PROMOTING HEALTH IN THE WORKPLACE : PROMOTING HEALTH IN THE WORKPLACE : Applying the WHO HPH tool in Public Hospitals Applying the WHO HPH tool in Public Hospitals
in KwaZulu-Natal, South Africain KwaZulu-Natal, South Africa
Ramdas P Geddes R Jinabhai C Cassimjee M Zungu S M KwaZulu-Natal HPH Committee-Department of Health; School of Public Health,
University of KwaZulu-Natal.
AcknowledgementAcknowledgement
Dr S. Sirkar – Path Technical Co-ordinatorDr C. Bhagwandeen – Human Resource Support Unit
Ms V. Moodley – Health Promotion Unit Mrs A. Khathi – Quality Assurance & Accreditation UnitMs J. Maher – Quality Assurance & Accreditation UnitMr C. Shawe – Quality Assurance & Accreditation UnitDr V. Maistry – Edendale HospitalMs H. Findlay – Greys HospitalMs. V. Bawany – Lower Umfolozi War Memorial HospitalMs R. Jele – Ngwelezana HospitalMs U. Sooruth – Northdale HospitalMs N. Mbambo – Inkosi Albert Luthuli Central Hospital
BackgroundBackground
• The Department of Health, KwaZulu-Natal, piloted the WHO Self-Assessment Tool (SAT), in six public hospitals, as part of an international collaboration with WHO, Barcelona Office.
70% of global total
SOUTH AFRICANDEVELOPMENTCOMMUNITY (SADC)
KWAZULU-NATAL
SOUTH AFRICA
SUB – SAHARANAFRICA
SAHARA
Socio – Demographic Socio – Demographic ProfileProfile Of KwaZulu- Of KwaZulu- NatalNatal
KZN RSATOTAL POPULATION 9.4m(20%) 44.8
POPULATION GROWTH RATE 2.8% 2.4%
ADULT LITERACY RATES 84% 82%
UMEMPLOYMENT RATE 39% 33%
PER CAPITA INCOME R1910 R2566
ACCESS TO SAFE DRINKING WATER 50%
Epidemiological Epidemiological ProfileProfile
• Triple burden of disease• HIV sero-prevalence –32%
KZN RSA
NEONATAL MORTALITY 23.2 19.8
INFANT MORTALITY 52.1 45.4
<5 MORTALITY 74.5 59.4
MATERNAL MORTALITY 170 150
Background Background Dept of Health KZNDept of Health KZN
Hospitals 83
Clinics 434
Community Health Centres
14
Health Budget
2005/2006
R 10.3 billion
(US$ 1.7 billion)
Background Background Dept of Health KZNDept of Health KZN
Total staff number 65 000
Category Percentage
Managers, Administrators &
Logistical Support Staff
49%
Nurses 38%
Allied Health Professionals &
Technical Staff
8%
Doctors and Pharmacists 5%
AimsAims
• This study assessed staff health, staff development and their involvement in hospital management.
MethodsMethods
• Cross sectional descriptive study• Six selected hospitals – all 3 levels of care • Sample of all health workers – sample size of
2105 • Data source :
Self administered questionnaires Hospital staff recordsHospital financial records
• Authorisation to undertake the study
Results & Results & DiscussionDiscussion
Total staff 6905
2105 administered
1610 staff questionnaires analysed
response rate 76%.
First study conducted in DOH
No provincial standards or norms
A : Staff HealthA : Staff Health
CRITERIA PERCENT COMMENTS
smokers 9% Legislation, sin taxes, awareness campaigns
Knowledge of own HIV sero status
66% Epicentre of epidemic VCT, ARV’s, PEP policies & programes
Workplace based response
Absenteeism: nursing staff
2.1% Malingering
Burn-out
Needle stick injuries 4.2% Policies, procedures- Universal precautions
High risk for sero-conversion
B: Staff B: Staff DevelopmentDevelopment
CRITERIA PERCENT COMMENTS
Job descriptions on commencement
61% Impact on stds setting,personal development, performance
Aware of performance appraisal system
51% Impact on performance and moral
Participation in CPD programme
78% Enforced through professional bodies
C: Hospital C: Hospital ManagementManagement
CRITERIA PERCENT COMMENTS
Involvement in hospital policy-making
38% Democratization of the workplace
Awareness of risk management procedures
79% 20% pose a hazard
Estimated budget for staff Health Promotion
R111,70 per employee per year
No dedicated budget for HP or EAP
Conclusion & Conclusion & RecommendationRecommendation
• HPH tool contextualised for South Africa• Policy implications • Improvements at hospital level • Deepened staff involvement in Health Promotion• Created awareness of own health status• Management areas for concerned• Improved relationships between management and staff• Expansion of projects to all hospitals
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