engaging with industries elm model
TRANSCRIPT
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
CG State Sensitisation workshop on ELM 3
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
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CG State Sensitisation workshop on ELM 4
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.
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CG State Sensitisation workshop on ELM 518.2.2015
CG State Sensitisation workshop on ELM 6
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
CG State Sensitisation workshop on ELM 7
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…
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CG State Sensitisation workshop on ELM 818.2.2015
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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.
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CG State Sensitisation workshop on ELM 11
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
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CG State Sensitisation workshop on ELM 12
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
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CG State Sensitisation workshop on ELM 13
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
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CG State Sensitisation workshop on ELM 14
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
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CG State Sensitisation workshop on ELM 15
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
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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
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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)
CG State Sensitisation workshop on ELM 18
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
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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
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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
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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
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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
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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
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Key take always of ELM.
• Clear model to be presented to CSR boards• Sustaining motivation of industries through
constant interaction and support through SACs
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