of HIV&AIDS and TB response activities within the Public Service and to monitor, evaluate and report on such responses to SANAC
• Policy pronouncements
• HIV&AIDS and TB Management in the Public Service-with HCT as an entry-point to treatment care and support
Introduction...3
• The burden of HIV&AIDS and TB in the Public Service
• HIV Prevalence was 17,8% among those aged 15-49 years with the prevalence being higher in women 25-29 years and men aged 30-34 years (UNAIDS:2010; HSRC:2008
• These are the age groups which are likely to dominate the Public Service world of work.
Key Health Trends
• The Key Health trends reported by GEMS – TB and HIV related claims among the top 10 cost
drivers– Public Servants accessing treatment at a very
advance stage of HIV infection, resulting in poor treatment outcomes
• Several research studies – 12,7% prevalence among educators (ELRC:2005)– Lower income and non-professionals had higher
prevalence rate than in higher income and professional groups
– The latter findings same in Health and in Correctional Services
*
VISION FOR EH&WA Healthy, Dedicated, Responsive and Productive Public
Service
Occupational Health Quality of Work Life
Research, Monitoring and Evaluation
Occupational Health Education and Promotion
Occupational Health and Safety Management
Individual Wellness Physical
Work life Balance
Organizational Wellness
Individual Wellness Psycho-SocialHuman Rights and
Access to Justice
Treatment Care and Support
Prevention
Injury on Duty & Incapacity due to ILL Health
Mental Health /Psychosomatic Illnesses
Disease Management and Chronic Illnesses
Environmental Management
Risk and Quality Assurance
HIV and AIDS & TB MANAGEMENT
Pillar 1
HEALTH and PRODUCTIVITY MANAGEMENTPillar 2
SHERQ MANAGEMENT
Pillar 3
WELLNESS MANAGEMENT
Pillar 4
4 KEY INITIATIVES FOR HIGH PERFORMANCE IN THE PUBLIC SERVICE THROUGH HEALTH AND PRODUCTIVITY MANAGEMENT
CORE PRINCIPLES INFORMING IMPLEMENTATION OF EHW STRATEGY
LEGISLATIVE FRAMEWORK AS A FOUNDATION
Policy Objectives:
• To provide HIV&AIDS and TB Prevention
• To provide Treatment, Care and Support for those infected and affected by TB and HIV infections
• To manage compliance to Human and Legal Rights; and
ensure access to Justice
• To ensure Monitoring, Research and Surveillance on HIV&AIDS and TB
Presentation Outline HIV&AIDS AND TB MANAGEMENT
• Poor HCT Uptake against the set targerts (14%) 86 324 vs 637 000.
• Low reporting rate from entities (58% national and 87 % Provincial)
• Poor data quality
• Non compliance to reporting templates
Challenges for EH&W- an HCT Perspective
Project / Program Level
Efficiency
PopulationLevel
Effectiveness
Resourcese.g.
FinanceStaff
Drugs, Supplies
Equipment
Functions,Activities
e.g.TrainingLogistics
IEC
Servicese.g. Facilities offering
ServiceTrained staffUtilization:New clients
Return clients
Intermediate
e.g.HIV+ on GEMS
Disease Management
InputsProcesses/Activities
Outputs Outcomes Impact
Long-terme.g.
Infection rateMortality
Disability and attrition
Results Based Management Approach Int RBM(2)
• Base line (Before HCT)- did not exist
• Process: – Policy Implementation Readiness Assessment
and EH&W System Monitoring Tool
- HCT Operational Planning
- HCT M&E Plan – Result Framework– Training and Workshops– Resource Mobilization– Partnerships with GEMS et al.
HCT as an example (Efficiency issues)
• Base line (Before HCT)- did not exist
• Outputs:– HCT Coverage – 58 % estimates from
reporting rate ( National 58% and Provinces 87%)
– HCT Uptake – 14 % of the set target– TB screening rate – 19%
• Outcome Evaluation- Change in attitude and behavior
• Impact (Evaluation)- IHRA
HCT as an example (Efficiency issues)
• Is at developmental stage
• Goal- Improve Coverage and Uptake of HCT services
• Coverage- – service broadly available and accessible
beyond workplace (site) and outside working hours (time)
• Uptake- – more employees consume HCT services
Improving HCT Service Delivery Model
Process:
• DPSA sign MoU with SAMA to implement HCT intensification project beyond June 30th
• Technical Task team formed comprising DPSA, GEMS, DOH and SAMA ( discussions to include other Public Sector Unions vs bilateral engagements)
• TOR developed to define individual responsibilities
Service Delivery Model…2
New opportunities:
• DPSA will mobilize its employees to know their HIV status
• Negotiate options of testing in the workplace and/or at the General Practitioner’s Network of SAMA
• A referral form will be issued for those choosing option 2
• Those not covered will be encouraged to join GEMS
Service Delivery Model…3
SAMA
• Mobilize their GP-network to participate in the Project
• Provide free HCT services and screening for other non-communicable diseases to employees and their dependents via the GP-network
• Document services offered and report to DPSA
Service Deliver Level…4
DOH
• Provide diagnostic packs and condoms to the GP’s under the project
• Provide technical support and HCT guidelines as required
• Support monitoring and evaluation at local level where possible
• Include the Workplace HCT indicators in the DHIS
Service Delivery Model…5
• Increased no of facilities where employees and their dependents can go for screening
• Increased number of hours available for employees to access the services
• Standardized reporting and referral tools between GP’s and Public Service
Anticipated HCT Intensification Outputs
• Improved tracking of HCT uptake, from members of other medical aid schemes and accurate HCT data.
• Reduced chances of loss to follow-up, and improved linkage to care and support
• Ongoing documentation of best practice for possible roll-out of the model
Anticipated outputs…2
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