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Engaging workplaces in TB care and control

Engaging workplaces in TB care and control. Evidence base and guidance framework. Dr Ernesto Jaramillo Stop TB Department World Health Organization Geneva, Switzerland. Engaging all care providers. Core component of the Stop TB Strategy Care delivery. PPM Scale Up Tool-Kit. Core Tools:

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Engaging workplaces in TB care and control

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  1. Engaging workplaces in TB care and control Evidence base and guidance framework Dr Ernesto Jaramillo Stop TB Department World Health Organization Geneva, Switzerland

  2. Engaging all care providers • Core component of the Stop TB Strategy • Care delivery

  3. PPM Scale Up Tool-Kit Core Tools: Rationale and Generic Approach National Situation Assessment Operational Guidelines Monitoring and Evaluation International Standards of TB Care Resources and Budgeting ACSM Specific Tools: Engaging private practitioners Engaging hospitals Engaging workplaces Engaging Social Security Organizations Engaging civil society Engagement in TB/HIV activities Engagement in MDR-TB management

  4. Global Snapshot • 9.37 million new TB cases in 2008 • An estimated three-quarters of those who fall sick or die of TB are aged • 15-54, that is, people of prime working age.

  5. The case for engaging businesses • Reach: 3 billion people in the world of work • Impact on workers • A TB patient loses 3-4 months of work time • 20% to 30% of a patient's annual income lost • 15 years of income are lost from premature death • Estimates for India- TB caused a loss of 7.9 million DALYs and a reduction of US$ 23.7 billion in economic wellbeing. • Impact on economy • An estimated 4-7% loss in GDP is due to TB in several Asian countries. • For India, the annual cost to the country's economy - $300 million in direct costs and over $3 billion in indirect costs • Overcoming barriers • Working hours • Job discrimination • Loss of wages

  6. Rationale for business participation • Transmission • TB incidence in miners is over 2000 per 100 000 employees per year in some workforces. • Garment workers in Bangladesh are 2.4 times more likely to develop active TB than the general population. • Worker Productivity • Globally, TB is known to cause a decline in worker productivity to the order of US$ 13 billion every year. • In India alone, TB causes a loss of 100 million workdays per year. • A gold mining company incurred an estimated cost of $410 in lost shifts for each case of TB among its unskilled employees in South Africa. • Nearly one-quarter of over 10,000 business leaders worldwide reported that TB was affecting their business.

  7. Evidence base • Literature review • Survey • Disseminated by ILO, GBC, CII, GHI and ITGLWF • 57% of 21,000 workplaces responded that they do not address TB within their HIV workplace programmes. • Site visits • Bangladesh, Cambodia, Kenya and the Philippines • 32 workplace initiatives • Delivery models • Gaps and potential

  8. COMPANY MEDICAL CENTRE COMPANY CONTRIBUTIONS NTP Delivery models:Kenya tea estates • Beyond the workplace • TB and HIV services provided to family members of employees and surrounding community DIAGNOSIS Anti-TB drugs M & E TREATMENT

  9. NTP Delivery models:Bangladesh EPZ • Beyond the workplace Big businesses influence practices and health service provision by small suppliers, by ensuring that these are pre-conditions for securing the work contract DIAGNOSIS Anti-TB drugs Shared Corporate Health Centre COMPANY CONTRIBUTIONS NGO TREATMENT M & E

  10. Directed at NTP-business-partner collaboration to initiate and implement workplace programmes Menu of options Practical steps for implementation Case studies Guidance framework

  11. Menu of options Every business counts! Big Companies Identify TB cases among workers and provide diagnosis at workplace Beyond the workplace: Implement comprehensive TB and HIV care programs for workers, families and communities. Support supply chain SMEs Increase awareness among workers, families and community Provide TB treatment and care at the workplace Include TB prevention, diagnosis and treatment in HIV workplace programs Identify TB cases among workers and refer to the public sector Families, Communities and beyond Comprehensive workplace programme Treatment and care Small Companies Referral and Treatment support Diagnosis Awareness

  12. Steps to initiate TB workplace programmes • Form a tripartite steering committee • Situation assessment • Identify and link with relevant partners • Develop a tripartite collaborative plan • Implementation • Monitoring

  13. “A good company delivers excellent products and services, and a great company does all that and strives to make the world a better place." William Ford Jr., Chairman, Ford Motor Co.

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