Building effective Employee Wellbeing Programmes in Ghana

FEDERAL REPUBLIC
GHANA WATER COMPANY
Building effective Employee Wellbeing Programmes in Ghana
CO-OPERATION
REPUBLIC OF
GHANA
OF
GERMANY

Painting on cover by Ghanaian artist
Larry Otoo
Title: “The Blue Zone”
Courtesy: Dei Centre for the Study of Contemporary African Art
www.deicentre.workpress.com
www.deicentre.org
Phone: +233 (0)30 70 13 133
Photography by AAF Art Studio

'A Call to Action'
by former UN Secretary-General Kofi Annan
In April 2001, then United Nations Secretary-
General Kofi Annan issued 'A Call to Action' to
reinforce the global battle against HIV. He
proposed the creation of a Global Fund to
mobilize financial resources and called on the
private sector to get more engaged in the
response to HIV, among other things.
As a result, the United Nations General
Assembly adopted a 'Declaration of
Commitment' in June 2001 which included a
commitment by African governments to
promote and support public and private sector
workplace programmes (WPPs) as part of their
overall strategies to prevent and control HIV. At
the same time, the International Labour
Organization (ILO) issued an 'ILO Code of
Practice on HIV/AIDS and the World of Work'
laying out the essential principles on which
these workplace programmes should be
based.
Recognizing HIV/AIDS as a workplace issue is
important, because private enterprises and
public organisations can play a vital role in
limiting the spread and effects of the
epidemic. If employers and employees come
together in a joint effort they can effectively
promote preventative measures through
information and education, and support
changes in attitudes and behaviour. Moreover,
workplace programmes can improve access to
treatment and health services, and protect HIVpositive
workers from discriminatory practices
at the workplace.
01
In response to the Secretary-General's call, a
number of large private companies established
the 'Global Business Coalition on HIV/AIDS,
Tuberculosis and Malaria' (GBC) in late 2001. In
early 2002, some of those companies
participated as donors when the 'Global Fund
to Fight AIDS, Tuberculosis and Malaria' was
launched. The Global Fund serves as a
mechanism through which public and private
sector donors and recipients contribute to the
1
global response to HIV and related diseases.
Today, due to the work of the ILO and the GBC,
the labour and the business sector are global
leaders in the effort to promote and support
workplace programmes to prevent and control
HIV and other diseases. Grants provided by the
Global Fund often support these programmes.
EMPLOYEES OF ADM COCOA GHANA
ON A PROCESSION ON WORLD AIDS DAY 2009
1
Unless it is diagnosed and managed early enough, the human immunodeficiency virus (HIV) can lead to
acquired immune deficiency syndrome (AIDS) which increases people's vulnerability to many other diseases.

02
Ghana's HIV/AIDS Policy
Under the auspices of Ghana's Ministry of
Health (MoH), the National AIDS/STD Control
Programme (NACP) and the National TBcontrol
Programme (NTP) have been
coordinating and implementing HIV and TB
programmes since 1987. The two programmes
now work together to address the serious
problem of HIV-TB co-infection.
Since 2000, the Ghana AIDS Commission
(GAC) has been leading and coordinating a
multi-sector response to HIV and AIDS that
involves government agencies, businesses,
labour organisations, faith-based and other
non-governmental organisations.
In 2009, the HIV prevalence in Ghana was
1.9 %. However, the 2009 HIV Sentinel Survey
Report states that “although the HIV
prevalence is low, it is firmly established within
the whole society, and sub-populations with
higher prevalence and risk of transmission
remain a reservoir for sustaining the
epidemic”. Therefore, the report calls for a
consolidation of all intervention activities to
keep the prevalence in further decline.
DEMONSTRATION OF THE PROPER USE OF CONDOMS BY A PEER EDUCATOR
Germany's support for
Workplace Programmes
In February 2001, Germany's Federal Ministry
for Economic Cooperation and Development
introduced “mainstreaming HIV and AIDS” as a
policy and strategy for the German
2
Development Cooperation in Africa. This was a
pioneering decision. Since then, all its
agencies working in Africa are required to
establish workplace programmes to prevent
and control HIV and related diseases among
their employees and their families. In addition,
all agencies (regardless of their work-related
tasks) are obliged to take advantage of any
opportunities they may have to contribute to
local, district or national responses to HIV.
Through mainstreaming and other initiatives
such as the “Support of the Private Sector in
Africa to fight AIDS” project the German
Development Cooperation now promotes and
supports workplace programmes in both the
public and the private sector in all countries in
sub-Saharan Africa where its agencies have a
significant presence.
2
German Development Cooperation includes the Federal Ministry for Economic Cooperation and Development and its implementing agencies:
German Development Service (DED), German Technical Cooperation (GTZ), KfW Entwicklungsbank (KfW) and Capacity Building International, Germany (InWEnt).

