Engaging with industries elm model

Engaging with Industries through:Employer Led Model

18th February 2015 .Presentation for CG State Level Sensitization workshop on

ELM for industries

CG State Sensitisation workshop on ELM 2

Rationale for private sector engagement in Health

• Indian healthcare sector to reach 97.2 billion by 2015 with 20 per cent annual growth

• Major medico-tourism destination; Indian Pharmaceutical sector being third largest globally

• Over 80% of out-patient and 50% of inpatient care sought from the private sector

• Difficult for the public sector alone to meet the health care needs of the population to address the public health goals

Public-private partnership (PPP) approachesto increase access to health care services, public awareness and equity for health,

and introduce technologies and systems that improve efficiencies18.2.2015


PPP models and initiatives in health programs

ContractingPrivate Sector as supplier of

service to improve access and efficiency

CSRMove towards mandatory CSR budgets; Great potential for resource leveraging

for health and HIV

Social MarketingIncrease penetration and sale

of subsidized products

Health care financing, etc.Demand side financing

models-vouchers; health insurance

Social FranchisingFew models tried; shows

potential for financial viability and acceptance by users

18.2.2015


Employer Led Model

• New Initiative under NACP-IV

• Aim: Engaging Industries for Reaching migrant workers with HIV/AIDS prevention to care program and services through their CSR commitments.

18.2.2015

CG State Sensitisation workshop on ELM 518.2.2015


Migrant Labor show HIV risk

States with higher vulnerability due to MigrationSource: NACO HIV Sentinel Surveillance 2010-11 – Provisional Findings; Source: Population Council Study -- Reference: Saggurti N, Mahapatra BB, Swain SN, Jain AK. Male out-migration and sexual risk behavior in India: Is the place of origin critical for HIV prevention programs?. BMC Public Health. 2011. 11:S6;

Higher HIV Prevalence among Pregnant Women with a Migrant Spouse

Migrants over-represented (80%) among HIV+ men (Ganjam)

RAJ UP BIH WB JHAR ORI CHHT MP0.00

0.20

0.40

0.60

0.80

1.00

1.20 1.13

0.39

Migrant Non-Migrant

HIV Positive Cases HIV Negative Controls0%

10%20%30%40%50%60%70%80%90%

100%

19.7

55.6

52.8

18.7

27.6 25.7

Non-Migrants Returned Migrants Active Migrants

Role of Migration-Low HIV among High risk groups in source states-Higher HIV in rural than urban-Higher HIV in spouses of migrants than non-migrants

18.2.2015


Emerging Vulnerabilities: Migration

States with higher vulnerability due to Migration

Mapped migration corridors with large volumes of out-migration to high prevalence destinations36% in the age group of 15-24 yrs66% Married56% had paid sex with female partner in last six months9% had sex with male partners in last six months4.5% injected drugs in last 12 months

Need to increase coverage of migrants at destinations, transit points & source villages, along with their spouses at sourceSource: NACO HIV Sentinel Surveillance 2010-11;

Bridge Population…

18.2.2015




Goal

To help prospective employers to implement a comprehensive program on HIV and AIDS prevention to care, by integrating awareness, service delivery with existing systems, structures and resources, within their business agenda.

18.2.2015


Objectives• Increase awareness and access to HIV

and AIDS prevention to care services for the informal workers

• To create enabling environment by reducing stigma and discrimination against PLHIV

• To encourage and help prospective employers to integrate and sustain the HIV and AIDS Intervention Program within existing systems and structures

18.2.2015


Strategic Approach to design of ELM

• Identifying and prioritising industries for focused advocacy

• Technical Support to ensure ownership by Industries

• Leveraging structures and systems

• Service Delivery Partnerships and quality assurance

• Linkages with mainstream services• Facilitating an enabling

environment

18.2.2015


Processes for Employer Led Model (Organized Sector – PSU and Private Sector Industries )

Prioritizing industries basis risk and vulnerability of Informal workers (Mapping Completed during AAP, vulnerability

assessment to be carried out during intervention)

Senior Management Sensitization from Identified Industries in collaboration of sectoral associations

Structures/Systems to be leveraged Existing health facilities, cost of providing services,

HR/Welfare/health safety program

With Health Facility(Prevention Services)

Integrating ICTC/PPTCT/STI & TB services

CSM through SMOs

Without Health Facility(Prevention Services)

On site health camps Referral linkages to

ESIC, empanelled doctors

Referrals/Mobile ICTC from SACS-Cost by company

CSM through SMOs

Outreach Awareness

Medical Doctor to lead in case of health facility

Through safety sessions

Integrating within existing activities of HR/Welfare/H & S

With Health Facility (Prevention and ART)

Integrating ART, ICTC/PPTCT/STI & TB services within the health facilities

CSM through SMOs

MOU with SACS and training of staffs

18.2.2015


Employer Led Model (Unorganized Sector)

Prioritizing Industries based on risk and vulnerability assessment

Structures/Systems to be leveraged

Associations/Federations/contractors/sub contractors/trade unions etc. from Identified Industries

Outreach Awareness

• Integrating in existing Health and Safety programs

• Through contractors/sub contractors

• Through trade unions e.g Nirman majdur sangh for construction workers

Service Delivery

(Prevention Services )

On site STI clinics in collaboration with Associations/Federations/ Unions

Referral linkages to Public health system,Referrals linkages/Mobile ICTC from SACSCSM through SMOs

18.2.2015


Proposed Sectors – across states

Sectors include..

