Employee Benefits to Reduce the Impact of HIV and AIDS on the Business

Replies to This Discussion

Permalink Reply by Tricia Jones on November 11, 2009 at 12:10pm

Hi Christopher,

You have certainly got the mind ticking....

On your first point - I'd be very interested in the how?
On your second point - the issue I think is the disclosure - one cannot force employees to disclose their status and at present most initiatives are focused on encouraging people to share their status - but this very notion is still a little harder to swallow. So the question would be, how would you incentivise this if you are unable to request their status? A very interesting concept though!

Would be interested in others opinions...

Regards,

Tricia

▶ Reply to This

Permalink Reply by DINA MATOME MAAPOLA on November 11, 2009 at 2:05pm

Hi Christopher!
That's an interesting way of thinking outsdide of the box!
With regard to the first question , i think, this will open up a can of worms. My question back to you is what about other chronic diseases like cancer? Why treat HIV and AIDS dIfferently? If restructuring employees benefits is a way to go, it will have to apply to other kinds of chronic diseases as this may have constitutional implications.

The second point would amount to unfair discrimination on the basis of health status. If i interprete the second question the other way round, it means "is it possible to deny HIV positive employee incentives because of his/her status?"Either way you would like to phrase your question, the bottom line is that , it will amount to unfair discrimination on employees who are already positive. Remember each employee have the right to equal benefits irrespective of their health status.Another question is how will you determine their statuses? The answer is obviously by voluntarily choosing to test. You therefore cannot compel them to test and this will render the whole endeavour futile and a waste of time.

Regards;

Dina

▶ Reply to This

Permalink Reply by Lunga on November 11, 2009 at 2:14pm

Hi Christopher

i just need to clear one thing on ur 2nd statement u say " incentives people to stay HIV negative" . . .my question is how u gonna do that.
* 1 first of all HIV is a sickness like any other and its highly confidential
*2 :how are u gona choose who qualifies for the incentive ??
*3 : all those people that are already infected will be discriminated against as they wont be getting this incentive ??

like u said HIV is very sensitive subject so i dont see this working.

▶ Reply to This

Permalink Reply by Odwa Mrauli on November 11, 2009 at 4:13pm

Hi Christopher

I think, might be wrong, that the only way you can assist employees living with HIV is to give them all the support they need like other employees who have chronic diseases. You as the employer shouldn't even be involved in the process, i think you need to outsource this service completely because employees won't be comfortable disclosing to you fearing victimisation. What you can do from as the employer is to get feedback from that company on the utilisation of the programme.

I'm very interested in how you can incentivise employees to stay negative. I don't see this one taking off without disclosing other employees HIV statuses indirectly, which would open a huge can of worms for you. It is a very sensitive issue i agree. I'm looking forward to hearing what other members have to say.

▶ Reply to This

Permalink Reply by Audrey Thwala on November 12, 2009 at 9:57am

Oh oh oh, ouch! careful you might burn your fingers "highly sensitive".

▶ Reply to This

Permalink Reply by Christopher McCreanor on November 15, 2009 at 9:55pm

Interesting replies from a diverse group. I think we should revise and restructure employee benefits to match their particular needs - not only the needs of HIV-positive employees, but also the needs of employees who are not HIV-positive, but may be affected by HIV.

How would you identify the needs of employees - internal audit? How do you overcome the "cost to company" factor when putting a benefits package together that will be most beneficial to the employee and the employer?

We need to be very creative and think out of the box!

I agree with Dina - we should not treat HIV-positive employees any different from any other employee with a manageable chronic illness. We therefore have to design benefits which will be beneficial to all employees and not only one group of employees. I have a couple of ideas and the most controversial could possible be rand-share live-cover policy.

It is a very simple approach to enable employees who are infected and or infected to afford life cover - as part of group life. The company and employee should enter into an agreement to co-pay the life cover premiums. The employee should then add the employer as one of the beneficiaries for the life cover. The employer will then, in case of the death of the employer be paid 50% of the benefit and the nominees nominated by the employee will receive the rest of the money. This will benefit the employee and the employer.

Second point.. the law states that we are not allowed to force employees to disclose their status, but it does not prohibit voluntary disclosure. The key is voluntary disclosure and employees who are negative may want to participate because they may see the benefit in regular testing and adhering to basics like the ABC principles to remain negative. It is also possible not to discriminate against infected employees by offering employees the benefit of entering a wellness campaign to ensure that the stay healthy and economically active as long as possible. it is an interesting concept, but Tricai said... would be great to get more opinions and ideas.

How do implement behavioral change initiatives and risk reduction strategies?

Christopher

▶ Reply to This

Permalink Reply by Christopher McCreanor on December 29, 2009 at 3:47pm

Hi Guys and Ladies, Thank you for your wonderful responses to the Employee Incentives Question I posted in November. I have completed a paper and this is a extract of the full paper. I am more than happy to share the full paper with you.

