Engaging with the industries

1. Engaging with Industries through:
Employer Led Model
18th February 2015 .
Presentation for CG State Level Sensitization workshop
on ELM for industries

2. Rationale for private sector
engagement in Health
• Indian healthcare sector to reach 97.2 billion by
2015 with 20 per cent annual growth
• Major medico-tourism destination; Indian
Pharmaceutical sector being third largest globally
• Over 80% of out-patient and 50% of inpatient care
sought from the private sector
• Difficult for the public sector alone to meet the
health care needs of the population to address the
public health goals
Public-private partnership (PPP) approaches
to increase access to health care services, public awareness and equity for health,
and introduce technologies and systems that improve efficiencies
CG State Sensitisation workshop on ELM 218.2.2015

3. PPP models and initiatives in
health programs
Contracting
Private Sector as supplier of
service to improve access and
efficiency
CSR
Move towards mandatory CSR budgets;
Great potential for resource leveraging
for health and HIV
Social Marketing
Increase penetration and sale
of subsidized products
Health care financing, etc.
Demand side financing
models-vouchers; health
insurance
Social Franchising
Few models tried; shows
potential for financial viability
and acceptance by users
CG State Sensitisation workshop on ELM 318.2.2015

4. Employer Led Model
• New Initiative under NACP-IV
• Aim:
Engaging Industries for Reaching migrant workers
with HIV/AIDS prevention to care program and
services through their CSR commitments.
CG State Sensitisation workshop on ELM 418.2.2015

5. CG State Sensitisation workshop on ELM 518.2.2015

6. Migrant Labor show HIV risk
States with higher vulnerability due to Migration
Source: NACO HIV Sentinel Surveillance 2010-11 – Provisional Findings; Source: Population Council Study -- Reference: Saggurti N, Mahapatra BB, Swain
SN, Jain AK. Male out-migration and sexual risk behavior in India: Is the place of origin critical for HIV prevention programs?. BMC Public Health. 2011. 11:S6;
Higher HIV Prevalence among Pregnant Women with a
Migrant Spouse
Migrants over-represented (80%) among HIV+ men
(Ganjam)
0.00
0.20
0.40
0.60
0.80
1.00
1.20
1.13
0.39
Migrant Non-Migrant
19.7
55.6
52.8
18.7
27.6 25.7
0%
20%
40%
60%
80%
100%
HIV Positive Cases HIV Negative Controls
Non-Migrants Returned Migrants
Active Migrants
Role of Migration
-Low HIV among High risk groups in source states
-Higher HIV in rural than urban
-Higher HIV in spouses of migrants than non-migrants
18.2.2015 CG State Sensitisation workshop on ELM 6

7. Emerging Vulnerabilities: Migration
States with higher vulnerability due to Migration
Mapped migration corridors with
large volumes of out-migration to
high prevalence destinations
36% in the age group of 15-24 yrs
66% Married
56% had paid sex with female
partner in last six months
9% had sex with male partners in
last six months
4.5% injected drugs in last 12
months
Need to increase coverage of
migrants at destinations, transit
points & source villages, along with
their spouses at source
Source: NACO HIV Sentinel Surveillance 2010-11;
Bridge Population…
18.2.2015 CG State Sensitisation workshop on ELM 7

8. CG State Sensitisation workshop on ELM 818.2.2015

9. CG State Sensitisation workshop on ELM 918.2.2015

10. Goal
To help prospective employers
to implement a comprehensive
program on HIV and AIDS
prevention to care, by
integrating awareness, service
delivery with existing systems,
structures and resources,
within their business agenda.
CG State Sensitisation workshop on ELM 1018.2.2015

11. Objectives
• Increase awareness and access to
HIV and AIDS prevention to care
services for the informal workers
• To create enabling environment
by reducing stigma and
discrimination against PLHIV
• To encourage and help
prospective employers to
integrate and sustain the HIV and
AIDS Intervention Program within
existing systems and structures
CG State Sensitisation workshop on ELM 1118.2.2015

