The DaimlerChrysler Chamber Health Trust (DCCHT) Siyakhana Project is an international benchmark intervention in which global automotive giant DaimlerChrysler, the Border-Kei Chamber of Business (BKCOB) and German development agency DEG (Deutsche Investitions- und Entwicklungsgesellschaft mbH) have established a public private partnership to provide participating small and medium sized companies with tangible HIV and Aids awareness, counselling, testing, treatment, care, support and impact mitigation.

The partners have raised R4,4 million with DaimlerChrysler South Africa (DCSA) contributing 58%, DEG 36% and BKCOB 6% which allows funding of this innovative health care model until the end of 2007.

Siyakhana offers 17 participating companies a unique programme that has been positively received and has improved testing rates and take up of antiretroviral treatment, thus keeping HIV-positive employees strong and economically active for longer. This provides a win-win situation for employers and employees.

This bold project operates on a number of levels to ensure that where possible every constraint to testing and treatment is removed and it received significant interest at the 16th World Aids Conference in Toronto in August 2006.

The project focuses on small and medium sized companies who elect to participate and who pay a nominal amount to do so. DCCHT staff then conduct an awareness campaign amongst all staff where they receive information on HIV and Aids and are advised of the benefits of knowing their status.

Thus far some 630 employees have been offered voluntary counselling and testing. HIV voluntary counselling and testing (VCT) is conducted on site. To date, 2,794 employees have responded to the offer of VCT and 1900 have taken HIV tests. In addition employees can access VCT for their partners / spouses and up to three children as well. In total the project will reach some 8 000 employees and, with dependants included, can potentially reach 32 000 people.

Typically on site treatment is problematic because of the stigma associated with HIV infection and so DCCHT has established a general practitioners’ network which is especially trained in HIV and Aids treatment and care – including access to anti-retroviral treatment. As at the end of 2006, 170 HIV-positive employees had been referred into the treatment programme.

There are nine doctors in the GP network. The cost of anti-retroviral and related medication is carried by the Eastern Cape Department of Health with the project carrying general practitioner, laboratory and related costs. Disease management services and the some costs of reimbursing the GP network are carried by BroadReach Healthcare LLC through a PEPFAR grant.

Participating workplaces are aware of the need to respond to HIV and Aids in a strategic way, but are often unsure how best to handle this operationally. Management buy-in is a critical component for the success of the project and so line managers receive training on the disease and how to respond to it from a management perspective. Thus far 315 line managers have received training.

Companies appoint focal persons (company co-ordinators) who are the in-house champions of the project and they meet with focal persons from participating companies each month to share challenges and achievements. This has been very successful and 27 focal persons have been trained. Within each company there are also peer group educators who are available to colleagues who might be grappling with the many complex socio-economic issues relating to HIV and Aids.

Broadly, it is accepted in South Africa that HIV and Aids is everybody’s business and DaimlerChrysler has led the way by initiating this programme and securing funding for its start up. Workplaces provide an ideal environment for engaging employees on issues like health and wellness and the region’s economic growth relies on a healthy and active workforce. It is the intention of the DaimlerChrysler Health Trust to consolidate its services to the 17 participating companies and to widen the net of support to dependants, however to do this it will require further funding in the future.

While in the longer term it is hoped that those already on HIV treatment will access it through ARV sites at public sector clinics, there are readiness constraints at present which is why the project has set up a private sector treatment network. The DCCHT has a positive working relationship with Buffalo City Municipality’s Directorate of Social Services which oversees health.

In its efforts to contribute to strengthening primary health care provisioning in the region the DCCHT has facilitated the training of 43 doctors from both the private and public sector in HIV/Aids management and 26 nurses have attended training in HIV/Aids clinical care. The project is also engaged in mentoring and support to 10 public sector primary care clinics in the Buffalo City Municipal region.

However it remains a challenge to expand the programme as intended and ensure those already on ARV stay on their treatment remains a funding challenge.

The DCCHT employs a project manager, a VCT co-ordinator, a part time administrator and 3 nurses who conduct counseling and testing. Their office is housed at the BCKOB offices in East London. - DCCHT

Click here for a presentation on the project:  siyakhana_project_april_07 209.06 Kb