Advocacy to Improve Access to Prevention & Treatment Services for Women & Children

On 23 March, as part of activities marking women’s month in the DRC, SWHAP collaborated with civil society organisation La Mains sur le Coeur and UNAIDS for high-level advocacy with women holding leadership roles in politics and business. The objective of the meeting was to create partnerships to influence improvements in access to prevention, testing and treatment services for women and children.

The advocacy was also in support of the UNAIDS campaign “Start Free, Stay Free, AIDS Free” a framework for ending AIDS in children, adolescents and young women by 2020. As this campaign directly relates to the 90-90-90 targets by ensuring no one is left behind, discussions also looked at supporting women living with HIV. The event was supported by the Minister of Health, Mr Ilunga Kalenga, and the Ambassador of Sweden to the DRC, H.E. Håkansson.

Minister of Gender, Mr Ilunga Kalenga

Ambassador of Sweden to the DRC, H.E. Håkansson.

According to the demographic and health survey (2013-2014), HIV prevalence in the general population is around 1.2% but 1.8% among pregnant women attending antenatal services. An analysis of the AIDS response in the country reveals significant inequalities in access to HIV information, testing and treatment services faced by children. Investments targeted towards children are low (less than 10%) and are not up to the needs of the country. Pediatric antiretroviral coverage is also low at 33% and communication is not adapted to the needs of children. Additionally, stigma and discrimination prevent many from taking up HIV prevention and treatment services.

SWHAP Networking Platforms

The SWHAP networking platforms that bring together key groups (management, Peer Educators, occupational health practitioners, and steering committee members) responsible for implementing and driving workplace programmes have been identified as a key strength of the Programme.

Already this year, over 90 senior level managers have participated in network training in Mozambique, Kenya and Tanzania, and 100 Peer Educators exchanged experiences in meetings held in Zambia and Zimbabwe.

East Africa

In East Africa, the network meetings focused on integrating tuberculosis (TB) responses within workplace HIV and wellness programmes. This was after a national survey, released last year, showed that the TB burden in Kenya was higher than previously estimated and that over 40% of TB cases in the country remain undetected. The meetings were held in partnership with the Centre for Health Solutions and included management from SWHAP partner companies and their value chains.

Mozambique

The gathering in Mozambique brought together companies implementing programmes through SWHAP, ECoSIDA members as well as representatives from unions and the government. It provided an opportunity for participants to share their experiences and challenges and to learn about Vodacom Mozambique’s experience in setting up a workplace wellness programme. The meeting successfully concluded with companies from the SWHAP network promising to submit their plans for the second year of their programmes.

Peer Educator Networks -Southern Africa

Peer Educators (including spouse peer educators) in Zimbabwe and Zambia used Valentine’s day to nurture healthy relationships, encourage self-care and share coping strategies for dealing with divorce and blended families. In Zimbabwe, the Peer Educators were joined by Tendayi Kateketa Westerhof, Country Coordinator, Pan African Positive Women’s Coalition – Zimbabwe (PAPWC) who talked about positive health, dignity and prevention. Tendai is on treatment and has been living positively for the last 17 years and now has an undetectable viral load.

In total over 100 Peer Educators from Sandvik, Epiroc, SKF, Scanlink and their supply chain counterparts benefitted from the training.

Tendai centre in white with Peer Educators from the SWHAP network in Zimbabwe

Read a case study on the SWHAP networking platforms here.

 

Partnership results in STI reduction

Last year in August, Sandvik Mining and Construction Zimbabwe partnered with Zimplats, SWHAP, the Southern Africa HIV and AIDS Information Dissemination Service (SAfAIDS), the National AIDS Council and the International Labour Organization to hold a community dialogue addressing sexually transmitted infections in the mining town of Ngezi. This was following reports of a spike in the numbers of STIs being recorded at the mine clinic.

The partnership was successful in encouraging the residents of the town to examine behavioural practices that were fuelling the rise in STIs (for example, infidelity, multiple concurrent partnerships, lack of condom use, alcohol and drug abuse) and to take responsibility for their sexual and reproductive health. In December 2017, the mining clinic recorded a reduction in the number of STIs compared to the usual spikes experienced during previous festive periods.

At the end of the discussions representatives from the community signed a pledge committing to marital fidelity, regular HIV and wellness screening, open communication between married couples and saying no to drug and alcohol abuse. These pledges were erected into billboards and placed around the mining town to help guide behaviours.