12. Strategic Approach to design of ELM
• Identifying and prioritising
industries for focused advocacy
• Technical Support to ensure
ownership by Industries
• Leveraging structures and
systems
• Service Delivery Partnerships and
quality assurance
• Linkages with mainstream services
• Facilitating an enabling
environment
CG State Sensitisation workshop on ELM 1218.2.2015

13. Processes for Employer Led Model (Organized Sector – PSU and
Private Sector Industries )
Prioritizing industries basis risk and vulnerability of Informal
workers (Mapping Completed during AAP, vulnerability assessment
to be carried out during intervention)
Senior Management Sensitization from Identified Industries in
collaboration of sectoral associations
Structures/Systems to be leveraged
Existing health facilities, cost of providing services,
HR/Welfare/health safety program
With Health Facility
(Prevention Services)
 Integrating
ICTC/PPTCT/STI &
TB services
 CSM through SMOs
Without Health Facility
(Prevention Services)
 On site health camps
 Referral linkages to
ESIC, empanelled
doctors
 Referrals/Mobile
ICTC from SACS-Cost
by company
 CSM through SMOs
Outreach Awareness
 Medical Doctor to
lead in case of
health facility
 Through safety
sessions
 Integrating within
existing activities of
HR/Welfare/H & S
With Health Facility
(Prevention and ART)
 Integrating ART,
ICTC/PPTCT/STI & TB
services within the
health facilities
 CSM through SMOs
MOU with SACS and training of staffs
CG State Sensitisation workshop on ELM 1318.2.2015

14. Employer Led Model (Unorganized Sector)
Prioritizing Industries based on risk and
vulnerability assessment
Structures/Systems to be leveraged
Associations/Federations/contractors/sub contractors/trade
unions etc. from Identified Industries
Outreach Awareness
• Integrating in existing Health and
Safety programs
• Through contractors/sub contractors
• Through trade unions e.g Nirman
majdur sangh for construction
workers
Service Delivery
(Prevention Services )
On site STI clinics in collaboration with
Associations/Federations/ Unions
Referral linkages to Public health system,
Referrals linkages/Mobile ICTC from SACS
CSM through SMOs
CG State Sensitisation workshop on ELM 1418.2.2015

15. Proposed Sectors – across states
Sectors include..
Cement Automobile
Transport
Steel
Textile
Paper
industries
Oil and
Petroleum
Fertilizer
Manufactur
ing
Power
plantsConstructio
n
Seasonal
harvesting
Tea
Plantation
Mining
Quarry
workers
Service
Sector
(Hotel
Industry)
Fishing
Leather and
Tannery
CG State Sensitisation workshop on ELM 1518.2.2015

16. Key personnel and stakeholders
NACO
•Overall policy
directions and
guidance
SACS/TSU
•Responsible for
roll out and
facilitation
state level
DAPCU
•Facilitation at
district level or
in a cluster of
districts
Employer
Structures
•Initiate, Finance
and sustain ELM
•Overall
implementation
of ELM
•Ownership of
ELM
PIPPSE
•Support NACO
in developing
Operational
guidelines
•Technical
support and
handholding of
SACS in roll out
of ELM
Employer
Associations
•Advocacy with
Employers
•Sensitization of
Employers on
the issue of
HIV/AIDS
PLHIV Networks
•Involvement in
Advocacy with
key
stakeholders
MOLE/DOL
•Roll out of the
National Policy
on HIV/AIDS and
World of Work
Trade Unions
•Need based
Implementation
support to
Employers
•Facilitate
interventions
along with
employers
Other
Stakeholders
•Facilitate an
enabling
environment
CG State Sensitisation workshop on ELM 1618.2.2015

17. Role of industry level actors for
implementing ELMs
I. Organized Sector with Health Facility (Prevention
Services)
II. Organized Sector without Health Facility (Prevention)
III. Unorganized Sector (Prevention Services)

