Ethiopia

Programme overview

As part of the global ILO and US Department of Labor Partnership on HIV/AIDS and the World of Work responses, ILO/USDOL International HIV/AIDS Workplace Education Programme in Ethiopia has been initiated along with other programmes of similar nature supported by Swedish International Development Agency and Italian Cooperation. The programme Started in May 2004 and ended in March 2008 focusing on piloting work place HIV/AIDS prevention and control activities through provision of technical support and a workplace focused Comprehensive Behavioural Change Communication (BCC) intervention in enterprises and the ILO constituents. The programme had a total budget of US$ 859,988.00 for four years with an overall gaol of “creation of sustainable programme to combat HIV/AIDS in the world of work with combined stakeholders’ effort”. The programme had 2 development and 4 immediate objectives.

Development objectives

• Reduced HIV/AIDS Risk Behaviours Among Targeted Workers
• Reduced level of Employment-related Discrimination against Persons Living with HIV/AIDS

Immediate objectives

• Improved Knowledge, Attitudes and Perception of Norms Related to HIV/AIDS Risk Behaviours
• Increased Use of Available HIV/AIDS Workplace Programmes
• Reduced Stigma against Persons Living with HIV/AIDS
• Increased Knowledge and Understanding of HIV/AIDS Workplace Policies

Programme achievements

Fifteen enterprises were piloted and workplace HIV/AIDS education programme were introduced. New HIV/AIDS committees had been formed and the existing ones were strengthened through training, technical support and other capacity building initiatives. The impact assessment shows that the knowledge about HIV/AIDS transmission and protection amongst workers has increased. Despite the existence of misconceptions, the programme has also brought significant improvement on the attitude of the workers towards people living with HIV/AIDS. Different communication materials (IEC/BCC materials) including posters, leaflets, billboards, audiovisuals that address different issues related with HIV/AIDS were developed and used. All of the enterprises covered by the pilot programme had developed a workplace HIV/AIDS policy and the policy documents were printed and distributed among the workers. Moreover, there was a significant increase in the respondents’ level of awareness about the type of HIV/AIDS related services available in their workplace and the respondents’ access to HIV/AIDS related services and information in the workplace settings. The programme was preceded by a mapping exercise that helped identify 15 enterprises of 7 sectors with 50,000 workforces as target under the sectors.

Major programme activities

There was extensive workplace education activities for 4 years in the 15 selected enterprises and also capacity building activities within the tripartite and tripartite plus constituents including Ministry of Labour and Social Affairs (MOLSA), Ethiopian Employers Federation (EEF), Confederation of Ethiopian Trade Unions (CETU) Federal Civil Service Agency (FCSA), Federal Micro and Small Enterprise Development Agencies (FEMSEDA) and Down of Hope (a PLHIV Association) with most important outputs of the programme including:

• Preparatory works and briefings:this includes activities of MOU signing with government (MOLSA) and service contract agreements following the mapping exercise, formative assessment and development of BCC strategy and introduction of this strategy to enterprises and implementing partners. There were also briefings of workplace policies, BCC strategy and mainstreaming for various groups including directors, deputies, HR managers and unions of enterprises.
• Workshops and trainings: There were workshops on topics including familiarization of National Workplace Policy Framework and the BCC strategy, collective agreements to textile enterprises’ managers and labour union leaders, accelerating the private sectors’ response to HIV/AIDS and also had sustainability and dissemination workshops. Major types of trainings were Peer Education and Master Trainers and TOT on Peer Education, Monitoring and Evaluation of HIV/AIDS Programmes, Policy Formulation, Mainstreaming, Occupational Safety and Health and HIV/AIDS Prevention at Workplaces and also Private Sector AIDS Responses.
• Production and distribution of IEC materials: The programme also helped development distribution of extensive IEC materials including newsletters, leaflets, policies, banners, flip charts and also a local documentary film. There 300,000 leaflets produced on ten identified topics including HIV/AIDS and Gender, Stigma, Nutrition, ART and VCT.
• Monitoring and evaluation: The programme had regular programme advisory board meeting and technical progress report throughout, midterm review as well as baseline and impact surveys.

Programme impacts

In general, the Programme has successfully met its development objectives in reducing workers HIV related risky behaviours and reducing stigma and discrimination against workers living with HIV/AIDS. Moreover, the Programme has built the capacity of its stakeholders to implement a sustained HIV/AIDS programme. An impact survey conducted at the end of the project had supportive findings including:

• All 15 enterprises have started education activities and prevention and control services.
• Enterprises organized committees and focal persons together with the existence of workplace polices and guidelines.
• The proportion of workers that received HIV/AIDS related education increased eight fold (from 3.3 percent at baseline to 24.2 percent at the end).
• Awareness of workers on the availability of any HIV/AIDS related services at workplace was doubled (from 40.6 percent in the baseline to 82.3 percent in the impact assessment)
• Percentage of ever-tested for HIV increased by 19 percent (from 25.8 percent in the baseline to 44.8 percent in the impact assessment)
• There are 3 out of 15 enterprises that allocated regular programme budget to support and sustain the workplace HIV/AIDS interventions.
• The national tripartite policy on HIV/AIDS and the world of work has been adopted

The way forward

Due to improved capacity of implementing partners including the government (MOLSA) and the 15 enterprises with the existence of the National Workplace Policy Framework, workplace policies and availability of the a tested appropriate BCC strategy and tools of workplace education programmes including the peer educators, peer education manual various IEC materials, those workplaces involved in the programme are currently in a state of better position to plan, implement and monitor workplace HIV/AIDS Programmes.

But most of these organizations do not yet have yet allocated enough resources to continue and strengthen initiated activities. There is a need to strengthen initiated activities and effectively mainstream HIV responses. There are more than a thousand peer educators trained and deployed at enterprises. These peer educators must get continued refresher training and replacement. Moreover, with improved knowledge and reduced stigma, demands to services including condoms, VCT and ART are increasing while the health care services in these workplaces are limited.

Potential areas of actions recommended as part of the continuation of the programme include:

• Extension and Scale up of the education programme
• Initiation of Strengthening of HIV/AIDS Mainstreaming
• Strengthening and initiation of services
• Capacity Building
• National Workplace Policy Framework familiarization

Key lessons learnt from this programme include that the issue of behaviour change at the individual level and mainstreaming of HIV/AIDS at the enterprise level is a time demanding process yet worth implementing for it will make a huge difference in reducing risky behaviour as well as reducing stigma and discrimination against workers living with HIV/AIDS. To sustain the changes over longer period, strengthening the already initiated and proven to be effective approaches like upgrading the HIV/AIDS committees to the level of an association in all the enterprises and greater involvement of decision makers at all levels is crucial.