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Services - Health programmes - Workplace health programmes
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| Program Manager: Dr Craig Innes |
The Aurum Institute has vast experience in developing and delivering health programmes in industrial settings with large patient populations. These programmes originated in the gold mining industry some 15 years ago. Today the Aurum Anti-Retroviral (ART) programme team has accumulated a wealth of expertise in combining of occupational health, HIV medicine and epidemiology. Team members apply this knowledge as part of a broad panel of scientists and health care workers, ensuring a multidisciplinary approach to the issues.
Local collaborators, such as include the SA HIV Clinicians Society, Toga Laboratories, the S Buys Pharmacy Group and Kimera Solutions, provide the Aurum team with additional expertise in the different aspects of HIV management and research. The institute’s international collaborators include the London School of Hygiene and Tropical Medicine (LSHTM) and Johns Hopkins University (JHU), considered among the most highly regarded institutions in the field of public health in the world. All aspects of the Workplace Health Programme system have been designed with the assistance of these collaborators and have been endorsed by them.
Workplace Health Programmes include:
- Development of systems for a wellness programme rollout, including protocols, forms, educational materials and a data collection system.
- Provision of a wellness services and ART for those who are medically eligible.
- Training of doctors, nurses and counsellors in wellness and ART implementation, including clinical training and training in counselling, administration and patient follow-up.
- Clinical support of doctors through Aurum’s clinical support department and Kimera Solutions.
- Clinical support of nursing staff.
- Administrative support of the sites and distribution of materials, forms and protocols to the sites.
- Management of data collection with data entry and data checking.
- Site monitoring visits.
- Reporting to client companies on a regular basis on important HIV programme outcomes, including uptake, acceptability, toxicity, adherence and laboratory measures of performance.
Once Aurum implements a Workplace Health Programme, the Institute provides ongoing support in the form of monitoring and evaluation site visits/audits and by telephonic access to professional advice and assistance. The focus is on developing and providing support to HIV clinics so that they can provide optimal care to their patients and on measuring and reporting outcomes of the HIV programme, so that it can be improved on a management level.
From the data Aurum collects, it is able to conduct operational research into aspects of providing HIV services in an industrial environment. This research is presented regularly at local and international HIV conferences to assist other organisations in developing countries to improve the HIV services they offer to their clients.
At present, Aurum primarily provides its Workplace Health services to the Anglo American group of companies, including Anglo Platinum, Anglo Coal and Scaw Metals, representing a total of 81 330 employees (at the end of 2008). The Institute also provides services to the former Anglo group companies of Tongaat Hulett and Highveld Steel and Vanadium Corporation. Past clients include Anglo Gold Ashanti, Anglo Medical Scheme and Sasol.
At the end of 2008, the Aurum Workplace Health team had 9 895 employees registered on its HIV disease management programme and 5 181 receiving ART at 34 sites in the current companies. The first patients began ART in November 2002, making the Anglo American Workplace Health Programme one of the first to introduce patients to ART in South Africa, outside of drug trial sites. Some of these patients have been on ART for more than six years, with less than 20% of these patients reporting any side effects on the medication, and fewer than 5% of patients reporting severe side effects.
The Aurum Workplace Health team recently, we have joined forces with the SME (Small and medium enterprises) Program funded by the President's Emergency Plan for AIDS Relief (PEPFAR) and hopes to extend its reach to other companies using these funds.
Challenges
Dr Craig Innes, Workplace ART Programme Manager at The Aurum Institute, says:
Our biggest challenges on this programme are to succeed in persuading employees to go for HIV testing, to register on HIV disease management programme and to begin ART once eligible. Once started on ART, our biggest challenge is to ensure that patients continue taking their tablets on a regular basis. We have proved that ART has immense benefits for patients – their general health improves, they have less hospital admissions and the sick leave they require reduces significantly. They are almost guaranteed a normal life span while they continue on ART.
Yet despite this, 16% of the patients on our disease management programme on ART have had their medication cancelled, because they no longer come and collect it. Patients who take their treatment intermittently face the danger of their HIV becoming resistant to the ART, which means the medication is no longer effective and their health starts to deteriorate again.
TB prevention
HIV patients on the programme who do not have tuberculosis (TB) can benefit from TB preventative therapy for six months, which has been shown to reduce the risk of TB disease in these patients significantly.
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