HIV SCREENING AT THE GTZ RECHT OFFICE

04
Ghanaian-German Collaboration on Public
and Private Sector Workplace Programmes
In 2006, the Ministry of Health, the Ghana AIDS
GTZ's technical support is implemented by the
Commission as well as a number of public and
GTZ-Regional Coordination Unit for HIV and TB
private sector organizations started working
(GTZ-ReCHT). GTZ-ReCHT has several
with the German Technical Cooperation (GTZ)
components:
to develop workplace programmes. These
programmes were tailored to particular needs • The Public-Private Partnership components
and opportunities of the participating
for Ghana and West Africa support public
organizations. Collaborating public agencies
and private sector organisations to build
and private companies include the Ministry of
and maintain workplace programmes in
Justice, the Revenue Agencies, Ghana Water
Ghana and the region.
Company Limited (GWCL) together with Aqua • The Mainstreaming Component assists
Vitens Rand Limited (AVRL), and ADM Cocoa
partners of the German Development
(Ghana) Ltd.
Cooperation with the implementation of HIV
workplace programmes. This includes the
Kofi Annan International Peacekeeping
Training Centre (KAIPTC), the Ministry of
Justice and its subvented agencies, the
Ministry of Food and Agriculture, the
Ministry of Local Government and Rural
Development, among others.
• The High Risk Component supports efforts
to reach construction workers, hospitality
workers, sex workers, men who have sex
with men, and street children with
interventions for health and social
protection.
STAFF OF AVRL AT WORK

05
The Ministry of Justice (MoJ) includes the
Attorney General's Department (with a Civil
Division headed by the Solicitor-General),
Registrar-General's Department, Law Reform
Commission, Council for Law Reporting, General
Legal Council, Serious Fraud Office, Legal Aid
Scheme, and Copyright Office.
In the end, the initial three-year project (2006-
2009) covered 600 people, mostly employees.
Currently, an embedded programme, the MoJ's
WPP, is reaching beyond employees to their
families and wider communities. One of its aims is
to sensitize legal service workers to the health
issues that impact on vulnerable populations they
often deal with in their work such as sex workers,
injecting drug users, men who have sex with men,
migrants or prisoners.
Revenue Agencies and Ghana Community
Network Services Limited (GCNet) include the
Revenue Agencies Governing Board (RAGB), Large
Taxpayer Unit (LTU), Customs, Excise and
Preventive Service (CEPS), Internal Revenue
Service (IRS), Value Added Tax Service (VATS), and
GCNet, a Swiss-Ghanaian company that provides
the agencies with computerized systems for
processing documents.
The initial three-year project (July 2006-July
2009) covered 23,000 people including 7,600
employees plus members of their families as well
as people with whom the agencies' employees
come into contact with their daily work. These are,
for example, transport workers, migrants and sex
workers who pass through or congregate in border
towns, ports, and airports. A second three-year
phase (2009-2012) aims to reach 38,000 people.
Ghana Water Company Limited (GWCL), a stateowned
company, and Aqua Vitens Rand Limited
(AVRL), a private company jointly owned by Dutch
and South African companies and contracted by
GWCL to produce and distribute drinking water.
The current three-year project (July 2007-July
2010) aims to reach 3,000 employees, many of
whom are mobile as well as members of their
immediate families, making it a total of 9,000
people.
ADM Cocoa (Ghana) Ltd is a subsidiary of the
Netherlands-based ADM Cocoa B.V., a division of
Archer Daniels Midland (ADM) Company, one of
the world's largest agricultural processors. Its plant
in Kumasi became fully operational in 2009 and
buys cocoa from nearby plantations.
The current three-year project (May 2009-May
2012) aims to reach 6,300 people, including
ADM's employees, members of their immediate
families, people living near ADM's plant and cocoa
plantation workers, many of whom are migrants.