Wellness Days – Supporting Healthy Behaviours

Workplace wellness programmes can help support healthy behaviours as the average full-time worker spends a third of their day at work. Additionally, regular wellness days keep employees updated on their health status which is beneficial as they are then more likely to take measures to improve their health. For the employer, wellness days help in the compilation of data necessary for designing programmes based on the health needs of employees and for tracking progress across time.

Kenya

Oriflame conducted onsite screening for HIV, body mass index, diabetes and hypertension for its employees in Kenya and Tanzania during February.  In Kenya, the opportunity for testing was timous as the majority of workers had not taken an HIV test in more than two years.

A knowledge, attitudes and behaviour survey conducted prior to the testing (to generate information for future wellness planning) revealed gaps in knowledge about HIV and AIDS and lifestyle diseases that will be filled with employee education sessions. The demographics of the company mean that a programme will be tailored to address the health needs of a predominantly female workforce.

The wellness days and KABP surveys were the last activities under the start-up programme support which started in August last year. Oriflame has been taken through steering committee training and set-up, HIV and wellness policy development and employee education sessions.

Zimbabwe

Sandvik Zimbabwe held a wellness day for employees, value chain and neighbouring companies on 16 February. There were opportunities for HIV and biometric testing as well as sight and dental check-ups. Around 250 people were tested for HIV.

 

Supply Chain and Mentorship Updates

Companies that have received SWHAP support to set up HIV and wellness programmes often go on to share their experiences with other workplaces usually through the SWHAP supply chain or mentorship models. SWHAP also works with unions and employers’ organisations to assist their members to set up HIV and wellness structures.  In 2017, such programmes helped SWHAP to reach an additional 82 workplaces with access to testing services and information on HIV for employees.

Below are some updates from supply chain and mentorship programmes from South Africa, Zambia, Zimbabwe and Kenya.

South Africa

On 16 February, Sandvik South Africa held a feedback meeting on their recently completed supply chain programme. Through the programme, seven companies completed management sensitisation, steering committee training, policy development, baseline knowledge, attitudes and practices surveys and wellness days. In all, 244 employees conducted health risk assessments and 212 participated in HIV counselling and testing. Companies were informed of their risk burden and employees in need received telephonic support from the service provider.

Reports from the feedback session suggested that future programmes should be tailored to suit the needs and dynamics of smaller companies. Suggestions made included breaking down training sessions into smaller chunks so as to lessen time away from work, and enhancement of management sensitisation in order for managers to be more fully aware of the business case for programmes and to thus drive participation.

Zambia

The Orica mentorship programme reached the midway point with steering committee training conducted on 5 and 6 February. The training equipped participants with information on wellness programmes and built capacity on initiation, planning, implementation and evaluation of workplace programmes. This was achieved through practical case studies, interactive presentations and group discussions that, for example, helped participants create appropriate benchmarks towards the evaluation of programmes.

As the way forward the trained steering committee members committed to conducting awareness sessions at their respective workplaces to sensitise their colleagues on the importance of workplace health, and to carry out needs assessments that will enable them to tailor appropriate programmes. These assessments will involve; environmental inspections; review of absenteeism rates and current health care costs; review of current programmes; and identification of common health conditions faced by employees.

Participants were awarded certificates on completion of training. The next stage in the mentorship process will be the development of HIV and wellness workplace policies.

Zimbabwe

Employee sensitisation for the Revco mentorship programme was held on 13 December for 44 employees from Professional Security. Information was shared on the key drivers of HIV, sexually transmitted infections (STIs) and correct condom use demonstrated. The awareness session highlighted the importance of condoms as a prevention method within workplace HIV programmes. In total 1 800 condoms were distributed and employees expressed appreciation of the condom demonstration with one employee saying, “all along I did not know how to put on a condom properly. I would like to thank [you] for coming to save my life maybe one day I was going to contract HIV through incorrect condom use.”

Condoms are a cost-effective tool for preventing HIV and other STIs. Globally since 1990, an estimated 45 million HIV infections have been averted through condoms. Currently, there is an annual gap of more than 3 billion male condoms in sub-Saharan Africa (UNAIDS).

Kenya

The Raffia Bags mentorship programme that was launched in October last year culminated in testing for the two participating companies in December. Over 500 employees updated their health risk profiles. Appropriate referrals were made for cases that fell outside the normal range for blood pressure and blood sugar, or tested positive for HIV. Additionally, employees were empowered with information on how to identify hazards and risky behaviours in the workplace, and on how to take steps to prevent ill health or harm to themselves and others.

The successful implementation of the programme was driven by the management and wellness champions at Atta and Krystalline Salt Kenya who recognised the correlation between a healthy workforce and productivity. They created a conducive environment for employees to get information and help regarding their health.