18. Overall framework of key actors for ELM implementation- Organized Sector
Coordination Committee
- Overall monitoring and
supervision of activities
along with Nodal officer
Medical Officer at the
Health Facility Linked
with Industries
- Outreach
- STI Services
- ICTC Services Report
- ART services in case
industry integrating
ART services
Medical Officers
Conducting Health
Camps in case no
health facility
- STI Services
- Referral linkages
report for ICTC/ART
services
SMOs at State Level
- Ensuring availability
of condoms at
Industry level
- Reporting of condom
uptake from the
outlets nearby the
industries to nodal
officer
Nodal Officer Identified by Industries
(CSR/HR in charge, Medical Officer.
Health safety in charge)
Key Roles
- Coordinate with different
departments for implementation
- Coordinate for reporting
- Compiling monthly ELM report
SACS / TI
Division Support and
Facilitation by
SACS
Outreach
- 1 volunteer :250 workers
- One to one and one to
group sessions
conducted by peers
- No of Informal workers
reached
Supervisors/ Contractors
Senior Management at
Industry
CG State Sensitisation workshop on ELM 1818.2.2015

19. Medical Officers
Conducting Health
Camps
- STI Services
- Referral linkages
report for ICTC/ART
services
- Mobile ICTC services
Nodal Officer Identified by
Industries
(Supervisor, Chief Contractor,
Secretary of society, federation,
industry association, Representative
from trade unions)
- Coordinate with different
departments for implementation
- Coordinate for reporting
- Compiling monthly ELM report
Coordination Committee
- Overall monitoring and
supervision of activities along
with Nodal officer
SMOs at State Level
- Ensuring availability of
condoms at Industry
level
- Reporting of condom
uptake from the
outlets nearby the
industries to nodal
officer
SACS / TI Division
Support and
Facilitation by
SACS
Outreach
- 1 volunteer :250 workers
- One to one and one to group
sessions conducted by peers
- No of Informal workers
reached
Supervisors, Contractors
Overall framework of key actors - Unorganized Sector
18.2.2015 CG State Sensitisation workshop on ELM 19

20. Institutional Arrangements
NACO SACS/TSU Employer
• TI Division on lead in
inter divisional
coordination
• PO TI, Consultant PPP (2)
• Tech support through
PIPPSE
• ELM Coordination
Committee (CC) at NACO
• Dedicate PO-ELM at
SACS/TSU
• JD TI (SACS) on lead
and inter divisional
coordination
• TL (TSU) on support
at Districts level
• Coordination
Committee at SACS
level
• Senior Management
• Nodal Officer
- Health Facility in
Charge
- CSR Head/Head HR
• Coordination
Committee involving
SACS
Institutional Framework
• Intend letter from industries
• Proposal of Activities : Co created by SACS/TSU and Industries, signed by all parties
• Identification of Nodal Officer by the industries
• Formation of Coordination Committee involving all stakeholders, including SACS/TSU
representation
• MOU for the services in PPP mode
• Reporting from industries (Nodal officer) to SACS
• Monitoring and Supervision by Coordination Committee
2018.2.2015 CG State Sensitisation workshop on ELM

21. CG State Sensitisation workshop on ELM 21
0
2
4
6
8
10
12
14
16
18
TamilNadu
Gujarat
Odisha
Maharashtra
Uttarakhand
Punjab
UttarPradesh
Ahmadabad
Goa
Bihar
Kerala
W.Bengal
Chhatisgarh
Mumbai
AndhraP
Delhi
Rajasthan
Jharkhand
17
7
6 6
5
4 4
3 3 3 3
2
1 1 1 1 1 1
Statewise no of industries under ELM
18.2.2015

22. CG State Sensitisation workshop on ELM 22
0
2
4
6
8
10
12
14
16 15
8 8 8
6
3 3 3
2 2 2 2 2
1 1 1 1 1
Sector wise industries under ELM
18.2.2015

23. CG State Sensitisation workshop on ELM 23
64
31
34
5
18
5 3
Total Industries
(69)
0
10
20
30
40
50
60
70
80
Awareness Testing STI ART Condom
(free/SM)
Onsite
health
camps
Any other
Service wise seggregation of industries
Number of industries involved Total industries
18.2.2015

24. Key take always of ELM.
• Clear model to be presented to CSR boards
• Sustaining motivation of industries through
constant interaction and support through
SACs
CG State Sensitisation workshop on ELM 2418.2.2015

25. Discussions & Thanks
Dr K Madan Gopal
9999189794
kmadangopal@naco.gov.in
kmadangopal@gmail.com