Employee Wellness: India

Employee Wellness as a Strategic Priority in India

Preventing the Burden of Non-communicable Diseases through

Workplace Wellness Programmes

COMMITTED TO IMPROVING THE STATE

OF THE WORLD

Report of a Joint Event of the World Economic Forum and

the World Health Organization CountryOffice for India

In cooperation with Public Health Foundation of IndiaWorld Health Organization Country Office for India

World Economic ForumSeptember 2009

Employee Wellness-India:Layout 1 09.09.09 17:24

The views expressed in this publication do not necessarily reflect those of the World Economic Forum.

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© 2009 World Economic ForumAll rights reserved.No part of this publication may be reproduced or transmitted in any form or by any means, including photocopying andrecording, or by any information storage and retrieval system.

REF: 150909

This report was written by Ambika Satija and Puja Thakker of the PublicHealth Foundation of India, with support from Vanessa Candeias TeixeiraRodrigues and Godfrey Carmel Xuereb of the World Health Organization,J. S. Thakur and Kavita Venkataraman of the World Health OrganizationCountry Office for India, and Eva Jané-Llopis, Chronic Disease andWellness Initiative at the World Economic Forum.

Employee Wellness-India:Layout 1 09.09.09 17:24

Contents

Executive Summary 2

Commitment from the Meeting 3

1. Introduction: The Burden and Causes of NCDs 4

2. Rationale: Why Invest in Workplace Wellness? 6

3. Evidence: Workplace Wellness Works 8

4. The WHO India/World Economic Forum Joint Event on Employee Wellness as a Strategic Priority in India 10

5. Barriers and Opportunities 11

6. Strategy for a Successful Programme 15

Model for Setting up a Workplace Wellness Programme 18

Monitoring and Evaluation 21

Bringing It All Together: The Power of Comprehensive Interventions 22

7. Conclusions and the Way Forward 25

Outcomes of the WHO India/World Economic Forum Joint Event 25

References 27

Annex 1: Agenda of the Joint Meeting of the World Economic Forum and World Health Organization

Country Office for India 29

Annex 2: List of Participants 32

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Background: NCDs and Workplace Wellness Non-communicable diseases (NCDs) are on the riseglobally, and the low and middle income countries(LMICs) are the worst hit – 80% of projected deathsfrom NCDs in 2005 occurred in LMICs, according toa World Health Organization (WHO) report. India isalso on the brink of an NCD epidemic – the burdenit faces is high in terms of mortality, morbidity andeconomic productivity, and it stands to facesignificant loss if effective NCD prevention strategiesare not implemented. The good news, however, isthat NCDs are to a great extent preventable, as theirmain underlying causes are modifiable lifestyle-related, behavioural and environmental factors.

Focusing on the workplace for the prevention ofNCDs has a double target: health and businessreasons. India’s growing working population and thehigh NCD burden among its workforce make theworkplace ideal for NCD prevention. The economicbenefits of NCD prevention at the workplace foremployers are vast, including reduced absenteeism,reduced injuries and workers’ compensation costs,reduced healthcare costs, reduced employeeturnover, increased productivity and profits, greaterworker satisfaction, improved morale, and increasedattraction of talent and potential employees to theworkplace. Thus, focusing on workplace wellness issupported by the ethics of corporate responsibility,as well as by the rationality of corporate profitability.

Barriers and Opportunities Various barriers and opportunities should beconsidered and analysed while designing andimplementing employee wellness programmes.Barriers and opportunities are discussed in thisreport with respect to attitudes, employers,employees and capacity development. While facinghurdles is disheartening, it must be remembered thatbarriers transform over time into facilitators, and thatevery barrier has a hidden golden opportunity forchange and transformation – this is why everyperceived barrier has been presented with anopportunity to overcome it.

Strategy for a Successful Programme To overcome barriers and make optimal use of theavailable opportunities, an employee wellnessprogramme should follow a “strategy for success”.This strategy has four key elements that must beincorporated into a wellness programme in a

coordinated manner: leadership, people, culture andprocess. Only when all of these are addressed in acomprehensive way can an employee wellnessprogramme be successful.

Model for Developing a Healthy WorkplaceFor workplace wellness programmes to accomplishthe above, they must be designed, implementedand evaluated in a systematic manner. WHO Indiahas developed a schematic model to describe theprocess of developing, implementing and evaluatingworkplace wellness programmes. The process startswith the formation of a wellness committee thatundertakes the baseline evaluations and situationassessments, on the basis of which health policiesare chosen, implemented and then evaluated.

Monitoring and Evaluation of WorkplaceWellness Programmes One step in the above-mentioned model is themonitoring and evaluation of wellness programmes.It is essential that time and resources are invested inthis, as it is only through constant monitoring at thebaseline during the implementation process, as wellas of the outcomes of the programme, that anyimprovements can be made in the policies andprocesses of the programme and best practicesdocumented. Also, it is only with the demonstrationof the success of the programme that theinvestments made can be justified.

World Economic Forum and World HealthOrganization Country Office for India JointEvent The World Economic Forum and the WHO CountryOffice for India jointly convened a meeting on“Employee Health as a Strategic Priority in India”.This joint event was held in New Delhi, India, on 14-15 November 2008. Participants included keystakeholders from the commercial sector, academia,non-governmental organizations (NGOs), the UnitedNations and other international organizations.Existing barriers and potential opportunities inworkplace wellness programmes in India werediscussed, as well as the rationale for workplacewellness investment in India, strategies forsuccessful programmes, how to implement theseprogrammes, their monitoring and evaluation, andhow to adapt these programmes to small andmedium enterprises.

Executive Summary

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Conclusions and Way ForwardBusiness leaders must join the fight to containNCDs. It is not only altruism but also enlightenedself-interest. Investing in the health of employeesincreases productivity, cuts down spending onhealthcare costs, reduces turnover and attracts

talented individuals. Such an investment is inalignment with India’s economic and developmentpriorities as a nation and an essential step in thefostering of a healthy workforce, nationally andglobally.

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Commitment from the Meeting

At the World Economic Forum and the WHOmeeting in New Delhi in November 2008, severalcommitments were put forward to advanceemployee health, which was unanimouslyacknowledged as a strategic priority for India.Multistakeholder action was identified as the singlemost effective vehicle for change. In line with this,the creation of a council inclusive of severalministries, corporate leaders and civil society, with

international organizations such as the WorldEconomic Forum and the World Health Organizationplaying the foremost role of stewardship, wasrecognized as the primary course of action. ThePublic Health Foundation of India was identified as akey organization positioned to bring togethermultiple stakeholders on a platform for action.Annexes 1 and 2 provide the agenda for themeeting and a list of the participants.


As India pursues a pathway of acceleratedeconomic development, growth in industrial andservice sectors offers more employmentopportunities. Promotion of employee health shouldbe recognized as a prioritized need, as it representsa prudent investment for enhanced productivity andalso signs responsible corporate conduct. Thegrowing realization that health and economic growthhave a bi-directionally reinforcing relationship is nowbeginning to foster investment in workplace wellnessin many countries. Workplace health programmesprovide protection against occupational healthhazards and first line treatment for medicaldisorders. It is important that India adopts“workplace wellness” as an important pillar of itsgrowth strategy.

Burden of Non-communicableDiseases

Globally, six out of 10 deaths are due to non-communicable diseases (NCDs – see box 1).Cardiovascular diseases (CVDs) are the leadingcause of death in the world, particularly amongwomen1. According to the World Health Organization(WHO) report Preventing Chronic Diseases, a vitalinvestment, 60% of the projected 58 million deathsin 2005 and almost 50% of the projected globalburden of disease for 2005, as measured byDisability Adjusted Life Years or DALYs*, in the worldwere due to NCDs, with the four major NCDs –CVDs, cancer, diabetes and chronic respiratorydisease – accounting for most of this burden. Whiledeath from infectious diseases, maternal andperinatal conditions and nutritional deficiencies areexpected to decline by 3% by 2015, deaths fromNCDs are expected to increase by an alarming 17%over the same duration2.

Although the rise in NCD burden is a globalphenomenon, it is the low and middle incomecountries that face the biggest challenge. WHOreports that a staggering 80% of deaths from NCDsoccur in developing countries2.

India is no exception to this trend – the major NCDs,including CVDs, diabetes, cancer and chronicrespiratory disease, accounted for 53% of allprojected deaths and 44% of DALYs in India in2005. Over the period 2005-2015, while deathsfrom infectious diseases, maternal and perinatalconditions and nutritional deficiencies are expectedto decrease by 15%, deaths from NCDs areexpected to increase by 18%, and, mostsignificantly, deaths from diabetes are expected toincrease by 35%3. The cost of this burden cannot beignored.

In 2005 alone, India lost US$ 9 billion of its nationalincome due to NCD deaths, and by 2015 isprojected to lose US$ 237 billion in national incomedue to deaths from CVDs, stroke and diabetes4.

1. Introduction: The Burden and Causes of NCDs

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* A measure of the years lost to disease, calculated bycombining the healthy years lost due to premature deathfrom the disease, and the number of years spent in illhealth due to the disease; one DALY can be taken tomean one lost year of healthy life.

What is Health and Wellness? In the preamble to the Constitution of the WorldHealth Organization (1948), health is defined as“a state of complete physical, mental and socialwell-being and not merely the absence of diseaseand infirmity”*. Health and wellness refer to astate of physical, mental, social and spiritualbalance, and the ability to make choices that helpachieve or maintain such a state of balance.Workplace wellness in this sense refers to allthose activities that are designed to help andsupport employees and their families followhealthy lifestyles that are conducive to achievingsuch a state of well-being.

What is a Non-communicable Disease?A non-communicable disease is an illness thatpersists for a long duration. It usually progressesslowly, and unlike infectious diseases, cannot beprevented by vaccinations, nor can it betransmitted from person to person. The majorNCDs include cardio-vascular diseases (CVDs)such as heart attack; stroke; diabetes; cancerssuch as breast cancer and prostate cancer;chronic respiratory disease (CRD) such asasthma; bone and joint impairments such asarthritis; vision and hearing impairments; oraldisorders, etc. Mental disorders, such asdepression, dementia, schizophrenia and anxietydisorders also fall in this category due to theirchronic nature.

