By M. K. Kodjo and D. Tadesse

1. Benefits of promoting access to SRH services within private and parastatals companies. Experiences of 4 MAs of IPPF By M. K. Kodjo and D. Tadesse

2. Presentation Outlines • IPPF African Region • Justification of the study • Involved organizations • Study objectives and methodology • Findings: benefit of access to SRH services • Recommendations

3. Background IPPF: • IPPF: voluntary organization working in sexual and reproductive health • IPPF, headquartered in London, UK • Current strategic plan focus on – Adolescents/young people, HIV/AIDS, Abortion, Access (including family planning) and Advocacy. IPPF Africa Region (IPPFAR) • is one of the six regions of IPPF. • Plays a key role in promoting sexual and reproductive health, in sub-Saharan Africa in 44 countries through the member associations (MAs) • IPPF Africa Regional Office is based in Nairobi, Kenya

4. Justification of the study Huge unmet needs in SRH across Africa Limited Access to reproductive health After ICPD 1994, national policies on SRH or population Funding of SRH programmes by external partners National governments are more and more funding the sector. But access is still limited. Private companies can play complementary role in promoting access to SRH services at workplace Some IPPFAR-MAs were involved in such initiatives from 2003 to 2005. 4 cases were chosen to be assessed in 2006 to draw lessons from process

5. IPPFAR-MAs involved • The Family Life Association of Swaziland (FLAS): offered SRH services (FP, STI prevention & treatment, VCT,etc) to six (6) companies situated within the Matsapha industrial site at a cost recovery charge. • The Family Health Options Kenya (FHOK): offered SRH services (VCT, STI management, FP) at workplace for three agro-based companies;

6. IPPFAR-MAs involved • The Planned Parenthood Association of Ghana (PPAG): offered HIV/AIDS workplace programmes to five companies and their local partners; • “L’Association Pour le Bien-être Familial/Naissances Désirables”(ABEF-ND) of the Democratic Republic of Congo offered mainly FP services for 5 parastatal companies.

7. Study objectives • Overall objective: assess the SRH activities implemented in partnership with the private and parastatal sectors by the MAs mentioned above. • Specific objectives included: • To analyse the process of identification and introduction of SRH services within the private and parastatal sectors; • To gather information on the perception of different stakeholders on those services; • To assess and document the benefits of the initiative on the company it’s workers and their families.

8. Study methodology Study was conducted from 06-09 2006 Data collection methods were mainly qualitative • Focus Group Discussions • In-depth interviews using structured and semi-structured questionnaires, • Desk reviews of relevant primary and secondary sources of information SWOT analysis technique was applied to draw lessons learned & make recommendation This is a qualitative study. The findings are based on opinions of persons interviewed. No observation as evidence to support the declarations.

9. Benefit of access to SRH services Workers reported that the services benefited in term of: • increased understanding of SRH issues, • access to family planning and access to condoms, • treatment of STI, • increased awareness of HIV/AIDS issues “My wife puts condoms in my pockets when I go on a safari just in case!” • Behavioural changes: sexual abstinence, reduced high risk sexual behaviour (e.g. unprotected sex, multiple sexual partners) and decrease of negative attitudes towards those infected by HIV and AIDS, among others

10. Benefit of access to SRH services • Empowerment of women to decide when and whether to have more children through access to FP services (DRC) • Increase of HIV testing among pregnant women (Swaziland and Ghana ) • Community behavioural changes: safe circumcision of boys, reduced engagement in casual sex by male transport workers; reduced cases of wife inheritance; and reduced cases of discrimination and isolation of HIV positive (Kenya) “I had even abandoned a shared toilet facility in the company. I had to walk back to my house several meters away to answer short call. At the moment that is no more. I interact and share a lot with colleagues who are infected by HIV”

11. Benefit of access to SRH services • Women in DRC said they now spent less time attending to sick members of the family, leaving more time to attend to their businesses. • dual benefit of increased household income from business activity and reduced workload on the domestic front • A company HR manager in Kenya reported: • before the programme, the situation at the company was worrying as many employees were dying and the numbers off-duty was equally high “I now sign few sick leaves and certificates of incapacity to work, and approve few medical bills. Medical expenses are now down by about 25%”.

12. Lessons learnt • Most successful factors: the development of workplace SRH policies, the use of peer educators and the commitment of company managers were of great importance • A major weakness recorded was the frequent stock out experienced • Great opportunities include: possibility of establishing partnership with other facilities for referral and availability of funding mainly for integration of HIV/AIDS services • A major threat was the non implementation / existence of a SRH policy at country level.

13. Recommendations • Development of SRH workplace policy (including HIV/AID workplace policy) at a first stage • Ensure availability of contraceptives and other supplies and equipments needed for the services • Enhance the number and quality of peer educators (include more women in the group) • Ensure the implementation of proper monitoring and evaluation of the SRH activities • Enable the sharing of information amongst peers and between peer educators and company health workers