PROMOTING HEALTH IN THE WORKPLACE : PROMOTING HEALTH IN THE WORKPLACE : Applying the WHO HPH tool in Public Hospitals Applying the WHO HPH tool in Public Hospitals

in KwaZulu-Natal, South Africain 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.

AcknowledgementAcknowledgement

Dr S. Sirkar – Path Technical Co-ordinatorDr C. Bhagwandeen – Human Resource Support Unit

Ms V. Moodley – Health Promotion Unit Mrs A. Khathi – Quality Assurance & Accreditation UnitMs J. Maher – Quality Assurance & Accreditation UnitMr C. Shawe – Quality Assurance & Accreditation UnitDr V. Maistry – Edendale HospitalMs H. Findlay – Greys HospitalMs. V. Bawany – Lower Umfolozi War Memorial HospitalMs R. Jele – Ngwelezana HospitalMs U. Sooruth – Northdale HospitalMs N. Mbambo – Inkosi Albert Luthuli Central Hospital

BackgroundBackground

• 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.

70% of global total

SOUTH AFRICANDEVELOPMENTCOMMUNITY (SADC)

KWAZULU-NATAL

SOUTH AFRICA

SUB – SAHARANAFRICA

SAHARA

Socio – Demographic Socio – Demographic ProfileProfile Of KwaZulu- Of KwaZulu- NatalNatal

KZN RSATOTAL POPULATION 9.4m(20%) 44.8

POPULATION GROWTH RATE 2.8% 2.4%

ADULT LITERACY RATES 84% 82%

UMEMPLOYMENT RATE 39% 33%

PER CAPITA INCOME R1910 R2566

ACCESS TO SAFE DRINKING WATER 50%

Epidemiological Epidemiological ProfileProfile

• Triple burden of disease• HIV sero-prevalence –32%

KZN RSA

NEONATAL MORTALITY 23.2 19.8

INFANT MORTALITY 52.1 45.4

<5 MORTALITY 74.5 59.4

MATERNAL MORTALITY 170 150

Background Background Dept of Health KZNDept of Health KZN

Hospitals 83

Clinics 434

Community Health Centres

14

Health Budget

2005/2006

R 10.3 billion

(US$ 1.7 billion)

Background Background Dept of Health KZNDept of Health KZN

Total staff number 65 000

Category Percentage

Managers, Administrators &

Logistical Support Staff

49%

Nurses 38%

Allied Health Professionals &

Technical Staff

8%

Doctors and Pharmacists 5%

AimsAims

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

MethodsMethods

• 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 recordsHospital financial records

• Authorisation to undertake the study

Results & Results & DiscussionDiscussion

Total staff 6905

2105 administered

1610 staff questionnaires analysed

response rate 76%.

First study conducted in DOH

No provincial standards or norms

A : Staff HealthA : Staff Health

CRITERIA PERCENT COMMENTS

smokers 9% 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 injuries 4.2% Policies, procedures- Universal precautions

High risk for sero-conversion

B: Staff B: Staff DevelopmentDevelopment

CRITERIA PERCENT COMMENTS

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

C: Hospital C: Hospital ManagementManagement

CRITERIA PERCENT COMMENTS

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

Conclusion & Conclusion & RecommendationRecommendation

• 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