Box 1


Tremendous gains can be made with even thesmallest of reductions – according to WHO, anadditional 2% annual reduction in NCD death ratesbetween 2005 and 2015 would result in anaccumulated gain in income of around US$ 15billion in India2.

The Causes

One characteristic feature of most NCDs is that theyare mainly caused by lifestyle, behavioural orenvironmental factors, most of which are modifiable.A small number of such modifiable lifestyle-relateddeterminants are accountable for most of the majorNCDs. The most important of these are anunhealthy diet and excessive energy intake, physicalinactivity (all of which lead to overweight/obesity) andtobacco consumption. Other important changeablerisk factors include excessive alcohol consumption,psycho-social factors such as stress, andenvironmental toxins. In conjunction with the non-modifiable risk factors of age and genetic heredity,these account for most of the NCD burden we seetoday2.

India’s risk factor profile has been worsening overthe decades, and is now a cause for concern.Around 17% of males and 15% of females abovethe age of 15 years have a body mass index (BMI)**above 254, and these figures are even higher inurban areas, being 22.2% and 28.9% respectively5.In fact, some risk factors such as physical inactivity,inadequate fruit and vegetable consumption andunhealthy alcohol consumption have been found tobe higher among Indians and South Asians relativeto individuals in other regions6.

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** BMI is a statistical measure of a person’s weight relative toheight. A BMI of 25 kg/m2 is considered the global cut-offfor overweight, and that of 30 kg/m2 is considered theglobal cut-off for obesity.


NCDs are costly to employers in a direct way.Modifiable risk factors such as smoking, lack ofexercise, alcohol use, poor nutrition, obesity andhypertension increase an employer’s healthcareexpenditures by 25% and are currently estimated toaccount for 2.1% of gross domestic product inIndia. In today’s market-driven, competitive world, acapable and resilient employee is an importantresource and fundamental to productivity. NCDs arethe prime cause of lost work time in the working-agepopulation. An Indian industry survey identified thatlifestyle-related illnesses account for 27% of illnessesamong employees. A quarter of the respondentfirms lost approximately 14% of their annual workingdays due to sickness7. In India, productive years oflife lost to cardiovascular disease alone will almostdouble between 2000 and 20302.

Being lifestyle-related diseases, NCDs must betackled at all stages of an individual’s life and in allspaces that an individual occupies – at home, atschool and in the workplace. Globally, 65% of thepopulation over the age of 15 is in the productiveyears and spending one fourth of its time in theworkplace. In absolute terms, this translates into3.18 billion people, a figure that is projected toincrease to 3.68 billion by 20208. In India, 58.5% ofthe population aged 15 years and above is currentlyeconomically active7. Thus, the working population inIndia is a huge, concentrated population which iseasy to target and, by implication, one in whichresults can show quickly and be substantial.

Interventions to improve nutrition, encourage regularphysical activity and avoid the use of tobacco andharmful alcohol use are cost-effective and canreduce up to 80% ill health and premature deathsdue to NCDs. Reducing just one health riskincreases an employee’s on-the-job productivity by9% and cuts absenteeism by 2%. In fact, preventivehealthcare activities at the workplace have beenfound to be related to increased profits of Indiancompanies7,9.

NCD prevention through workplace wellnessprogrammes is also important in the context of theincreasing sedentary nature of work. The servicesector is increasingly becoming the predominantemployment sector in the world – globally in 2006,for the first time the share of employment in theservice sector overtook that of agriculture, with 40%of employees working in the former9. In India theemployment share of services has also been steadilyincreasing, from 18.1% in 1965 to 23.5% in 200010.The workplace is also full of the pressures andstrains of deadlines and performance, and the highlevels of stress and burnout reported by Indianemployees confirms this. A recent survey by theAssociated Chambers of Commerce and Industry ofIndia (ASSOCHAM) found that work-related stress

2. Rationale: Why Invest in Workplace Wellness?

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Benefits of Workplace Wellness Programmesto Companies• Reduced absenteeism• Reduced injuries and workers’ compensation

costs• Reduced healthcare costs• Reduced employee turnover• Increased productivity and profits • Greater worker satisfaction• Improved morale• Increased attraction of talent and potential

employees to the workplace


and mental fatigue are common problems reportedby Indian employees not only in the areastraditionally associated with work stress such as theIT and BPO sectors, but also in many other sectors,including construction, shipping, banking, media,small-scale industries, trading houses andgovernment hospitals11. The high concentration oflifestyle-related NCD risk factors in the workplacemakes it imperative that preventive efforts befocused there.

A healthy population is an economically productivepopulation, and it is in the benefit of companies tosafeguard public health. Given the heavycontributions of the private sector to the economy,employee wellness programmes are not only astrategic priority for India, but also an economicimperative for corporations.

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Why the Workplace is Ideal for NCDPrevention• An easy, concentrated population to target• Multiple levels of influence can be used –

direct, such as the provision of healthy food,and indirect, such as creating a supportiveenvironment

• Possible to link workplace health promotion toother programmes at the workplace, such asoccupational safety programmes

• Concentration of lifestyle-related risk factors atthe workplace

• The workplace has been recognizedinternationally as an important healthpromotion setting


There is considerable evidence suggesting thatworkplace wellness programmes aimed atpreventing NCDs through lifestyle changes areeffective, although this evidence is by no meansexhaustive. Employee wellness programmes havebeen seen to have various types of effects, withimprovements observed in anthropometric*,behavioural, psychological and economic outcomes.

Anthropometric Outcomes

A review of workplace intervention programmesfocusing on weight control found that these wereable to produce a reasonable amount of short-termweight loss among the employees12. Similar resultswere found by Petersen et al. (2008) for an Internet-based employee weight-management programme –in fact, increased website use was associated withincreased weight loss13. The effect of such wellnessprogrammes on other physiological risk factors suchas hypertension14 and endothelial function**,15 hasalso been found to be positive.

Behavioural Outcomes

The three most important lifestyle-relateddeterminants of NCDs are physical inactivity, dietand substance abuse, in particular tobaccoconsumption. Workplace wellness programmes havebeen found to improve all these behavioural riskfactors.

Physical ActivityA number of techniques have been used toencourage physical activity at the workplace. Asystematic review of the effectiveness of workplacephysical activity interventions found the use ofpedometers to increase daily step counts, walking towork (active travel) and workplace counselling tohave a positive impact on physical activitybehaviour16. Counselling as a technique to increaseenergy expenditure and cardio-respiratory fitnesswas found to be effective in a Randomized ControlTrial as well17. Another study found acommunications-based campaign to be effective inincreasing knowledge of physical activity andencouraging walking18.

Diet A diet high in fats and sugars and low in fruits andvegetables has been identified by WHO19, WCRF20

and many other international organizations as a riskfactor for NCDs. Several interventions at the workplace

3. Evidence: Workplace Wellness Works

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* Anthropometry refers to the measurement of the humanbody; in this context, it implies all body dimension andphysiological measurements such as BMI and bloodpressure.

** Endothelial function refers to the functioning of theendothelium, which is the layer of cells lining the interior ofblood vessels and the heart.


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are aimed at improving the dietary habits ofemployees. For instance, the Heartbeat Award (HBA)scheme, which is a nutrition labelling scheme inEngland was found to be effective in increasing fourhealthy dietary behaviours – increased fruitconsumption, reduced fried food and sweetsconsumption, and a switch to lower fat milk21. Anothercomprehensive intervention programme designed totarget multiple levels of influence22 was found to beeffective in increasing fruit and vegetable intakeamong employees. This increase was much more inthe workplace-plus-family intervention relative to theworkplace-only intervention, highlighting theimportance of multi-component programmes.

Substance Abuse Programmes targeting substance use/abuse byemployees have been found to be effective inreducing tobacco consumption23 as well as alcoholabuse24. These intervention programmes have alsofound to be economically profitable for companies25,particularly since substance abuse can greatlyhamper an employee’s productivity.

Psychological Outcomes

Frequently, workplace wellness programmes have amental health component aimed at relieving stressand enhancing the feeling of well-being. In a reviewof workplace interventions to promote mental well-being, it was found that psychosocial interventioncourses, stress management training, counsellingand therapy, physical exercise and health promotioninterventions have a positive impact on mental well-being26. Physical activity programmes at work inparticular have been shown to enhance subjectivewell-being and enthusiasm of the employees atwork27, 28.

Economic Outcomes

Various types of programmes have been observedto enhance productivity and profitability. One studyfound work health promotion to decrease sicknessabsences and enhance work ability29, while anotherstudy found an employer incentive/disincentiveapproach to be effective in reducing illness-relatedabsenteeism30. Workplace physical activityprogrammes have also been seen to have positiveeffects in this regard, and have been found toreduce health-related impairments in timemanagement, physical work, output limitations,overall work impairment and short-term disabilityworkdays lost31.

Another study found workday exercise to improvewhite-collar workers’ mood and self-reportedperformance32. Overall workplace wellnessprogrammes have been found to be economicallybeneficial for organizations, brining about reductionsin sick leaves, health plan costs, workers’compensation and disability costs33.


4. The WHO India/World Economic Forum Joint Eventon Employee Wellness as a Strategic Priority in India

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Following several recent consultations in Davos andDalian, the World Economic Forum and the WorldHealth Organization jointly convened a meeting on“Employee Health as a Strategic Priority in India” inNew Delhi, India, on 14-15 November 2008.Employee wellness was unanimously acknowledgedas a strategic priority for India.

A clear need for dramatic change was reiterated,through ideas such as creating a new code onpublic health to be adopted by companies, withinterventions extending not only to the employee butalso to families and communities. Multistakeholderaction was identified as the single most effectivevehicle for change.

The immediate course of action identified at thismeeting was the creation of a council inclusive ofseveral ministries, corporate leaders and civil society,with international organizations such as the WorldEconomic Forum and the World Health Organizationplaying the foremost role of stewardship. The PublicHealth Foundation of India was identified as a keyorganization positioned to play a convening role inbringing together multiple stakeholders on a platformfor action, with support from organizations such asthe Confederation of Indian Industry, the IndianAssociation of Occupational Health, and theInternational Labour Organization.