Tanzania

On 22 November last year, management sensitisation was held for ten companies participating in the second mentorship programme involving the Association of Tanzania Employers (ATE) and the Trade Union Congress of Tanzania (TUCTA). As a result of the sensitisation process, all ten companies established steering committees. Training for 15 steering committee members was conducted on 23 January building understanding on the impact of HIV and health-related issues at workplace level and on how to develop strategies for policies and programmes. The training session was opened by a representative of the Tanzania Commission for AIDS (TACAIDS) who recognised the efforts to prioritise HIV and AIDS responses amongst the private sector.

Raising Awareness at Verde Azul

Verde Azul Mozambique held an HIV awareness session for new office and field employees. About 25 employees participated in the session including the General Manager where discussions examined risky behaviours and promoted consistent, correct condom use. Information on HIV and AIDS was distributed to the participants as well as three boxes of male condoms and two boxes of female condoms.

A knowledge attitudes behaviour and practices survey conducted on SWHAP partners in Mozambique revealed that just over 50% of respondents obtained information on HIV and health from their workplace HIV and wellness committees – underscoring the importance of workplace awareness raising programmes.

International Women’s Day Commemorations

During March, various events were held throughout the SWHAP network to commemorate International Women’s Day and Women’s Month.

DRC

In the DRC, SWHAP brought together 30 women from the Confédération Syndicale du Congo (CSC) and the Association of Female Entrepreneurs of the DRC (ASSOFE) to build capacity on social dialogue for gender equity. Each participant was guided through a gender mainstreaming and evaluation tool in order to help them identify the gender gaps in their companies.

Mozambique

SWHAP marked International Women’s Day in Mozambique with a dialogue for 55 of its partners who included companies participating in the programme, ECoSIDA (a local business council on HIV) members and representatives from unions and the National AIDS Council. Held under the theme “Time is now: Rural and Urban Activists Transforming Women’s Lives” the objective of the dialogue was to encourage the private sector to make greater strides in the empowerment of women towards gender equity and to encourage reflection amongst participants on the role they could play to empower both rural and urban women.

The dialogue also raised awareness on the importance of International Women’s Day as a platform for addressing women’s health and rights in the context of HIV and AIDS. The National AIDS Council reminded participants of the barriers to accessing health services faced by women, noting that in Mozambique HIV prevalence was higher in women than men and that only 45% of women successfully adhered to antiretroviral therapy.

Zambia

SKF and Epiroc participated in the district events in Kitwe. The companies celebrated the women in their workforce as well as the female spouses of employees, and in line with their annual tradition, purchased fabric for all the women to make outfits in their preferred styles.

Epiroc Zambia

Sandvik held a session on cervical cancer for women in their workforce and then treated them to a special lunch where the women celebrated their accomplishments.

Tanzania

Epiroc invited an external facilitator to talk to its employees about women’s empowerment.  The men at the office were invited to take part in the discussions as a way to inspire them to empower women in their workplaces, communities and families.

For the ladies at Sandvik, it was about giving back to the community. They made donations of food and general supplies to a local charity.

View more pictures on our International Women’s Day album on Facebook.

International Women’s Day 2018 – Stop GBV at work

The year 2017 was a watershed moment in history regarding awareness on the social issues faced by women. The #MeToo and #TimesUp movements raised the profile of workplace-based violence and discrimination experienced by women as millions shared their experiences via social media. Worldwide, women and men joined social campaigns and marches calling for change.

As we commemorate International Women’s Day this year, under the theme “Press for Progress“, we look at how grave the problem is and why the private sector should get involved in stopping gender-based violence (GBV) and gender-based discrimination at work.

The figures on discrimination and sexual harassment

Only 50% of women of working age are engaged in the labour force, compared to three-quarters of men, and women earn 77% of men’s salaries (ilo.org). Shockingly, more than a third of the world’s countries do not have any laws explicitly prohibiting sexual harassment at work (worldpolicycenter.org). Additionally, the World Health Organization has reported that globally, 35% of women over the age of 15 have experienced sexual or physical violence in homes, communities or workplaces.

On their website, the International Trade Union Confederation (ITUC) share disturbing global statistics on the pervasiveness of sexual harassment in workplaces. Just from Africa, they list the following:

  • 90% of women from Uganda (surveyed from over 2 900 organisations) reported being sexually harassed by senior male colleagues. Source: ILO Bureau for Workers’ Activities (ACTRAV)
  • 90% of surveyed workers in the Kenyan tea growing and processing sector reported experiencing or observing sexual abuse at their workplace. Source: Solidarity Center
  • 81% and 63% of women from Zambia and Lesotho respectively had experienced sexual harassment at work. Source: SADC Gender Protocol Barometer (2014)

Source: www.ituc-csi.org

Why is it important to get involved?

