PORTFOLIO COMMITTEE 20 OCTOBER 2004

MANAGEMENT OF HIV and AIDS IN THE PUBLIC SERVICE

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PRESENTATION OVERVIEW

What is the potential impact of HIV and AIDS on the Public Service?

How are we responding to this?

What can we do to improve this response?

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POTENTIAL IMPACT OF HIV and AIDS ON THE PUBLIC SERVICE

Public Service responsible for the delivery of services to the public Growing epidemic means increased demand for services

(Health, Social Services etc)

Public Service is the biggest employer in RSA, and is anticipating facing the following: Recruitment challenges Retention problems Escalating employee benefits costs Difficulty in meeting the increased demand for services

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PUBLIC SECTOR RESPONSE Based on the country’s HIV and AIDS Strategic Plan -

Impact and Action Project launched in January 2000

Purpose: to mitigate the impact of HIV and AIDS on the Public Service

3 Phases Phase I: Impact assessment Phase II: Policy and legislative review and revision Phase III: Implementation

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PHASE I: IMPACT ASSESSMENT

The Public Service consists of around 130 departments employing ±1,1 million employees.

Around 70% of these employees are employed by the provincial departments

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The impact of HIV and AIDS on various sectors and departments will differ based on the risk profiles of their workforce

All workplaces already having high workloads & over-extended capacity will be particularly vulnerable e.g. Remote areas & disadvantaged communities Functions that rely on scarce skills

PHASE I: IMPACT ASSESSMENT

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Policy & legislation review to - identify key principles upon which workplace

programmes should be based analyze existing legal framework of Public Service to

assess the extent to which this supports/contradicts the key principles

Key conclusion: Although legal framework doesn’t expressly violate any of these principles, also doesn’t provide an enabling environment

Hence a policy framework should be developed

PHASE II: POLICY REVIEW

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PHASE II: POLICY DEVELOPMENT

Public Service Regulations, 2001 amended to incorporate minimum standards on HIV and AIDS (Part VI of Chapter 1)

Mandatory guidelines to Heads of Departments on minimum requirements for managing HIV and AIDS in the workplace

Provides a basis for departmental workplace programmes

Now broadening to a comprehensive Health and Wellness focus

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PHASE II: POLICY DEVELOPMENT

Health Promotion Programmes

Introduce education, awareness and prevention programmes focusing on HIV and AIDS and other STIs to employees, where possible to families.

This programme is preferably to be integrated with broader programmes that promote the health & well-being of employees (e.g. EAP)

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PHASE II: POLICY DEVELOPMENT

Create mechanisms to encourage openness, acceptance, care and support for HIV-positive employees

Designate a senior manager(e.g HR) skills, seniority and support to champion the implementation of the minimum standards – accountable by means of performance agreement

Allocate adequate human and financial resources and form partnerships

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PHASE II: POLICY DEVELOPMENT

Establish an HIV and AIDS committee for the dept, with representation of relevant stakeholders

Ensure that the programme includes an effective internal communication strategy

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PHASE II: POLICY DEVELOPMENT

Occupational exposure Depts to identify units or employees at high risk of

contracting HIV & related life threatening diseases and take reasonable steps to reduce risk

Facilitate access to VCT (HIV & related diseases) and post-exposure prophylaxis

Assist employees to access compensation - Compensation for Occupational Injuries and Disease Act, 1993

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PHASE II: POLICY DEVELOPMENT

Non-discrimination

Policies and practices not to discriminate against employees on their HIV status or perceived HIV status

Take active steps to promote non-discrimination and protect HIV- positive employees from discrimination

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PHASE II: POLICY DEVELOPMENT

HIV testing

No pre-employment HIV testing unless Labour Court authorization has been obtained

Departments must promote VCT, and wherever possible, promote access thereto

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PHASE II: POLICY DEVELOPMENT

Confidentiality

All employees must treat information on an employee’s HIV status as confidential and not disclose this without the employee’s consent

Monitoring and Evaluation Introduce measures for monitoring policy

implementation and evaluating the impact of the programme on employees.

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PHASE II: POLICY DEVELOPMENT

Good Practice Manual was developed to complement the Regulations and serve as a guide for departments to develop workplace policies and programmes

The regulations indicate what departments have to do

and the Manual how

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PHASE III: IMPLEMENTATION

A three year strategy developed that focuses on supporting departments as they develop and implement their own programmes

Strategic focal areas: Institution building Consultation and co-ordination mechanisms Facilitating Policy Implementation Monitoring and Evaluation

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PHASE III: IMPLEMENTATION

Project team employed full-time on the project. - Team lead by a Senior Manager, supported by Project Manager, Employment Practice Specialist, Project Assistant, an administrator and two interns

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PHASE III: IMPLEMENTATION

Strengthen systems for consultation & co-ordination

Strengthening of the National Interdepartmental

Committee on HIV and AIDS (IDC)

Establishing/ Strengthening of Provincial IDCs

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PHASE III: IMPLEMENTATION

Increase capacity of the Public Service to implement the HIV and AIDS Policy guidelines Capacity audit commissioned

Develop and distribute well-documented good practices from the Public Service

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PHASE III: IMPLEMENTATION

Sustain and expand the Communication Strategy - to sensitize departments and individual public servants on their roles and responsibilities & to communicate the policy framework and systems that have been put in place

Website developed for departments to access information and share best practice (www.dpsa.gov.za)

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PHASE III: IMPLEMENTATION

Guidelines developed on integrated HR planning since DPSA studies have shown that this is a critical weakness in the Public Service - have been made available to departments

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CHALLENGES

Specific concerns: Lack of integration of HIV and AIDS policies &

programmes into broader wellness initiatives & HR practices

Major problems are being experienced around stigma - hence employees are reluctant to disclose their status & seek help

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CHALLENGES

Most programmes focus on awareness & prevention, with few focusing on sustaining service delivery – e.g strategies for replacement of skills often inadequate

Taking the programme to where people are is our major concern

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WAY FORWARD

Broadening our focus from HIV and AIDS to adopt a comprehensive approach of Employee Health and Wellness to enable departments to deal with the challenges the HIV and AIDS epidemic present.

The comprehensive approach should assist in dealing with some of the challenges experienced including stigma and discrimination

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WAY FORWARD

Assisting departments in strengthening their internal capacity and sustaining their programmes

Develop and implement a monitoring & evaluation framework in consultation with OPSC and relevant structures

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WAY FORWARD

The Medical Assistance Restructuring Programme will ensure that all employees have access to a reasonable level of health care -includes a comprehensive HIV and AIDS disease management programme

Draft new policy on incapacity management developed and being tested - provides for better health risk management and return-to-work strategies in the face of the HIV and AIDS epidemic