The next sections of this report reflect the scientificevidence presented during the Joint Event, andhighlight the key aspects discussed by theparticipants. Annexes 1 and 2 provide the agendafor the meeting and a list of the participants.


5. Barriers and Opportunities

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The increasing prevalence of NCDs is a relativelynew phenomenon in India, and the concept ofhaving wellness programmes at the workplace toprevent them is an even newer one. Barriers toimplementation of workplace health promotionprogrammes exist. However, many barriers becomefacilitators over time, and it is important that we lookfor opportunities within these barriers, as well asaspects of the Indian context that provide us with

unique avenues of initiating and sustaining change.The following section details the discussions of themeeting about barriers and opportunities relevant tothe India context.

There are four main types of barriers andopportunities – related to attitudes, employers,employees and capacity development – in additionto some general, overarching ones (see figure 1).

Figure 1: Potential Barriers and Opportunities Related to Implementation of EmployeeWellness Programmes in India

Barriers Opportunities

General Barriers and Opportunities 1. High NCD burden Possibility of making dramatic change

2. Global financial crisis affectingIndian companies – global economywill pose a challenge

Health as an investment

Attitudinal Barriers and Opportunities 3. Lack of awareness of the

implications of the NCD epidemicGrowing global recognition of NCDs, their potential impact and the opportunity touse national and local media to get the message across to the public a. Health is getting linked to productivity and profitability

4. Health is considered a philanthropicissue

b. Great opportunity to redefine human agenda to talk about human happinessand human well-being

c. Idea of creating a new code on public health to be adopted by companies andcountries

5. Preventive care lacks incentive –the focus is on curative health

a. Scope for appropriate policies and programmes for preventive healthcareb. High quality expertise in IT and medicine providing resources for state-of-the-art

work interventions

Barriers and Opportunities Related to Employers 6. Lack of visibility of leadership –

need to reach decision-makersReach out to chief executives (CEOs):• Through industry employee organizations• Engage CEOs from outset to be champions• Make and show business case• Capture CEOs emotions• Use the right language (tailor messages)• Non-cost, high return, simple interventions (e.g. information, environment)• Use of the media • Goal setting – 10 commandments to implement this year• Incentives – awards systems to best workplaces

7. Concern of employers regarding theemployees time

How can it be integrated so it does not detract from time?a. Make the case that it is cost effective by being an investment b. Find efficient delivery channels and structural support (e.g. sport, gym)c. Identify a menu of options to choose from (adaptable to workforce at any time)d. Management support medium and high levelse. Identify existing opportunities for health in existing structures rather than adding

(e.g. canteen, design)f. Go beyond individual education (environmental change) g. Health as a human right and not just business


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Barriers Opportunities

Barriers and Opportunities Related to Employers8. Employers are worried about issues

related to unionism (changing foodmenus, etc.)

Promote trade union leadership – getting unions engaged from the start

9. Issues related to high attrition incompanies

Workplace wellness as an incentive for employees to join the company and stay in it

Barriers and Opportunities Related to Employees 10.Engaging employees in health

programmes is difficult (lack ofvisibility and transient, if any); andlack of interest of youngeremployees in NCD prevention

Bottom-up approach (increase awareness to create demand for health):• Educate employees about their rights• Scope for creating healthcare opinion-makers among employees –

empowerment • Using other employees as vehicles for messages• Employees as champions (incentives)• Personal experience with diabetes and heart diseases• Capitalizing on family ties

11.Issue with annual health check-up –fear of losing job due to bad healthperformance

Ensure employee trust in confidentiality

Barriers and Opportunities Related to Capacity Development 12.Capacity gap a. Lack of a conceptual framework that explains why the change should happen

b. No Indian data showing that prevention is better than curec. Lack of more real-life data on the effect of NCDs on companies in India d. Lack of HP material specific to industriese. Create best practices in healthcare f. Network of people for sharing what is being done, barriers faced and how they

are being overcome g. Use existing organizations (e.g. CII) to disseminate informationh. Create a common set of HP materials to be used by all workplaces

13.Various interventions – what are thedifferent options available and theircosts?

Ensure employee trust in confidentialityWhat should be provided as a WHP? Menuof programmes:• Screening and medical check-up (tobacco, hypertension, diabetes, alcohol)• Support provision of treatment (as ethical practice)• Information and awareness raising• Health styles change guidelines – health promoting environments (canteen, low

salt/sugar food, tobacco, alcohol); include stress and posture as key• Structural and functional changes to workplace• Informal sector: self-help groups sensitization• Reimbursement for prevention/promotion

14.Management barriers – nobody tomanage workplace wellnessprogrammes

Ensure employee trust in confidentialityWhat should be provided as a WHP? Menuof proNeed to create a cadre of management personnel

15.Environmental barriers: availabilityand affordability to be physicallyactive and eat healthy

Structural and environmental changes are needed – do not only put theresponsibility on the individual to make this change


The main overarching barrier to implementingwellness programmes at the workplace is the globalfinancial crisis, which is bound to compromise theextent to which Indian companies and organizationscan spend on workplace wellness. However, ifworkplace wellness is seen as an investment asopposed to an expenditure, the global economicdownturn can become an opportunity to enhanceand augment human resources and better securethe future of an economy that is increasingly servicesector dominated.

The second set of barriers is attitudinal. Being newto NCDs and having faced a disproportionately highburden of infectious diseases, pregnancy-relatedconditions and under-nutrition for a considerableperiod of time, LMICs are only beginning tocomprehend the seriousness of the potentialnegative impact of a high NCD burden. Moreover,health has traditionally been perceived as a matter ofsocial welfare that lies within the domain of thegovernment, and not something in which the private,corporate sector should be involved. Even wherehealth has been recognized as a priority, almostcomplete focus has been on curative services, withnot enough emphasis given to preventive care – highhealth-care costs incurred by corporations attest tothat.

However, as more and more evidence highlights theeconomic gains to be made by corporations if theywork towards enhancing the health of workers, theglobal perception is rapidly changing from health associal welfare to health as business and an asset toproductivity and profitability. India must align itselfwith this global thinking, and look at its workforce asa vital human resource to be invested in for futureproductivity. It must create and impart a new codeon public health, specifically to be adopted bybusiness firms and corporations, so that healthbecomes a part of the value system of all firms inthe country.

There are also several barriers and opportunitiesrelated to employers, the most important ones beinglack of visibility of leadership in workplace wellness,the perception that health interventions take up aconsiderable amount of time of employees, andconcerns about the reaction of union members tothe drastic changes a workplace wellness

programme might introduce (for instance, changingfood menus to substitute high fat and sugar optionswith healthier ones might create resentment at thewithdrawal of acquired rights). Most of theseproblems stem from a lack of awareness andinvolvement. It is thus essential that all key payers –the top leadership, the employees, the union, etc. –are involved from the beginning in the planning,execution and evaluation of the programme. Lastly,employers are worried about investing in wellnessprogrammes when turnover rates are high; however,it might be that the high stress and unhealthyworking conditions are parts of the reason forattrition. There is an opportunity for companies topromote wellness programmes as an incentive toattract new talent as well as retaining it – a powerfulmeans for management to show it cares.

On the employee side, the main barrier is thedifficulty of encouraging participation in wellnessprogrammes. Again, the problem is mainly due to alack of awareness of the importance of maintaining ahealthy lifestyle; this is particularly true of youngeremployees who feel invulnerable to disease anddisability. This barrier creates the opportunity toenhance awareness in the workforce regardingNCDs and their risk factors – the employees mustbe educated about their rights and a bottom-upapproach must be adopted to create a true sense ofownership among the employees. The other barrierfaced by employees is a fear of losing one’s job dueto bad health performance on annual health check-ups. It is crucial to maintain complete confidentialityof results, and ensure the employees that the resultsof health check-ups are completely separate fromtheir performance appraisals on the job.

Lastly, there are certain barriers and opportunitiesrelated to capacity development. In the area ofpublic health, there is a huge capacity gap – therequisite data, studies, personnel and body ofknowledge to make the appropriate policy changesare not available. This lack of knowledge creates anideal opportunity to start gathering data fromexisting sources and disseminating it for others touse. It is no longer sufficient to follow best practices;India has the ability to create the next best practices.A key point will be to create a network oforganizations, industries and stakeholders so thatthere is transparent sharing of experiences and the

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lessons to be learned. Certain key organizations,such as the Confederation of Indian Industries (CII),the Public Health Foundation of India (PHFI), can actas nodal agencies for collecting, synthesizing anddisseminating information in the form of bestpractices.

There are still many questions that need to beanswered – how can interventions be translated intoother industry sectors? How can India tackle healthpromotion in its large, unorganized sector? How canwe address issues of sustainability? These and otherquestions cannot be dealt with by companies alone– there is an urgent need for multistakeholderdiscussions and collaborations. It is only when thevarious government departments, civil society, thecorporate sector and academia come together thatwe can begin to find solutions.

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To overcome the above-mentioned barriers andmake optimal use of the available opportunities, anemployee wellness programme should follow astrategy for success – it should appropriately takeinto account and influence the leadership, people,culture and processes deployed in the making of aprogramme34 (see figure 2). The lack of leadership,participation of employees, a health-promoting cultureand environment or effective processes can threatenand weaken the effectiveness of a programme.Thus, it is important to adequately address each ofthe four elements to infuse commitment, efficacyand sustainability – essential ingredients required forthe success of a wellness programme.

LeadershipLeaders are essential for the success of anyendeavour. Leadership lends visibility and sustainabilityto workplace wellness programmes, and can entirelydetermine the extent to which such programmesoperate within an organization. The lack of awarenessof workplace wellness among senior leadership isoften a barrier to committed action towards the healthof employees. Getting top leadership involved andengaged to advocate change and be committed toemployee wellness is an essential component of asuccessful workplace wellness programme.

PeopleIn general, people want to be healthier, providedthere is an environment that allows it. High rates ofparticipation are key to success and easier toachieve if the right strategies are deployed to reachout to employees.