06
Results and Achievements
Usually, all workplace programmes are
accompanied by surveys to establish baseline
data and to measure results and achievements
at a later stage. The surveys measure changes
with regard to knowledge, attitudes, behaviour
and practices of the participants of the
programmes (KABP surveys).
Typically, these surveys reveal that workplace
programmes do not necessarily increase the
level of knowledge of participants since
Ghana's mass media expose people to a lot of
HIV-related information already. However,
workplace programmes often change attitudes,
behaviour, and practices. The tendency to be
fearful, to stigmatize and to discriminate
against HIV-positive people decreases
significantly as well as the tendency to
participate in high-risk behaviour (e.g., not
using a condom while having sex with a nonregular
partner).
So far, workplace programme projects carried
out in collaboration with different public
agencies and the private sector have produced
good results. For example, the programme for
the Revenue Agencies and GCNet reached an
estimated 23,000 people, including employees
and members of their families and others,
thanks to educational material. The table
summarizes some of the key results achieved
by this project.
Selected results of Revenue
Agencies/GCNet WPP
project (2006-2009)
Results achieved by July 2009
732 focal persons trained for the
agencies' offices and stations
6,972 employees (92%) attended
information, education and
communication events
17,310 pieces of educational
material were produced and
distributed
1.5 million condoms were
distributed
56% of employees took up offers
of counselling; of those, 78% took
up offers of testing; of the latter,
2.2% tested HIV-positive
4,940 community members took
up offers of counselling; 4,727
took up offers of testing and 92
tested HIV positive

HEALTH FAIR FOR THE STAFF, FAMILIES AND
NEARBY COMMUNITIES OF AVRL AT ADA

08
Developing HIV Workplace
Workplace programmes provide
opportunities to address a broad range of
Programmes into Employee
preventable diseases.
In Ghana, the leading causes of loss of healthy
Wellbeing Programmes
and productive days of life due to illness and
premature death include communicable
From the experience to date with workplace
diseases (e.g. TB, malaria, and hepatitis B) and
programmes in Ghana two key lessons can be
non-communicable diseases (e.g.
drawn:
hypertension, diabetes and cancers) for which
there are known prevention, early diagnosis
The broader the focus, the more likely
and harm reduction measures. The major
people are to participate.
causes underlying the spread of these
In Ghana, HIV prevalence has been declining
diseases are the lack of basic health and social
since 2003 and was down to 1.9 percent by
protection, employees' lack of awareness of
2009. Many Ghanaians deny that HIV threatens measures to prevent these diseases, and a
them personally. And the fear of stigmatization
lack of access to adequate diagnosis and
and discrimination makes them reluctant to be
treatment facilities.
seen participating in HIV-related events. By
contrast, they know that other health
This severely affects private companies, which
conditions threaten them and their families and
lose huge numbers of their skilled workforce to
they are eager to obtain information and other
diseases, leading to high employee costs and
assistance to prevent or reduce the harm done
therefore to lower profit margins. In addition,
by those conditions.
poor personal financial management may have
a negative impact on employees' health and
In the Revenue Agencies/GCNet project, the
productivity level since it may result in non
proportion of employees taking up offers of
communicative diseases such as psycho-social
voluntary counselling and testing rose from 61
problems or hypertension. Therefore, private
percent to 92 percent when the offer included
companies need to apply measures to improve
counselling and testing for other health
the health situation and hence the productivity
conditions, in addition to HIV.
of their workforce.
STAFF OF GCNet AT WORK