The ITUC say, “there can be “no decent work with violence at work”. They have mounted a campaign to build support for the adoption of an International Labour Organization instrument on “Violence and Harassment against Women and Men in the World of Work”, which includes gender-based violence. GBV is rooted in gender-based inequalities and harmful social norms. Experiencing GBV hinders women from fully participating in the labour market and in economic and political spheres. There is also the intersection between inequalities, GBV and the spread of HIV.

The private sector: a key partner for gender equality in the 2030 Agenda

At the end of February this year, business leaders, trade unionists, civil society and government representatives collectively weighed in on the subject at the “4th Global Forum Business for Gender Equality: The future of work in the 2030 Agenda” held in Santiago, Chile. They pledged to change working conditions for men and women in order to promote equality and inclusion, and to share their experiences with other companies and actors working for gender equality. This was at the urging of representatives from the United Nations Development Programme and UN Women who advised them to, “capitalize on the momentum of recent activism by and on behalf of women and ensure that businesses understand that equality is good for the bottom line”.

How is gender equality good for the bottom line?

Apart from being a basic human right, gender equality is a cross-cutting theme without which the aims of Agenda 2030 will not be realised. Gender equality is also critical to business performance and sustainable economic growth.

  • It transforms businesses, economies and societies. If women and men participated equally in the labour market, the world economy could gain 28 trillion by 2025 (Mckinsey.com).
  • It provides opportunities for businesses. For example, inclusive workplaces help to identify new markets and investors. Increasingly investors are looking at the gender equality performance of companies as an indicator of potential growth (weps-gapanalysis.org). The IMF has said that gender inequality decreases the variety of goods countries produce and export – especially low-income and developing countries (imf.org).
  • Supporting women’s health (in particular sexual reproductive health) can lead to; healthier more productive employees, savings in healthcare costs over the long term, and increased morale in the workplace.

Source Copyright © International Labour Organization 2018

How we work with gender

The Swedish Workplace HIV and AIDS Programme (SWHAP) works with its partners to promote gender-sensitive workplaces. Through steering committees and peer educator teams who implement programmes companies:

  • mainstream gender into HIV and wellness policies and ensure that gender issues are considered and applied in all business decisions, management, operations, and sustainability strategies.
  • raise awareness and implement policies on sexual harassment in the workplace.
  • raise awareness on GBV and the sexual and reproductive health rights of all groups in workplaces and communities.
  • promote understanding of the gender-differentiated vulnerabilities and risks to HIV and other health conditions and design appropriate interventions.
  • hold internal and community gender dialogues where women and men can challenge gender bias and inequality.

Tetra Pak has been driving wellness which looks at the wellness of employees in totality, for example, the physical, financial and emotional. Working together with SWHAP, we have embraced the area of gender mainstreaming and in our recruitment process, we keenly advocate for female candidates to apply for traditionally “male” oriented jobs. 

Last year through a global Tetra Pak initiative we recruited a female Field Service Engineer. This brought a different mind shift to the rest of the employees especially the engineers. It also empowered the other ladies in the company as it has broken the traditional belief that it’s almost impossible to get female engineers. There is also a lot of respect that is given to this Field Service Engineer by the rest of the employees. – Judy Ndegwa, Tetra Pak Kenya

Read more on how we addressed gender last year on pages 16-17 of our Annual Report

Take Action

Press for progress and support the ITUC’s “23 Days of Action” campaign that is building support for the adoption of an International Labour Organizations Convention to stop gender-based violence at work.

Useful Links:

The Women’s Empowerment Principles Gender Gap Analysis Tool (WEPs Tool) – a business-driven tool designed to help companies from around the world assess gender equality performance across the workplace, marketplace, and community.

The Gender Equality Seal programme supported by the United Nations Development Programme which certifies public and private organisations efforts to eliminate gender gaps in the workplace.

Wellness Days

Uganda

Congratulations to Bearing and Power Transmission Technology (an SKF dealer from Uganda) who achieved 100% testing uptake at their first wellness day. The company also opened up testing to the contracted security firm at their premises – giving the security guards an opportunity to learn their HIV status.

Tanzania

Tigo Tanzania organised Hepatitis B testing and vaccinations for 231 employees in September. Employees that tested positive were counselled and referred to hospitals for further assessment and treatment.