Health EducationSmall lifestyle changes such as regular exercise andhealthy eating can prevent diabetes andcardiovascular disease, yet awareness of them ispoor. Health education, through the dissemination ofhealth-related materials, seminars and talks deliveredby experts can help raise the profile of theseavoidable conditions and motivate employees toadopt healthy behaviours (see box 2).

6. Strategy for a Successful Programme

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Figure 2: Key Elements of a Strategy toImplement Workplace Wellness Programmes

People

Culture

Process

Leadership

Through Knowledge Comes Power: HealthEducation at Reliance Health awareness and education forms a keycomponent of the health and wellness initiatives atReliance. Reliance has medical teams that regularlyconduct awareness campaigns, educatingemployees about lifestyle-related diseases andstress management through exhibitions, lecturesand camps. These medical teams regularlyconduct health promotion activities for advocatingand bringing about improvement in theenvironment of the workplace. The Project CASHe,Change Agents for Safety and Health, is anendeavour to bring about a change in the attitudesand behaviour of employees, to pave the way for ahealthier life. The project aims to bring aboutimprovement in occupational health practices andhas been found to reduce work-related diseasesand injuries, decreased the rate of absenteeismand improved productivity. The main result of thisproject has been to bring about a change inorganizational culture – today, health and wellnessare priorities in themselves at Reliance.

References:1. http://www.ril.com/html/aboutus/health_safety_environment.

html#policy (Last accessed January 2009) 2. Health, Safety and Environment, Reliance Industries Ltd 2004-053. Health, Safety and Environment, Reliance Industries Ltd 2005-06

Box 2


Tailored ProgrammesIn corporations, the pool of employees is oftendiverse, including people of different ages, sex andhealth profiles. Thus, wellness programmes cannotbe one-size-fits-all; they need to be tailored to targetdifferent audiences.

Age-specific programmes are such an example. Ingeneral, younger people (low-risk) assume a state ofgood health, whereas the elderly (high-risk) are moreserious about prevention. Interest in differentactivities also differs by age group. Adventure sportsand team sports, for example, can be used toattract the participation of younger employees.Programmes may also be disease-specific, or bedesigned to protect employees from potentialoccupational health hazards (see box 3).

IncentivesProvision of incentives to employees who participatecan be extremely useful in increasing enrolmentrates. Some corporations offer, for example,wellness allowances which employees can usetowards the purchase of fitness equipment.However, incentives need not be financial – rewardand recognition are also powerful tools.

Engaging EmployeesA workplace wellness programme is most effectivewhen it caters to the precise needs of the employee.Engaging the employee at each stage fromdevelopment to delivery not only provides theconstructive feedback needed in the eventuality ofapplying mid-course corrections, but also handsover ownership of the programme to the employee,thus ensuring greater responsibility towardsindividual health. The creation of managerial or

advisory groups in which employees arerepresented, such as employee-led walking clubsand peer coaching, are some examples35.

CounsellingPrivate counselling of high-risk individuals has provento be an effective method of prevention (see box 4).

CultureCulture plays an important role in conditioning theway individuals think about their health. Asdemonstrated in the previous section, severalbarriers and opportunities are attitudinal due to theprevailing socio-cultural perceptions. Inculcating apositive attitude towards prevention and wellnessamong employees and creating an environmentconducive to health-promoting activities arechallenging yet desirable for an organization. Beloware some examples.

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Prevention is the Key: Medical DiagnosticScreening and Targeted Interventions atReliance The Occupational Health Centres (OHCs) at themanufacturing divisions of Reliance are equippedwith state-of-the-art facilities and apparatus, aswell as competent health professionals whoconduct medical examinations of their prospectiveemployees and of their workers post-employmenton a regular basis. The results are used to createand implement targeted interventions amongindividuals and groups of individuals with similarrisk factor profiles. These OHCs are equipped toperform certain specialized tests, such asbiological monitoring, health risk assessmentstudies and audits for exposure to variousmaterials. The investment in the infrastructure andmanpower required to maintain such OHCs haspaid off, as it has translated into at-risk-employeestaking necessary preventive measures long beforecrippling lifestyle-related diseases are able to robthem of their efficiency and productivity.

References:1. http://www.ril.com/html/aboutus/health_safety_environment.

html#policy (Last accessed January 2009) 2. Health, Safety and Environment, Reliance Industries Ltd 2004-053. Health, Safety and Environment, Reliance Industries Ltd 2005-06

Box 3


Promoting Work-Life BalanceToday, the hours an employee spends at work aregetting longer, as fixed working hours are fadingaway. With recent technological advances andgadgets such as laptops, cell phones and handhelddevices, employees are essentially working round

the clock, even when at home. Such a high-stresslifestyle is a major risk factor for NCDs, and can leadto productivity losses due to mental exhaustion.Corporations can thus promote a healthy lifestylethrough defined working hours and offerings such associal gatherings and on-site exercise andrecreational facilities.

Healthy CafeteriaUnhealthy food choices and a sedentary lifestyle,often exacerbated by job profiles, are risk factors forNCDs. Offering healthy options at workplacecafeterias is an effective and immediate approach toreducing risk factors among employees.

Reaching the FamilyInclusion of the family in adopting healthy behaviourinfluences the employees’ broader social context.Family support and participation in making healthychanges increase the reach of such programmesand enhance sustainability due to greater adherence(see box 5).

Extending Outreach to the Community/UnorganizedSectorIt is not enough to invest in the health of one’semployees and their families – it is essential thatcompanies go into the community in which theyreside and which sustains them. Such a holisticapproach allows wellness initiatives to grow beyondthe boundaries of the corporation and impactsurrounding areas. Some companies also offersubsidized healthcare to contractual workers andclients, in addition to their own workers, as part ofcorporate social responsibility.

Effective Messaging Communicating the goals of the programme andmessaging effectively so that it cascades throughoutthe organization is essential. Effective and frequentmessaging lends visibility to the programme andgradually gets absorbed and accepted as an integralpart of organizational culture.

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Offering a Helping Hand: Wipro’s “Mitr” Wipro, one of the leading global corporationsbased in India, has a number of wellnessprogrammes running in both its IT and BPOsectors. Essential components of the programmesare, for example, nutrition counselling, cafésoffering low-calorie foods, health centres, medicalcamps, regular medical lectures and employeewell-being events. One of its most successfulinitiatives has been the in-house counsellingprogramme called “Mitr”, launched in 2003.Literally meaning “friend”, the programme trainsemployees to provide counselling services tocolleagues that are facing stress at work or in theirpersonal lives. The employees trained for thispurpose are volunteers, thereby ensuring highmotivation and a desire to help. The selection ofcounsellors from among the employee volunteersis stringent, ensuring that adequate motivation andcommitment are accompanied by the necessaryskills required to be a counsellor. As a programme“for Wipro employees, by Wipro employees”, it ishighly sustainable and provides employees with asense of ownership. The programme is highlypublicized within the company, to ensure that asmany employees as possible are aware of anavailable helpline, not only for work-related issuesbut also for personal problems. Certain keyelements of the programme have made it highlysuccessful – the use of technology such as theintranet, the involvement of key people and inparticular of top management, which gives it thenecessary support and backing needed forsustainability and further scalability, and interactionwith external public health agencies andcompanies dealing with specific diseases, as wellas with individual consultants.

References:1. Working towards wellness: An Indian perspective. 2007,

PricewaterhouseCoopers

Box 4


Process

While engagement of leadership, involvement ofpeople and promotion of a culture conducive tohealth are necessary for the success of an employeewellness programme, they alone cannot guaranteeresults – it is essential that adequate attention isgiven to ensure that the processes to implement andevaluate the programme are appropriate, efficientand cost-effective, and are put in place in a timelyand systematic manner. The following sections dealwith the process of setting up a workplace wellnessprogramme in detail.

Model for Setting up a WorkplaceWellness Programme

It has been clearly established that workplacewellness programmes have great potential to benefitnot only the employees that are or potentially couldbe suffering from debilitating NCDs, but also theorganizations they work for in terms of increasedproductivity and profitability. However, the questionthat remains is how such a wellness programmemay be designed, implemented and sustained, andits benefits measured over time. Although there arenumerous types of such workplace programmes,each targeting different aspects of health andwellness, there are certain basic steps in launchingsuch a programme, as developed by WHO India,which must be followed in order to have a programmethat is successful, sustainable and scalable. Thesesteps have been illustrated in figure 3.

Once the concept of having a workplace wellnessprogramme has been endorsed by industry andhealth departments, and the decision to implementone has been taken by the management of theorganization, a workplace wellness committeeshould be established, with representatives from alllevels – employees that are potential participants,individuals that might be involved in theimplementation and evaluation of the programme,and top management36. In addition, a wellnesscoordinator can be appointed to take charge of allprogramme activities. This step is essential to asuccessful programme, as research has shown thatprogrammes that have such committees and/orcoordinators in place to oversee them have more

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Reaching Out to the Family: The TCS MaitreeInitiative Under the leadership of Mala Ramadorai, wife of S.Ramadorai, Chief Executive Officer of TataConsultancy Services (TCS), Maitree was initiatedin February 2003 to “weld TCSers and theirfamilies” together. The main objective of Maitreehas been to reduce alienation and stress at workand increase a sense of empowerment andbelonging among employees and their families.This is done by holding regular social gatherings topromote common interests and have a relaxed,healthy atmosphere at work. Events include clubsand workshops on diverse hobbies such as music,dance, yoga, trekking, origami, flower arrangementand theatre. The events are open not only to TCSemployees but to their families as well – inparticular, the focus is to encourage the spousesof TCS employees to become a part of the TCSfamily. The company has open days during whichan employee’s family can visit the office to get afeel for the work environment. An effort is made toinvolve the children of employees as well, forwhom special workshops and camps areorganized. In addition, TCS Maitree providescounselling services to the 30,000 employees andtheir families, and there are several self-helpgroups within the organization that anyone canjoin. The idea is to build bridges between thecompany and its employees and their families, toencourage healthier, more meaningful lives.

References:1. “Saying tata to tedium”, The Hindu, Monday, July 23, 20032. http://www.careers.tcs.com/CareersDesign/Jsps/

WorkingatTCSMaitree.jsp (last accessed January 2009) 3. Navare, S. Counselling at work place: A proactive human

resource initiative. Indian Journal of Occupational andEnvironmental Medicine, April 2008, 12(1), 1-2

Box 5


policy support to bring about environmental andbehavioural changes promoting healthier lifestylesamong the employees37.

