The first two processes in the new national standard for HIV AIDS management in South Africa SANS 16001 :2007 A-P-I-M-E cycle are Assessment and Planning. These two critical processes require a closer look as the success of the strategy depends on accurate and reliable assessment and excellent planning. Linzi Smith, Director of Education, Training and Counselling (ETC) in South Africa, provides some insight.
The assessment phase of the standard aims to determine the risk of HIV AIDS to the company, the company needs, available HIV AIDS related services and systems, including testing and treatment, and efficacy of such systems and services.
A number of assessment tools can be used to determine the needs and risks of the organisation. These include:
- A Situational Analysis of current HIV AIDS risk management systems including an analysis of past interventions and their effectiveness, with input from the HR manager, financial manager and medical personnel.
- Actuarial Economic Impact Survey – The HIV AIDS information from the Situational analysis is fed into an Actuarial model which projects the economic impact on the organisation within various scenarios and recommendations for managing such scenarios.
- An anonymous KABP survey (Knowledge, Attitudes, Behaviours and Perceptions) of the employees to determine their current knowledge level, risk behaviours, attitudes towards and perceptions of HIV AIDS related issues. These insights assist management to put in place good destigmatisation processes prior to attempting to offer HIV AIDS testing. It also directs the educational component of the programme.
- Prevalence Survey – This is the anonymous linked or unlinked HIV AIDS testing of as many employees that agree to participate, providing management with an indication of the prevalence of infections.
There are enormous drawbacks to doing stand-alone prevalence HIV AIDS testing, including:
- Unions may hold up the process and prevent important epidemiological HIV AIDS information from being gathered, preventing management from intervening in the high-risk population groups in the company.
- Any non-participation can skew the prevalence results, especially if those that do not participate are in the highest risk group.
- Employees do not get their results, preventing them from managing their illness and the management of subsequent absenteeism and loss of productivity.
- Prevalence surveys are simply a snapshot of the situation at a given point in time, but do not provide any insight into the future.
KABP surveys together with actuarial surveys are better for planning purposes as they include current behaviours and possible outcomes based on scenario planning.
The planning phase entails planning and developing a customised HIV AIDS management intervention based on the assessment and setting targets, objectives and success criteria. Responsibility and resources are allocated to carry out the intervention.
The steps are as follows:
- Select a fully representative HIV AIDS committee according to the Department of Labour Code of Good Practice, including senior representation e.g. the CEO, Financial Director or HR Director.
- Train the HIV AIDS committee.
- Workshop to develop a HIV AIDS Policy and procedures with the HIV AIDS committee.
- Develop a project plan to implement the HIV AIDS policy and procedures.
- Set project plan targets and objectives, success criteria, budgets, timelines and allocate responsibility.
Parts of the assessment phase and planning phase can be done concurrently.
In our next article, we consider some of the steps and issues in the Implementation, Monitoring and Evaluation phases of this new standard for HIV AIDS management in South Africa.