Hepatitis B usually occurs as a result of contact with infected body fluids. Because of shared modes of transmission (sharing of needles amongst injecting drug users, unprotected sexual contact), a high proportion of adults at risk for HIV infection are also at risk for Hepatitis B infection. Moreover, HIV positive individuals who become infected with the Hepatitis B virus are at increased risk for developing chronic hepatitis, complicating treatment. The World Health Organisation (WHO) estimates that as many as 4-5 million people may be infected with both HIV and Hepatitis B.

DRC

The Confédération Syndicale du Congo (CSC) held sensitisation sessions on HIV, family planning and gender-based violence for its members in Lubumbashi in November and December – 114 people established their HIV status. Additionally, 4 752 male and 44 female condoms were distributed. CSC is a union confederation represented at national level in the DRC and a member of IndsutriALL. SWHAP is supporting the Union to set up HIV and wellness workplace programmes in 29 companies where the organisation has representation.

ICASA 2017 – Africa: Ending AIDS- delivering differently

We were excited to participate in the 19th International Conference on AIDS and STIs in Africa (ICASA), held between 4-9 December in Abidjan Cote d’ Ivoire. The conference brought together 7 000 of the world’s leading scientists, policymakers, activists, PLHIV, civil society representatives and government leaders to discuss how Africa could do things differently to end AIDS by 2030.

SWHAP was honoured to present posters on:

  1. The SWHAP Model: Joint consultation and collaboration for workplace policies by employer and worker representatives in East, Central and Southern Africa
  2. Introducing non-discrimination policies and programmes as an extension of highway corridor testing amongst truck drivers: a union employer partnership
  3. Why engaging men, women and gender transformative norms matters
  4. Relating HIV and AIDS knowledge levels to attitudes, behaviour and practice parameters at the workplace as indicators of impact of workplace HIV and AIDS programme interventions
  5. People living with HIV access to support, treatment and care: focus on SWHAP

The posters highlighted amongst other issues; the possibilities that exist for scaling-up programmes within sectors through partnerships between union and employer organisations; social dialogue as a tool for programme implementation; the need to engage men in workplaces and communities to tackle harmful gender norms that increase HIV transmission risk; and the importance of raising awareness on HIV as it reduces stigma and discrimination and increases rate of testing and uptake of prevention services.

SWHAP also conducted a radio interview with the Children’s Radio Foundation at the Community Village, discussing the private sector contribution to the HIV response and how workplace programmes help to deal with stigma and discrimination.

Some themes from the conference

Universal Healthcare Coverage –  New data is showing that at least half of the world’s population does not have access to essential health services. Universal Healthcare Coverage (UHC) means that everyone can have access to affordable quality healthcare. UHC is at the core of the HIV response and important for ending AIDS as a public health threat by 2030. Read more from GBC Health about how the private sector can play a part in scaling-up access to UHC.

Differentiated Care – The 90-90-90 Targets will require a near doubling of the number of people on treatment putting pressure on health facilities. Differentiated care aims to simplify and adapt HIV services to reflect the needs of the various groups of people living with HIV enabling them to access treatment closer to the community (where possible) – relieving pressure on health facilities. It involves tailoring the frequency and location of services as well as the type of health worker providing the services. Read more from Differentiated Care.

Male Engagement to end AIDS – “Men and boys are underrepresented in HIV services while being over-represented amongst AIDS deaths and a key part of the cycle of new HIV infections, a cycle which needs to urgently be broken to reduce new infections among adolescent girls and young women.” – Sonke Gender Justice and Men Engage Africa.

Some examples of how to engage men that were shared during the conference:

  • Through prevention of mother-to-child transmission (PMTCT) programmes
  • Voluntary Medical Male Circumcision (VMCC) using community-based approaches to increase uptake
  • Increasing access to HIV self-testing
  • Workplace testing
  • Facility-based changes, for example, routine testing after hours, weekend testing and  increasing the number of male nurses or male healthcare providers
  • Venue-based outreach, for example at, sporting events and bars
  • Use of mass media and community mobilisation to transform gender norms, address risk perception and increase demand for testing and prevention services
  • Use of influencers to change community norms on masculinity

Read more from the UNAIDS report Blind Spot – Reaching out to men and boys

Leave no one behind – In 2016, 610 000 young people were newly infected with HIV, and in the last decade AIDS-related deaths among adolescents have increased (decreases have been observed in all other age groups). We need policy changes to help young people especially those from key populations to access sexual reproductive health information and services.

A session by GBC Health,  the United Nations Population Fund (UNFPA) and the African Youth Network (AfriYAN) provided a platform for governments, technical and financial partners, the private sector, civil society organizations, and young people to discuss investment opportunities for ending AIDS.

“We will not end AIDS without young people”- Michel Sidibé UNAIDS Executive Director