The wellness committee is encouraged to:

• Undertake a detailed analysis of the situation atthe workplace, also called an organizationalhealth survey36, 37, to assess the extent to whichthe organization has the necessary prerequisitesin terms of its physical and psychosocialenvironment, work policies, managementrelations, etc., to pursue a healthy life.

• Assess the physiological, behavioural andpsychological characteristics of the employeesthemselves, to ascertain the kinds of problemsand behaviours the programme should focus on,both in terms of prevalence and perceived need.Such an exercise should include a Health Risk

Assessment36, profiling the risk factors of theemployees for NCDs, on the basis of which anoverall organizational profile can be created. Sucha profile will indicate priority areas, as well as helpidentify high-risk individuals for targetedinterventions. It should also include anassessment of the mental health status of eachemployee.

• Depending on the nature of work, perform anoccupational health assessment specific to theindustry and type of work involved.

• Conduct an Individual Interest Survey36 to get anidea of employee preferences for how they wantto receive information (e.g. electronically orpamphlets), the kind of group activities theywould be most interested in joining (e.g. dance oryoga), etc. This would ensure greater participationand commitment from employees.

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Figure 3: Model for Developing a Healthy Workplace

Healthy Workspace Committee (All stakeholders)

Endorsement by Industry and Health Departments

Evaluation of Current Status

Workplace Level Situation Analysis Policies, Infrastructure

Employees’ Level Health Behaviour Survey – on a sample

Plan of Action

NCD Risk Factor Profiling by a Standard and Short

Performance e.g. IDRS + TA

Assessment of Occupational Health Specific for

the Industry

Assessment of Mental Health Status

Health Promotion Policies: Commitment from Management (HR)

Physical Work Environment

• Healthy canteen• Facilities for recreational activity• Reduction of occupational hazards• Availability of basic sanitary

facilities• Availability of child care facilities• Waste management• Safety of employees

Psychosocial Work Environment

• Counselling facilities• Social club formation and

improving co-worker relations• Defined working hours• Periodic seminars to update

knowledge• Healthy employer-employee

relationship• Supportive work environment

Promoting Healthy Practices

• Tobacco and alcohol free workspace• Promotion of healthy lifestyle• Health education messages on stress

reduction techniques• Periodic screening• Frequent follow up of high-risk individuals• Access of health services by family

members of the employee

Developed by World Health Organization Country Office for India


This preliminary analysis will determine theforthcoming plan of action for the ensuing wellnessprogramme. The recommendations will be used bythe workplace wellness committee and/or topmanagement to formulate the goals, strategies andpolicies that will constitute the wellnessprogramme37. It must be ensured at this stage ofdesign that the formulated policies have the fullsupport of top management, human resources andthe decision-makers of the organization. This is oneof the key components of any successful workplacewellness programme.

The plan of action will consist of the basicoverarching goal or mission statement declaringwhat the programme aims to achieve. Under this willbe the main goals or objectives through which theprogramme will achieve the overarching goal – theseobjectives must be made measurable, with specific,realistic timelines so that it is possible to assesswhether they have been achieved. Alongside this, abudget should be developed so that the costs can beeasily compared to the benefits of the programmeand the feasibility of the programme determined.

The mission statement and goals of the programmewill determine the kinds of health promotion policiesthat should be adopted to accomplish them. As theidentified goals and objectives will come from thesituation analysis, the policies selected on the basisof these goals will be specifically designed toaddress the particular needs of the workforce andthe organization, thereby allowing for tailor-madeinterventions.

According to the specific needs of the organization,a committee can pick and choose from a number ofavailable policy options listed in figure 3. These canbe classified into three broad categories:1) Changing the physical work environment2) Changing the psychosocial work environment3) Promoting healthy behaviours and/or

discouraging unhealthy behaviours

These are not mutually exclusive and might bechosen in combination to have a multilayeredintervention for maximum effect on the targetedproblem. The level of commitment by the company,the resources available, and the seriousness of thehealth issue targeted will in tandem determine the

type and extent of intervention chosen. Theorganizational culture of the company and theconstitution of the workforce will also play a role inthis decision. Small and medium enterprises, forexample, may alter certain components of theprocess and still accomplish health goals (see box 6).

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Workplace Wellness Programmes for Smalland Medium-sized Organizations Small and medium-sized organizations do nothave the same managerial and monetarycapabilities as large organizations to focus onemployee wellness programmes. Nevertheless,there are several cost-effective interventions thatcan be easy to implement:• Outsource health check-ups and screenings to

save on full-time, on-site health facilities• Provide vouchers for use at local gyms rather

than on-site recreational facilities, or negotiatecorporate rates at gyms

• Distribute information on healthy eating andnutritional seminars in the absence of a canteenoffering healthy food choices

• Partner with community centres and localevents (e.g. marathons, exercise classes) opento employee enrolment

• Disseminate health information at the workplace

Box 6


Monitoring and Evaluation

Monitoring and evaluation (M&E) is an essentialcomponent of any wellness programme and to agreat extent determines its success or failure. Aconsistent M&E element must be incorporated in thedesign and implementation of the programme, andfollow-ups must be made and recorded at regular,predetermined intervals, so that: • Progress can be recorded• Policies can be changed and improved• Comparison between intended deliverables with

actual outcomes can be made• Better results can be observed and documented,

justifying the investment made in the programme

This process must be accompanied by constantdocumentation of best practices and, if possible,dissemination of the same.

M&E is intricately tied to all preceding stages ofdevelopment and implementation of workplacehealth programmes38. The different levels ofevaluation indicate this. Figure 4 illustrates the levelsof evaluation of a workplace health intervention39:

1) First level – known as formative evaluation, isundertaken at the beginning and assesses theemployees’ opinions and preferences of thepolicies to be implemented. In addition, it caninclude a stakeholder interview to assess theprobability of success of the programme. Theresults of this first stage of evaluation should bekept in mind while taking decisions regarding thenature of policies and processes ofimplementation to be adopted.

2) Second level – is called process evaluation, as itrefers to the monitoring of the processes involvedin the actual implementation of the programme.This aspect of M&E must be done in acontinuous manner as the policies areimplemented. Examples of process outcomesinclude the extent to which the programmereaches the target population, the costs incurred,the numbers and profiles of the individualsactually implementing the policies, etc.

3) Third level – involves collecting information on theintermediate effects of wellness programmes andincludes all the social, cultural and psychologicalfactors that are believed to influence healthbehaviours, such as self efficacy, perceivedenvironment, social support, etc.

4) Fourth level – consists of assessing energybalance-related behavioural change, or all thosebehaviours that actually impact health, such asfruit and vegetable consumption, physical activity,smoking, alcohol consumption, etc., as well asbiological measures such as weight and bloodpressure, and environment-level changes such asavailability of healthy foods and walking trails.Economic outcomes such as absenteeism andsick leave should also be assessed as part of thislevel.

5) Fifth level – consists of assessing the long-termeffects of a wellness programme, i.e. a reductionin the incidence of disease among theemployees.

All outcome evaluations must be done in a sustainedmanner, starting with baseline level assessments(which are equivalent to the situation analysismentioned earlier), followed by periodicassessments, while the programme is beingimplemented, that continue into the long term.

Monitoring and evaluating a workplace wellnessprogramme should be initiated by ensuring there isrecognition of and commitment to M&E at the initialplanning stages among both policy formulators anddecision-makers. The next step is to look, fromexisting record keeping or monitoring activities, forthose activities or records that are relevant for theimpending wellness programme, and to use thisexisting data to inform and improve the policies ofthe programme. For instance, if some records arealready available of sales in workplace cafeterias,then these can be used to determine the need for afood policy. Similarly, from existing records on sickleave and the causes of disability and sickness, thedisease conditions requiring immediate attention canbe ascertained38.

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Having identified existing and needed M&E activities,the appropriate indicators or outcomes for the M&Eactivities must be identified. While it is imperativethat the outcome indices chosen are practical andeconomically viable, it is also necessary that they arevalid and objective to minimize error and bias. Forinstance, while self-reported questionnairesassessing food intake look appealing, they are veryprone to bias, and hence objective measures suchas food purchases in workplace cafeterias, beingmore objective, should supplement such measures.The background paper on M&E prepared for theWHO India/World Economic Forum joint event onpreventing NCDs in the workplace, held in Dalian,People’s Republic of China, in September 200738,includes a review of indicators used by workplacewellness programmes.

The actual implementation of these evaluationactivities starts from a baseline record before theprogramme is initiated, followed by assessments atappropriate intervals after the onset of theprogramme. The findings of these evaluationsshould then be systematically analysed andappropriate changes to improve the wellness

policies for better results should be put in place.Periodic repetition of the M&E activities should bedone so that a sustainable monitoring system canbe established and records are maintainedsystematically over a period of time. The entire step-by-step process of planning, developing,implementing and evaluating a workplace wellnessprogramme is summarized in figure 5 for quickreference.

Bringing It All Together: The Power ofComprehensive Interventions

Several organizations, instead of focusing onmodifying one aspect of the work environment or onchanging one unhealthy behaviour of theiremployees, have opted to introduce more inclusivewellness programmes which aim to bring aboutchange in multiple environmental and behaviouraloutcomes, so as to impact the health of theiremployees in a holistic manner34 – being socomprehensive in nature, they tend to have asubstantial effect on the health of their employees.The following are a few examples.

Infosys40, 41

Infosys has adopted a very inclusive andcomprehensive approach to health and wellness.The company has regular health check-ups, eyecamps, dental camps, etc., performed by in-housedoctors, as well as professional counselling servicesfor employees. In 2005-2006, it introduced annualhealth checks for contractual employees as well.There are several heath clubs at the Infosyscampuses, which have been seeing a steady rise inmembership. In line with this increasing participation,they have been expanding their gymnasiums andadding to the existing recreational facilities, such asbowling alleys. The health clubs provide employeeswith various facilities, including regular yoga andaerobics sessions, as well as on-sitephysiotherapists to help alleviate workers’ergonomics-associated problems such asspondylitis.

