Effectiveness of the Implementation of the Work Place HIV.AIDS Policy and Technical Guidelines for the Health Sector

Abstract

HIV Infection continues to impact the world of work. This is especially more evident in the health sector where health workers are at risk of hospital acquired infections and attitudes and practices strongly influence the response to the provision of prevention, treatment, care and support interventions for infected patients. The ILO thus recommends the implementation of HIV Work place policies at Global, Regional, County and Local levels. In line with this the MOH, Ghana published its Work Place Policy in 2004, for implementation by all institutions under the Ministry of Health. The policy has three major objectives: Protection from Stigma and Discrimination, Prevention of spread of HIV; and the Provision of care and support. The study sought to determine the effectiveness of the implementation at an urban tertiary referral hospital located in the Greater Accra Region of Ghana. A qualitative cross sectional descriptive, mixed methods study was carried out using in depth and key informant interviews and open, non participant structured observations of managers, infected and non infected health workers at the hospital. Interviews were transcribed verbatim and coding was done by two investigators. Codes were compared and categorized into recurring and extreme themes. Data from interviews from the three groups was triangulated for validity. Data from the structured observations was also used to validate the interviews. Quotations representing themes were selected for inclusion. The level of attainment of each objective was summarized from data from the themes and described as fully achieved, partially achieved and not achieved. The three objective achievements were summarized to describe the policy implementation as highly effective, partially effective and not effective. The knowledge and awareness of the policy document was poor. Provision of care and support to health workers was fully achieved prevention of HIV infection at the workplace partially achieved and protection from stigma and discrimination not achieved. The policy was thus judged to have been partially effective in its implementation. Recommendations were made to the hospital management to help achieve full implementation of the policy objectives.