The approach in all workplace projects has
been “learn-as-you go” and this has led to
expanded coverage that reaches towards
Employee Wellbeing Programmes. For
example, the workplace programme of the
Revenue Agencies and GCNet has evolved
into a comprehensive Employee Wellbeing
Programme in its second phase. The
programme has three components: health,
social protection, and financial wellness. It
aims to improve access to health, social
protection and financial counselling services
as well as to education, prevention, treatment
and care facilities that are related to infectious
and non communicable diseases for the
employees, their core families and members
of their immediate communities.
kjj
COMMUNITY MEMBERS ARE ATTENDING AN INFORMATION SESSION AT THE HEALTH FAIR FOR AVRL EMPLOYEES

10
Steps to establish and maintain effective Workplace Programmes
A set of activities has to be carried out to develop and implement a workplace programme successfully.
Although the necessary steps vary between the projects according to the specific needs of the respective
organisation, workplace programmes usually include the following activities:
Planning
• Preliminary discussion and situation analysis, identifying the organization's unique needs and opportunities
to respond to HIV and other diseases through a workplace programme
• A planning workshop to agree on objectives, activities, time schedules, targets for achievement,
resource needs, and allocation of responsibilities among the partners
• A Memorandum of Understanding specifying the responsibilities of each partner
Steering
Structure
• Establishing a working group or steering committee with representatives from the organization's main
divisions and from both genders
• Selection and training of focal persons to provide leadership and coordination
Research
• A knowledge, attitudes, behaviour and practices (KABP) survey and any other research needed to
establish baseline data against which to measure achievements
Information
Education
• Development and dissemination of a workplace policy; all employees should be aware of its existence and content
• Selection and training of additional peer educators (besides focal persons)
• Development and dissemination of organization-specific information, education and communication (IEC) material
Health
Related
Activities
• Procurement and distribution of condoms and other preventive supplies (e.g., insecticide treated mosquito nets)
• Regular events (e.g., twice-monthly talks with employees on relevant topics) and special events (e.g., for employees'
families or for communities) to inform and educate people and engage them in discussion and debate
• Provision of opportunities for voluntary and confidential testing and counselling for HIV and other health conditions
(usually at regular or special events)
• Encouraging registration in Ghana's National Health Insurance Scheme for which all qualify but only if they register
Evaluation
• Monitoring and evaluation - with forms and systems for collecting, analyzing, and reporting data; KABP surveys and
any other research needed to measure progress against baseline data or to gain a better understanding of emerging issues
• Periodic programme review and adjustment, often widening the scope to take in more health conditions

ANTI-STIGMA POSTER OF THE GHANA AIDS COMMISSION

Published by:
Deutsche Gesellschaft für
Technische Zusammenarbeit (GTZ) GmbH
- Office Accra -
Website: www.gtz.de/ghana
Responsible:
Holger Till, GTZ ReCHT Team Leader
Regional Coordination Unit for HIV & TB
Editor:
Dr. Griet Newiger-Addy
Design & Print:
Legend Design House Ltd
Date:
Accra April, 2010

Please contact for further information:
German Technical Cooperation (GTZ)
Regional Coordination Unit for HIV & TB (ReCHT)
Holger Till
Teamleader
GTZ Office Accra
P. O. Box KIA 9698
GTZ ReCHT Office
32 Cantonment Crescent
Accra, Ghana
Phone
Fax
: +233-21-775 811
: +233-21-777 890
Email
Website
© GTZ Ghana
: ghanahivppp@gtz.de
: www.gtz.de/ghana