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1st level: Collect information on program feasibility

(formative evaluation)

2nd level: Continuously collect data on program preparation preparation and implementation (Process evaluation)

3rd level: Collect data on intermediate outcome (i.e. behavioural determinants)

4th level: Collect data on energy balance related behavioural change (i.e. PA and

dietary outcome, biological disease indicators, environmental changes)

5th level: Collect data on long term outcome of a WHPP. If possible

(i.e. reduction in disease incidence)

Inte

rpre

tatio

n of

su

cces

s or

failu

reW

HP

P s

ucce

ss;

Hea

lth im

pact

Adapted by Engbers (2007)38 from Bauman et al. (2006)39

Figure 4: Levels of Evaluation in a WorkplaceWellness Programme


The company’s most successful health initiative hasbeen HALE, the Health Assessment LifestyleEnrichment programme, which has six extensiveelements: health, safety, leisure, stress, fun at workand team building. The health and safety elementsare delivered through health awareness campaignsand lectures on relevant issues such as cardiologyand stress management; the spread of awarenessusing enjoyable means such as health quizzes,puzzles and competitions; health consultations onnutrition, diabetes, women’s health etc.; andworkshops and programmes on specific problemsor unhealthy behaviours. For instance, in 2005-2006, Infosys conducted under HALE a nutritionprogramme which focused on the eating habits ofemployees, advising them on maintaining abalanced diet.

In the same year, a workshop was organized onergonomics, educating employees about computer-related injuries, training them on maintaining goodposture, and teaching head and neck exercises. Thestress element under HALE is covered by the HALEHotline – a 24-hour/365-day counselling serviceavailable to Infosys employees. A master healthcheck and stress-relief campaign called HALEHealth Week was organized in March 2008, with6,000 employees receiving extensive health checksand expert consultations. For monitoring andevaluation, the company has a HALE tool – anonline questionnaire, examining and addressing thecauses of stress. Responses to this questionnaireare regularly followed by the human resourcesdepartment, and appropriate action is taken in theform of the “fun at work” and “team building”

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Figure 5: Quick-step Guide to Constructing and Implementing a Workplace Wellness Programme

Establish a Workplace Wellness Committee

Have the Committee undertake a Situation Analysis

Organisational Health Survey Health Risk Assessment Individual Interest Survey

Develop a Plan of Action on the basis of the Recommendations of the Committee1. Formulate the Mission Statement of the programme2. Develop the specific Goals and Objectives to accomplish the mission statement3. Develop a Timeline corresponding to these goals4. Develop a Budget

Select specific Health Promotion Policies in accordance with the plan of action

Implement the policies

Monitor & evaluate the policies to assess their effectiveness

Change the policies as necessary

Document best practices for dissemination

Scale up the programme as necessary


elements, which include hobby sessions, team gamesand movie screenings, ensuring that all sources ofstress are minimized. Thus, an attempt is made atInfosys to address every aspect of health at work.

Procter & Gamble (P&G)42

To encourage and enable employees to follow andimplement the newly initiated organizational structureand culture of Stretch, Innovation and Speed (SIS),Procter & Gamble Hygiene and Health Carelaunched the Vicks Wellness Programme in 2000,headed by P&G’s Health Team. This entailed a fullmedical check-up for all employees, along with afitness programme. It included interactive sessionswith experts in the field – nutritionists, stresscounsellors, yoga specialists, etc., who could adviceemployees on how to adopt healthier lifestyles. Italso entailed changes in the work environment, tomake it a healthy place to work, both physically andmentally. For instance, the canteen not only servednutritious food, but was also converted into arecreational area where employees could relax andtake a break from work. The programme alsoincluded an evaluation component, with feedbackfrom employees informing the Health Team of theprogramme’s impact on productivity.

Aditya Birla Group43

A multinational corporation based in India, the AdityaBirla Group has opted for a comprehensive set ofinitiatives promoting the health of employees. Itprovides employees with the physical infrastructurenecessary to maintain good health, including a well-equipped gymnasium, and a cafeteria servingnutritious food. Also, an onsite doctor caters to theneeds of workers. The company organizes regularyoga sessions, and has a meditation room whereemployees can take their mind of work and home-related problems. In addition, clubs, auditoriums,walking tracks and other facilities are open to thefamilies of employees, and the company offers thefacilities of various townships to the families of thosewho join the organization. These include sports andrecreation, parks and gardens, and medical services.It also has several group events in which employeesas well as their families can participate, such asfamily picnics, Kids’ Day Out and Sawan Mela,further enhancing the feeling of well-being andconnection among workers. Lastly, its healthprogramme has a strong monitoring and evaluationcomponent in the form of a biennial Occupationaland Health Survey (OHS), which has proved useful,being the source of many of the health promotioninitiatives of the organization.

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There is increasing global recognition of the benefitsof investing in employee wellness. Business leadersmust join to contain NCDs. It is not only altruism butalso enlightened self-interest. Investing in the healthof employees increases productivity, cuts spendingon healthcare, reduces turnover and attractstalented individuals. While the search for low-cost,high-return interventions continues in this economicclimate, examples of success exist in other countriesand settings. Sharing knowledge and maintaining along-term vision for such investments is in alignmentwith India’s economic and developmental prioritiesas a nation, and an essential step in fostering ahealthy workforce, nationally and globally.

Outcomes of the WHO India/WorldEconomic Forum Joint Event

One of the outcomes of the WHO India/WorldEconomic Forum joint event held in New Delhi inNovember 2009 was the identification of the PublicHealth Foundation of India (PHFI) as a keyorganization, entrusted with the task of creating aplatform for bringing together multiple stakeholdersfor workplace wellness. Since then, severalimportant events have taken forward the agenda forworkplace wellness in India.

Worksite Wellness: A Resource Kit forSmoke-free Workplaces, a Workshopon New Delhi, India, 10 February 2009

As a first step, PHFI in partnership with HRIDAY(Health Related Information Dissemination AmongstYouth), the World Economic Forum, Confederationof Indian Industry (CII) and the International Unionagainst Tuberculosis and Lung Disease (The Union)organized a workshop for corporate managers andmedical officers on “Worksite Wellness: A ResourceKit for Smoke-free Workplaces” in New Delhi on 10February 2009. The main intent of this workshopwas to build awareness of workplace wellness withspecial focus on smoke-free workplaces.

The workshop began with opening statements fromK. Srinath Reddy, President, Public HealthFoundation of India (PHFI); Shaloo Puri Kamble,Head, India Business Alliance, and Adviser, WorldEconomic Forum; Harpal Singh, Chairman, ImpactGroup, CII; and Catherine Jo, Manager, International

Tobacco Control, American Cancer Society (ACS).All four emphasized the need for creating acongenial workplace environment, which can only beachieved if companies commit to providing theresources and awareness needed to maintain ahealthy diet, regular physical activity, and to avoidtobacco use in the workplace. This inauguralsession was followed by plenary sessions,interactive sessions and working group discussions.The guest of honour, R. K. Srivastava, Director-General, Health Services, Ministry of Health andFamily Welfare, India, reaffirmed the commitment onthe part of the Government of India to providemeasures to safeguard the health of Indian citizensand, in particular, enforce the recently adoptedsmoke-free rules in all public places, includingplaces of work. A significant outcome of the eventwas the release of a resource kit entitled “WorksiteWellness: A Resource Kit for Smoke-freeWorkplaces” as well as two posters on smoke-freeworkplaces, which are to be used as guiding toolsto help Indian corporations make their workplacessmoke-free.

Worksite Wellness Initiative:Promoting Smoke-free Workplaces inIndia, a Symposium in Mumbai, India,9 March 2009

As a follow-up to the 10 February workshop, PHFIand HRIDAY, in partnership with ACS, the WorldEconomic Forum, the Asian Heart Institute andResearch Centre (AHIRC) and the Indian Associationof Occupational Health (IAOH), organized asymposium on “Worksite Wellness Initiative:Promoting Smoke-free Workplaces in India” on 9March 2009 in Mumbai, during the 14th WorldConference on Tobacco or Health (14th WCTOH),with participation from corporate leaders fromacross the country. The aim of the symposium wasto discuss workplace wellness, promote smoke-freeworkplaces in India and urge domestic andmultinational companies based in India to declaretheir workplaces smoke free.

Jeffrey P. Koplan, Director of the Global HealthInstitute, Emory University, USA, chaired thesymposium, and the Guest of Honour wasAnbumani Ramadoss, Minister of Health and FamilyWelfare of India. Other participants included John

7. Conclusions and the Way Forward

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Seffrin, President and Chief Executive Officer, ACS;Shaloo Puri Kamble, Head, India Business Alliance,and Adviser, World Economic Forum; Shyam Pingle,President, IAOH; Douglas Bettcher, Director,Tobacco Free Initiative, World Health Organization,Geneva; Ashish Contractor, the Asian Heart Institute;and K. Srinath Reddy, President, PHFI. The globalyouth delegates from the Global Youth Meet onTobacco Control, which had been held in Mumbaion 6-7 March 2009, also took part in thesymposium. Many prominent corporate leadersexpressed their support for this venture andapplauded the significant initiative to promotesmoke-free environments in the country.

The event was followed by a press conference withRamadoss and other participants at the symposium.There were 29 corporations represented at thesymposium, and 33 have signed the Statement ofCommitment (SoC) entitled “The smoke-freeworkplaces initiative – Mumbai Declaration”. As afollow-up to this symposium, PHFI, HRIDAY andtheir partners aim to increase the number oforganizations that have signed the SoC in favour ofa smoke-free workplace, and are following up withthe companies invited to the symposium to ensurethat all signed SoCs are received before 2 October2009, by which date a report will be released withthe final list of signatories and their profiles.

As an outcome of the above events, PHFI aims topartner with other organizations and agencies todevelop a comprehensive programme on NCDprevention in workplaces, focusing on reducing thethree major behavioural risk factors of NCDs –tobacco use, physical inactivity and poor nutritionamong employees. To plan this comprehensiveprogramme, PHFI, in collaboration with its partners,is working towards formulating a work plan tointroduce workplace wellness in as many businessesas possible. As a direct follow-up of the symposium,the focus in 2009 will be on implementing smoke-free workplaces, with a focus in 2010 on diet andnutrition, and on introducing the importance ofphysical activity at workplaces in 2011. The aim is toprovide tailored programmes that fit the specificneeds of different organizations.