Cement AutomobileTransport

Steel

Textile

Paper industries

Oil and Petroleum

Fertilizer Manufactur

ing

Power plantsConstructio

n

Seasonal harvesting

Tea Plantation

Mining

Quarry workers

Service Sector (Hotel

Industry)

Fishing

Leather and Tannery

18.2.2015


Key personnel and stakeholders

NACO

• Overall policy directions and guidance

SACS/TSU

• Responsible for roll out and facilitation state level

DAPCU

• Facilitation at district level or in a cluster of districts

Employer Structures

• Initiate, Finance and sustain ELM

• Overall implementation of ELM

• Ownership of ELM

PIPPSE

• Support NACO in developing Operational guidelines

• Technical support and handholding of SACS in roll out of ELM

Employer Associations

• Advocacy with Employers

• Sensitization of Employers on the issue of HIV/AIDS

PLHIV Networks

• Involvement in Advocacy with key stakeholders

MOLE/DOL

• Roll out of the National Policy on HIV/AIDS and World of Work

Trade Unions

• Need based Implementation support to Employers

• Facilitate interventions along with employers

Other Stakeholders

• Facilitate an enabling environment

18.2.2015

Role of industry level actors for implementing ELMs

I. Organized Sector with Health Facility (Prevention Services)

II. Organized Sector without Health Facility (Prevention)III. Unorganized Sector (Prevention Services)


Overall framework of key actors for ELM implementation- Organized Sector

Coordination Committee

- Overall monitoring and supervision of activities along with Nodal officer

Medical Officer at the Health Facility Linked

with Industries - Outreach - STI Services - ICTC Services Report - ART services in case

industry integrating ART services

Medical Officers Conducting Health Camps in case no

health facility

- STI Services - Referral linkages

report for ICTC/ART services

SMOs at State Level

- Ensuring availability of condoms at Industry level

- Reporting of condom

uptake from the outlets nearby the industries to nodal officer

Nodal Officer Identified by Industries(CSR/HR in charge, Medical Officer.

Health safety in charge)Key Roles- Coordinate with different

departments for implementation- Coordinate for reporting- Compiling monthly ELM report

SACS / TI Division Support and

Facilitation by SACS

Outreach

- 1 volunteer :250 workers- One to one and one to

group sessions conducted by peers

- No of Informal workers reached

Supervisors/ Contractors

Senior Management at Industry

18.2.2015


Medical Officers Conducting Health

Camps - STI Services - Referral linkages

report for ICTC/ART services

- Mobile ICTC services

Nodal Officer Identified by Industries

(Supervisor, Chief Contractor, Secretary of society, federation, industry association, Representative from trade unions)- Coordinate with different

departments for implementation- Coordinate for reporting- Compiling monthly ELM report

Coordination Committee

- Overall monitoring and supervision of activities along with Nodal officer

SMOs at State Level- Ensuring availability of

condoms at Industry level

- Reporting of condom uptake from the outlets nearby the industries to nodal officer

SACS / TI Division

Support and Facilitation by

SACS

Outreach

- 1 volunteer :250 workers- One to one and one to group

sessions conducted by peers- No of Informal workers

reached

Supervisors, Contractors

Overall framework of key actors - Unorganized Sector

18.2.2015

CG State Sensitisation workshop on ELM

Institutional Arrangements

NACO SACS/TSU Employer

• TI Division on lead in inter divisional coordination

• PO TI, Consultant PPP (2)• Tech support through

PIPPSE• ELM Coordination

Committee (CC) at NACO

• Dedicate PO-ELM at SACS/TSU

• JD TI (SACS) on lead and inter divisional coordination

• TL (TSU) on support at Districts level• Coordination

Committee at SACS level

• Senior Management• Nodal Officer - Health Facility in

Charge - CSR Head/Head HR• Coordination

Committee involving SACS

Institutional Framework• Intend letter from industries • Proposal of Activities : Co created by SACS/TSU and Industries, signed by all parties • Identification of Nodal Officer by the industries • Formation of Coordination Committee involving all stakeholders, including SACS/TSU

representation • MOU for the services in PPP mode • Reporting from industries (Nodal officer) to SACS • Monitoring and Supervision by Coordination Committee

2018.2.2015


Tamil Nadu

Gujarat

Odisha

Mahara

shtra

Uttarakhand

Punjab

Uttar Pra

desh

AhmadabadGoa

Bihar

Kerala

W.Benga

l

Chhatisgarh

Mumbai

Andhra P

Delhi

Rajasthan

Jhark

hand0

2

4

6

8

10

12

14

16

18 17

76 6

54 4

3 3 3 32

1 1 1 1 1 1

Statewise no of industries under ELM

18.2.2015


Texti

leSte

el

Automobile &

Tran

sport

Constructi

on

Cement

MiningDair

y

Ferti

lizer M

anufac

turing

Oil & Petro

leum

Servi

ce Se

ctor

Port

Power plan

ts

Associa

tion & Cooperati

ve

Tobac

co

Diamond M

anufac

turing

Manufac

turing

Electr

onics

Leath

er & Ta

nnery0

2

4

6

8

10

12

14

16 15

8 8 8

6

3 3 32 2 2 2 2

1 1 1 1 1

Sector wise industries under ELM

18.2.2015


Awareness Testing STI ART Condom (free/SM)

Onsite health camps

Any other0

10

20

30

40

50

60

70

80

64

3134

5

18

5 3

Total Industries (69)

Service wise seggregation of industries

Number of industries involved Total industries

18.2.2015


Key take always of ELM.

• Clear model to be presented to CSR boards• Sustaining motivation of industries through

constant interaction and support through SACs

18.2.2015

Discussions & Thanks

Dr K Madan Gopal9999189794

[email protected]@gmail.com

mailto:[email protected]

mailto:[email protected]

Healthcare

Engaging with industries elm model