Employee Incentive and Recognition Schemes have become significant elements in the HR toolbox and could well become an important tool for the strategic HIV and AIDS Managers of organisations. This is due to the possible impact of HIV and AIDS on organisations; competitive pressure and the pace of change increased the demands on everyone at all levels of organisations. Retaining key human performance became notably more integral to the success of any company.

The main objective of well-planned and bespoke incentive programmes is to increase individual, group and organisational performances. Incentive programmes show a number of potential advantages if managed and administered correctly. Traditional incentive programmes are based on recognising outstanding performances against very specific and measurable organisational goals. Incentive programmes are therefore set up to motivate employees to set and attain personal goals as well as organisational goals linked to individual and group goals. One of the key success factors of meaningful incentive programmes is the ability of the programme and programme managers to measure the physical outputs of employees. Programmes aimed at measuring sensitive and subjective ratings, such as HIV status may be more complex to manage effectively and efficiently.

Incentivising employees to remain HIV negative may at first glance seem plausible, but may have far-reaching legislative and human right implications. Incentive programmes of this nature may present organisations with moral and ethical dilemmas and may, in the long run, have an impact on: employee morale, lower productivity, and a decrease in organisational performance. Dr Robert D. Hobert recently investigated the psychological rationale for the use of incentives; how they work, why they work on some occasions and not others, with some people but not all people, and how incentive programme users could determine, scientifically, whether incentive programmes really do work, and what would have happened if they had not used an incentive programme. Hobert argues, “when behaviour is followed by a reinforcer, the behaviour increases in frequency, strength, or duration.”

It therefore seems that the reinforcement theory “is the key to answering the questions that should be asked about incentives” and why some reinforcers work and others do not work. The key to successful incentive programmes to encourage and motivate employees to stay (or be) HIV negative may lie in the fact that organisations should first establish the most effective reinforces and if the reinforces would have the desired outcomes as stipulated by the incentive programme objectives. The reinforcement theory, according to Hobert, “deals with behaviour and with the events that precede and follow specific behaviours.” In order for HIV incentive programmes to be successful, the programme designers and managers should understand the relationship between antecedents, behaviour, and consequences, and the fact that the relationships between them will form the basis of successful programmes - the three key success factors.

The following definitions, adopted from Hobert’s acclaimed paper and the reinforcement theory, will define the three key factors in context of possible HIV incentive programmes:

Antecedents are defined as those events, which occur before the performance of a behavior. For example, a request to register for an HIV incentive programme and to be tested for HIV before admission to the programme is an antecedent to be tested for HIV, to participate in an incentive programme and to stay negative for the remainder of the incentive programme.

Behaviour, in reinforcement terms, must be identified in measurable, countable and specific terms. Behaviour is any thing a person says or does, any activity, any response made by an individual. Behaviour is strengthened, or more likely to occur, with greater frequency, if something positive happens as a consequence of the behavior. In such a case, the behaviour is reinforced. If behaviour does not increase in frequency, it has, by definition, not been reinforced. In the event of an HIV incentive programme it is expected of employees to be tested on a regular basis, but more importantly, change their sexual-risk behaviour to remain HIV negative. The expected behaviour may be directly and / or indirectly communicated, depending on coherent communication with employees and how well employees understand the ‘rules or guidelines” for participating in the programme.

Consequences are those results or events, which follow behaviour. Changing high-risk sexual behaviour, staying negative and continuance on the programme is a consequence of testing for HIV and changing behaviour. Testing (negative) for HIV and changing high-risk sexual behaviour is a consequence of accepting the rules and guidelines of the HIV incentive programme.

The main question still to be answered, even with a scientific approach to incentive programme design and development is, what will happen once the employee completed the participation in the incentive programme? The Debswana case study delivered interesting results, but there is no (empirical) evidence that all the participants continued to eradicate high-risk sexual behaviour after the completion of the apprenticeship. The lack of evidence may be due to the fact that the Debswana incentive programme included only the first four steps of a six step phased approach to incentive programmes (Miller, 1978). Miller postulates that “ as a scientific organisational intervention, a well-designed incentive programme should include six essential phases: (1) specification of performance, (2) measurement of performance, (3) behaviour analysis, (4) design and implementation, (5) evaluation and (6) maintenance of performance. It is not clear from the Debswana case study if the organisation followed Miller’s proposed steps.

In conclusion, it is possible to incentivse employees remain (or be) HIV negative. It is, however, important for any HIV programme, in order to be successful, to implement a six-step approach to ensure that future programmes use data from the evaluation to modify and/or improve future programmes due to significant gains in terms of “performance” and/or “high-risk change behaviour” during an incentive program are likely to disappear if the programme does not include a plan for sustaining the sexual high-risk change behaviour developed while the incentive was in effect – if even developed at all.

Regards

Christopher

▶ Reply to This

▶ Reply to This