In the long term, PHFI, in conjunction with otherorganizations, aims to conduct high-impact, India-relevant health, social, legal and, above all,

economic research to improve workplace wellness,and enable appropriate policy formulation in thecountry to achieve the ultimate objective of NCDprevention among Indian adults.

Impact of a Workplace Intervention Programmeon Cardiovascular Risk Factors: ADemonstration Project in an Indian IndustrialPopulation

The recent results of a study on workplace NCDprevention funded by the World Health Organizationand the Ministry of Health and Family Welfare of theGovernment of India, and carried out by severalIndian academic organizations including the Centrefor Chronic Disease Control (CCDC) and PHFI, werepublished in the Journal of the American College ofCardiology44. The study highlights the results of afour-year comprehensive, multi-componentworkplace intervention programme carried out as ademonstration project in seven Indian industrial sites.The intervention had significant impact, reducing thelevels of several cardiovascular disease risk factorsamong the industrial workers, including weight, waistcircumference, blood pressure, serum cholesteroland plasma glucose.

The significance of these findings for a country withhigh rates of CVDs was highlighted in the editorial ofa leading national newspaper The Hindu, advocatingfor the government to scale up such workplaceintervention programmes at the national level. Thisunderlines the significance of high quality research invalidating the crucial role that workplace wellnesscan play in combating India’s impending NCDepidemic, and demonstrates that there is growingrecognition in the country of the workplace as apowerful platform for initiating the agenda of ahealthy India.

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1 The global burden of disease: 2004 update. WorldHealth Organization, Geneva, 2008

2 WHO, 2005, Preventing Chronic Diseases: A vitalInvestment: WHO Global Report. Geneva

3 WHO, 2005, The impact of chronic disease inIndia, WHO Global Database,http://www.who.int/chp/chronic_disease_report(last accessed January 2009)

4 WHO Global Infobase, 2008 5 International Institute for Population Sciences

(IIPS) (2007). National Family Health Survey(NFHS-3), 2005-06: India. Mumbai: IIPS

6 Joshi et al. 2007. Risk factors for early myocardialinfarction in South-Asians compared withindividuals in other countries, Journal of theAmerican Medical Association, vol. 297:286-94

7 Impact of Preventive Health Care on IndianIndustry and Economy, Indian Council forResearch on International Economic Relations

8 LABORSTA, Geneva, International LabourOrganization, 2008, http://laborsta.ilo.org/ (lastaccessed January 2009)

9 ILO, Global Employment Trends: January 2008,Geneva, International Labour Office

10 Banga, 2006, Critical issues in India’s services-ledgrowth, INRM Policy Brief No. 2

11 Job-related stress spreads to more sectors inIndia, shows study, Dance with Shadows, 19 May2007 http://www.dancewithshadows.com/society/work-stress.asp (last accessed January2009)

12 Hennrikus D. J. and Jeffery R. W. Worksiteintervention for weight control: a review of theliterature. American Journal of Health Promotion,1996, 10(6):471–498

13 Peterson, R. et al. Effectiveness of employeeInternet-based weight management program.Journal of Occupational & EnvironmentalMedicine, 2008, 50(2): 163-171

14 Stamler, R. et al. Primary prevention ofhypertension by nutritional-hygienic means. Finalreport of a randomized, controlled trial. TheJournal of the American Medical Association,1989, 262(13):1801-1807

15 Lippincott, M. et al. Predictors of endothelialfunction in employees with sedentary occupationsin a worksite exercise program. The AmericanJournal of Cardiology, 2008, 102(7): 820-24

16 Dugdill, L. et al. Workplace physical activityinterventions: A systematic review. InternationalJournal of Workplace Health Management, 2008,1(1), 20-40

17 Proper, K. I. et al. Costs, benefits, andeffectiveness of worksite physical activitycounseling from the employer’s perspective.Scandinavian Journal of Work Environment andHealth, 2004, 30(1): 36-46

18 Melissa, A. N. et al. Worksite and communicationsbased promotion of a local walking path. Journalof Community Health, 2006, 31(4): 326-42

19 WHO, 2003, Global Strategy on Diet, PhysicalActivity and Health

20 World cancer research fund/American institute forcancer research. Food, nutrition and physicalactivity and the prevention of cancer: a globalperspective. Washington DC: AICR, 2007

21 Michelle, H. et al. Does the Heartbeat Awardscheme in England result in change in dietbehaviour in the workplace? Health PromotionInternational, 2004, 19(2):197-204

22 Sorensen, G. et al. Increasing fruit and vegetableconsumption through worksites and families in theTreatwell 5-a-day study. American Journal ofPublic Health, 1999, 89:54-60

23 Moher, M. et al. Workplace interventions forsmoking cessation. Cochrane Database ofSystematic Reviews, 2008 (4):CD003440

24 Roman, P. M. and Blum, T. C. Alcohol: A review ofthe impact of worksite interventions on health andbehavioral outcomes. American Journal of HealthPromotion, 1996, 11(2):136-149

25 Warner, K. E. et al. Health and economicimplications of a work-site smoking-cessationprogram: A simulation analysis. Journal ofOccupational and Environmental Medicine, 1996,38(10): 981-92

26 Graveling, R. A. et al. A review of workplaceinterventions that promote mental wellbeing in theworkplace. Draft Report, Institute of OccupationalMedicine, 13 February 2008. Edinburgh

27 Sjögren, T. Effectiveness of a workplace physicalexercise intervention on the functioning, workingability, and subjective well-being of office workers:A cluster randomized controlled cross-over trialwith a one-year follow up. Studies in Sport,Physical Education and Health, 118, University ofJyväskylä

References

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28 Thøgersen-Ntoumani, C. et al. Relationshipsbetween exercise and three components ofmental well-being in corporate employees.Psychology of Sport and Exercise, 2005, 6(6):609-27

29 Kuoppala, J. et al. Working health promotion, jobwell-being and sickness absences: A systematicreview and meta-analysis. Journal of Occupationaland Environmental Medicine, 2008, 50(11): 1216-27

30 Stein, A. et al. Financial Incentives, Participation inEmployer-Sponsored Health Promotion, andChanges in Employee Health and Productivity:HealthPlus Health Quotient Program. Journal ofOccupational and Environmental Medicine, 2000,42(12): 1148-55

31 Burton, W. et al. The Association of Health Status,Worksite Fitness Center Participation, and TwoMeasures of Productivity. Journal of Occupationaland Environmental Medicine, 205, 47(4):343-51

32 Coulson, J. C. et al. Exercising at work and self-reported work performance. International Journalof Workplace Health Management, 2008,1(3):176-97

33 Chapman, L. S. Meta-evaluation of worksite healthpromotion economic return studies: 2005 update.The Art of Health Promotion: Practical informationto make programs more effective, July/August2005

34 Working towards wellness: An Indian perspective.PricewaterhouseCoopers, 2007

35 Hersey et al (2008). “Promising Practices inPromotion of Healthy Weight at Small andMedium-Sized US Worksites”. Preventing ChronicDisease 5(4)

36 http://www.wellnessproposals.com/wellness_proposals_guide_to_worksite_wellness.htm (lastaccessed January 2009)

37 Brissette, I. et al. Worksite characteristics andenvironmental and policy supports forcardiovascular diseases prevention in New Yorkstate. Preventing Chronic Disease: Public HealthResearch, Practice and Policy, 2008, 5(2).http://www.cdc.gov/pcd/issues/2008/apr/07_0196.htm. (last accessed January 2009)

38 Engbers, L. “Monitoring and Evaluation ofWorksite Health Promotion Programs – Currentstage of knowledge and implications for practice”.Background paper prepared for the WorldEconomic Forum/WHO joint event on preventingnon-communicable diseases in the workplace(Dalian/China, September 2007)

39 Bauman, A. et al. Physical activity measurement –a primer for health promotion. Promotion &Education. 2006, 31(2): 91-100

40 Changing Mindsets: Infosys Annual Report, 2005-06

41 Enduring Values: Infosys Sustainability Report,2007-08

42 Singh, N. “P&G kicks off Vicks WellnessProgramme for employees”, Thursday, 9 March2000, The Financial Express, Indian ExpressNewspaper (Bombay) Ltd

43 http://www.adityabirla.com/careers/ourculture.asp (last accessed January 2009)

44 Prabhakaran D., Jeemon P., Goenka S., LakshmyR., Thankappan K. R., Ahmed F., Joshi P. P.,Murali Mohan B. V., Meera R., Das M. S., Ahuja R.C., Saran R. K., Chaturvedi V. and Reddy K. S.2009. Impact of a worksite interventionprogramme on cardiovascular risk factors: Ademonstration project in an Indian industrialpopulation, JACC, 53(18): 1718-28

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Agenda of the Joint Meeting of theWorld Economic Forum and WorldHealth Organization Country Office forIndiaEmployee Health as a Strategic Priority 2008

New Delhi, India 14-15 November 2008

Programme

Friday 14 November

12.00 - 13.30Taj Mahal Hotel - Pool LawnOpening Lunch and WelcomeThe World Health Organization and the WorldEconomic Forum will jointly hold this meeting whichwill bring together leaders from business,government, select NGOs, IOs and academics tounderstand how to create and stimulate effectiveworkplace wellness programmes with the goal ofpreventing chronic disease globally. Keyrecommendations from this meeting will be used bythe World Health Organization, in India, to furtherdevelop its strategies in this area.

The following key issues will be addressed:• What are the economic benefits and cost-

effectiveness of chronic disease preventionprogrammes in the workplace?

• How can chronic disease prevention programmesin the workplace be best monitored andevaluated?

• What are the roles of different stakeholders, inIndia, in developing and implementing thesepolicies and programmes?

• How can these strategies be sustained?

13.30 - 14.00Taj Mahal Hotel - Aftab MahtabWorkshopEmployee Health as a Strategic PriorityOpening remarks from the hosts of the event, theWorld Economic Forum and World HealthOrganization

Co-ChairsS. Habayeb, Representative, World HealthOrganization (WHO), New DelhiSarita Nayyar, Senior Director, Head of ConsumerIndustries, World Economic Forum

Moderated byK. Srinath Reddy, President, Public HealthFoundation of India (PHFI), India

14.00 - 16.00Taj Mahal Hotel - Aftab MahtabWorkshopSuccess Stories in Workplace HealthPromotion in IndiaThrough an interactive marketplace process whichrotates participants between brief presentations onexisting knowledge, this session will bring allparticipants up to speed on the state of workplacehealth promotion in India. Participants will identifyhighlights and barriers they see in each case studypresented.

Discussion LeadersRakesh Gupta, Consultant, Cancer ControlStrategies-Workplace, American Cancer Society(ACS), IndiaPaul Litchfield, Chief Medical Officer and Head,Health and Safety, BT, United KingdomShrinivas M. Shanbhag, Medical Adviser, RelianceIndustries, IndiaHarpal Singh, Non-Executive Chairman, RanbaxyLaboratories, India


Annex 1

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16.00 - 16.30Taj Mahal Hotel - Pool LawnNetworking Break

16.30 - 18.30Taj Mahal Hotel - Aftab MahtabInteractive SessionOpportunities and BarriersDiscussion leaders will present the top highlightsand barriers back to the full group for agreementthrough voting and discussion on the critical areasfor focus in the second day of the workshop. Aworking draft of the group’s top recommendationswill be created.


18.30 - 22.00Taj Mahal Hotel - Pool LawnReception and DinnerJoin participants for an informal networkingreception and dinner

Saturday 15 November

08.30 - 09.30Taj Mahal Hotel - Pool LawnContinental BreakfastA buffet breakfast will be available for participants onthe lawn

09.30 - 12.30Taj Mahal Hotel - Aftab Mahtab WorkshopDeep Dive on the Question AreasThrough an interactive group process, testing andfirming up ideas and recommendations, participantswill focus on key problem areas of evaluation,sustainability and resource mobilization as well asadditional questions identified on the first day. Eachgroup will prepare a presentation back to the fullgroup which will cover:• Breakthrough idea• Objectives and timeframes• Stakeholders• Critical success factors

Discussion LeadersShifalika Goenka, Senior Research Fellow, Centerfor Chronic Disease Control, IndiaMallika Janakiraman, Vice-President, Health andWellness, PepsiCo India Holdings, IndiaAnand Krishnan, Associate Professor, All IndiaInstitute of Medical Sciences, IndiaThirumalai Rajgopal, Vice-President, Medical andOccupational Health, Unilever Asia, AMETScott Ratzan, Vice-President, Global Health andGovernment Affairs & Policy, Johnson & Johnson,USAShrinivas M. Shanbhag, Medical Adviser, RelianceIndustries, IndiaPaul Litchfield, Chief Medical Officer and Head,Health and Safety, BT, United Kingdom


12.30 - 13.30Taj Mahal Hotel - Pool LawnNetworking Lunch

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13.30 - 15.30Taj Mahal Hotel - Aftab MahtabWorkshopRecommendations for ImplementationDiscussion leaders of each group will report back.The full group will build on these ideas then agree onthe final list of recommendations to present toexternal stakeholders and state next steps forparticipants themselves, individually and as a group.


15.30 - 16.00Taj Mahal Hotel - Pool LawnCoffee Break

16.00 - 17.00Taj Mahal Hotel - Aftab MahtabWorkshopNext Steps, Actions and Closing RemarksA final group discussion around how therecommendations can be translated into practicalactions. The Moderator and representatives of thehosting organizations will then sum up what hasbeen learned, what recommendations can beshared and what commitments have been madeduring the workshop.

Closing Remarks byOlivier Raynaud, Senior Director, Health Initiativesand Healthcare, World Economic ForumParamita Sudharto, Public Health Administrator,World Health Organization (WHO), New Delhi


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Meenu Anand, Director, Operations and Strategic Initiatives,American Cancer Society (ACS), USAShekhar Banerjee, Vice-President, Corporate Affairs,Monsanto Company, IndiaVineet Bhatia, Technical Consultant, India Resource Centre(IRC), IndiaPiroska Bisits Bullen, Manager, Medical Projects,International SOS, United KingdomVanessa Candeias, Technical Officer, Global Strategy onDiet, Physical Activity and Health, World Health Organization(WHO), SwitzerlandSiraj Chaudhry, Country Director, Cargill India Private Ltd,IndiaTilak S. Chauhan, Asia Representative, TB Alert India, IndiaViraj Chouhan, General Manager, Public Affairs andCommunications, Coca-Cola India, IndiaIngrid Christensen, Senior Specialist on OccupationalSafety and Health, International Labour Organization (ILO),IndiaNivedita Dasgupta, Project Director, Modicare Foundation,IndiaRaymond M. DeMarco, Senior Director, Corporate Strategyand Operations, Monsanto Company, USAAlistair Dornan, Head, Health and ProductivityManagement, Right Management (a Manpower company),United KingdomRakesh Dullu, Manager, Hero Honda Motors Ltd, IndiaAshok Ghose, Chief of Environment, Health & Safety,Jubilant Organosys Ltd, IndiaShifalika Goenka, Senior Research Fellow, Center forChronic Disease Control, IndiaChris Gray, Director, International Policy, Pfizer Inc., USARakesh Gupta, Consultant, Cancer Control Strategies-Workplace, American Cancer Society (ACS), IndiaS. Habayeb, Representative, World Health Organization(WHO), IndiaJagdish Harsh, Co-Founder and Director, HIV ATLAS, IndiaMallika Janakiraman, Vice-President, Health and Wellness,PepsiCo India Holdings Pvt. Ltd, IndiaSitanshu Kar, Cluster Assistant, World Health Organization(WHO), IndiaSai Krishna, Head, HIV/AIDS, Satyam Foundation, IndiaAnand Krishnan, Associate Professor, All India Institute ofMedical Sciences, IndiaNalini Krishnan, Director, The Hindu, IndiaA. Laxmaiah, Scientist “E” - Epidemiology, National Instituteof Nutrition, IndiaPaul Litchfield, Chief Medical Officer and Head, Health andSafety, BT Plc, United KingdomSophia Lonappan, Research Associate, InstituteSustainable Development Outreach, The Energy andResources Institute (TERI), IndiaRekha M. Menon, Executive Vice-President, AccentureServices Pvt. Ltd, IndiaDebasish Mishra, Executive Director and Partner,PricewaterhouseCoopers Pvt. Ltd, IndiaDavison Munodawafa, Regional Adviser, Health Promotionand Education, World Health Organization (WHO), IndiaP. K. Nag, Director, National Institute of Occupational Health,IndiaRama Naidu, Chief Executive Officer, Chronic CareFoundation, IndiaHarish Narula, President, Lupin Ltd, IndiaSudhir Nayar, General Manager, Corporate Affairs,Hindustan Unilever Ltd, India

Kalendu Patel, Executive Vice-President, EmergingBusiness, Best Buy Co. Inc., USASunita Prasad, Consultant, MDR-TB, Eli Lilly and Co. IndiaPvt. Ltd, IndiaAnil Purohit, Country Director, University of Washington,IndiaDoug Quarry, Medical Director, International SOS(Australasia) Pty Ltd, AustraliaKumar Rajan, Cluster Assistant, World Health Organization(WHO), IndiaThirumalai Rajgopal, Vice-President, Medical andOccupational Health, Hindustan Unilever Ltd, IndiaJohanna Ralston, Vice-President, Global Strategies andManaging Director of International Affairs, American CancerSociety (ACS), USAScott Ratzan, Vice-President, Global Health andGovernment Affairs & Policy, Johnson & Johnson, USAK. Srinath Reddy, President, The Public Health Foundationof India (PHFI), IndiaShrinivas M. Shanbhag, Medical Adviser, RelianceIndustries Limited, IndiaHarpal Singh, Non-Executive Chairman, RanbaxyLaboratories Limited, IndiaV. K. Srivastava, Professor, Department of Social andPreventive Medicine, Chhatrapati Shahuji Maharaj MedicalUniversity, IndiaParamita Sudharto, Public Health Administrator, WorldHealth Organization (WHO), IndiaPuja Thakker, Research Associate, Health Systems, ThePublic Health Foundation of India (PHFI), IndiaNathu M. Thakre, Assistant General Manager, IndoramaSynthetics, IndiaJ. S. Thakur, Assistant Professor, Department of CommunityMedicine, Postgraduate Institute of Medical Education andResearch, IndiaAnnapurna Vancheswaran, Associate Director, SustainableDevelopment Outreach, The Energy and Resources Institute(TERI), IndiaSteven J. Veldhoen, Managing Director, Asia, Booz &Company (Japan) Inc., JapanKavita Venkataraman, National Consultant, World HealthOrganization (WHO), IndiaGeetu Verma, Executive Director-Strategic Initiatives,PepsiCo India Holdings Pvt. Ltd, IndiaJanet Voûte, Partnerships Adviser, NoncommunicableDiseases and Mental Health, World Health Organization(WHO), SwitzerlandNevin Wilson, Director, India Resource Centre (IRC), IndiaNaveen Yelloji Chief Executive Officer, Satyam Foundation,India

From the World Economic Forum

Eva Jané-Llopis, Project Manager, Working TowardsWellness, World Economic Forum, Helena Leurent, Director, Agriculture, Food & BeverageCommunity, World Economic Forum, Olivier Raynaud, Senior Director, Health, World EconomicForum,

From the World Economic Forum USA

Sarita Nayyar, Senior Director, Consumer Industries, WorldEconomic Forum USA

Annex 2: List of Participants

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Employee Health as a Strategic Priority 2008New Delhi, India 14-15 November


The World Economic Forum is an independentinternational organization committed to improvingthe state of the world by engaging leaders inpartnerships to shape global, regional andindustry agendas.

Incorporated as a foundation in 1971, and basedin Geneva, Switzerland, the World EconomicForum is impartial and not-for-profit; it is tied tono political, partisan or national interests.(www.weforum.org)


Employee Wellness: India

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