Workplace Health Services

Workplace Health Services

East London, South AfricaEast London, South Africa
Year Founded:
2006
Organization type: 
nonprofit/ngo/citizen sector
Project Stage:
Established
Budget: 
$500,000 - $1 million
Project Summary
Elevator Pitch

Concise Summary: Help us pitch this solution! Provide an explanation within 3-4 short sentences.

Siyakhana Health Trust is a not-for-profit public benefit organization, established to provide health management support to small and medium sized businesses. SHT’s medium-term goal is to provide an integrated health services offering that includes health screening, workplace medical surveillance and limited primary health care services to SMEs and their employees.

About Project

Problem: What problem is this project trying to address?

SMEs tend to focus on their core business, and not on the health of their employees. However, healthy employees are crucial to business success, and contribute directly to a thriving economy. For workers to access basic health care in the public sector in South Africa often requires them to take substantial time from work to join long queues in over-crowded, often poorly resourced clinics. Also, the notion of creating healthy workplaces is often assumed to be the preserve of big, rich companies. Many SMEs are unaware of the obligations placed on employers with respect to the health and safety of their employees by the OHS Act. By providing onsite health and hazard screening, Siyakhana makes it possible for SMEs to meet legal (OHS Act) obligations & to ensure the health of their workers.

Solution: What is the proposed solution? Please be specific!

We have always partnered with the chamber of business to reach local SMEs, where we have provided HIV/AIDS & health services that would otherwise be unaffordable. Since 2012, our general health offerings have been augmented by comprehensive Occupational Health Services. A team of health professionals, highly skilled in the areas of infectious diseases, non-communicable diseases and occupational health, delivers services on-site in a flexible manner that ensures minimal disruption to the operations of the SMEs. Spouses and children of SME employees can access the exact same services (except for occupational health screening) at an off-site location at no cost to the individual employees or their dependents.
Impact: How does it Work

Example: Walk us through a specific example(s) of how this solution makes a difference; include its primary activities.

Our mission is to provide holistic workplace health management to our member SMEs through operationalising the World Health Organisation’s Healthy Workplaces Model. Our vision is of a society where communities are aware of common health risks and are able to take responsible action. We have three objectives: (1) By the end of 2017, 85% of Siyakhana SME Project members will comply with the pertinent provisions of the Occupational Health and Safety Act of 1993 (2) By the end of 2017, the ill-health absenteeism rate at the Siyakhana SME Project members will have declined by 10% due to the delivery of comprehensive health screening services (3) Siyakhana will deliver a minimum of four wellness expos, with an emphasis on HIV/AIDS, to communities in the Border-Kei region each year

Impact: What is the impact of the work to date? Also describe the projected future impact for the coming years.

An independent external evaluation of the Siyakhana SME Project conducted in 2010 found that: "Siyakhana’s innovative approach to providing access to HIV/AIDS care for employees in small enterprise and to their dependents is now widely recognised, not only in the project area, but nationally in South Africa and even internationally. Its value‐added engagement with organised business and with public entities in delivering health care services to people living with HIV and to patients with AIDS and/or TB has been very successful, and this report will show that the effort is highly deserving of continued support. The partnership model has definite potential to be fully integrated into public services in a sustainable way, and is no doubt one of the flagship projects operating in the Eastern Cape. Participating government clinics in the project without exception indicated that Siyakhana has become an integral part of their service delivery capacity in the region, and that their ability to deliver a high standard of quality of care has been, and is, directly attributable to the support provided via the project." By December 2012, Siyakhana had: Trained 638 managers on HIV/AIDS in the workplace Prepared 90 focal persons to coordinate workplace programs Equipped 190 peer educators Conducted 101workplace health screening campaigns Trained and counselled 16 648 employees Tested 13 345 of the employees counselled for HIV Referred 1 382 people who tested positive into the HIV treatment programme Provided treatment, care and support to 715 patients
Sustainability

Financial Sustainability Plan: What is this solution’s plan to ensure financial sustainability?

Our mid-term growth time frame is five years (2013 - 2017). Our growth milestones are divided into Membership, Revenue and Cost Recovery. MEMBERSHIP MILESTONES 2013: 2 520 employees in 29 SMEs 2014: 2 790 employees in 35 SMEs 2015: 3 390 employees in 39 SMEs 2016: 4 080 employees in 47 SMEs 2017: 4 920 employees in 57 SMEs REVENUE MILESTONES 2013: R240 000 2014: R723 000 2015: R900 900 2016: R1 107 000 2017: R1 400 700 COST RECOVERY MILESTONES 2013: 4% 2014: 11% 2015: 13% 2016: 15% 2017: 17% Our key growth activities centre on marketing, delivering the highest possible quality services, recruiting "champions" from the ranks of satisfied clients,

Marketplace: Who else is addressing the problem outlined here? How does the proposed project differ from these approaches?

We are the only NGO delivering these services in this region. We collaborate with a private sector provider of occupational health services to reach non-qualifying companies in the region. General practitioners who may otherwise have deemed our services to be competing with theirs have instead become an integral component of our service offering. Because we have always adopted a collaborative approach, we have not encountered hostility or negative competition. We are therefore able to focus on delivering the best quality of services to the intended beneficiaries.
Team

Founding Story

The “Siyakhana SME Project” was established as a public-private-partnership at a time when the South African Government's response to the HIV/AIDS pandemic was incoherent and highly contested. Building on its own workplace programme, DCSA (now MBSA) sought to provide a comprehensive HIV/AIDS programme to SMEs in Buffalo City in order to stave off a looming catastrophe.
Organization Name

Siyakhana Health Trust

About You
About You
First Name

Siyakhana

Last Name

Health Trust

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Innovation
Explain what the "innovation" is about, e.g., is it the idea and/or the model you use to accomplish the idea, or your understanding of the target population, etc.?

In South Africa, issues of Workplace Health are well-addressed through legislative mechanisms. While it is improving, the monitoring of compliance with legislation has, unfortunately, been weak. At the same time, SA has, since 1994, subscribed to a free market approach to economic policy. The consequent deregulation of aspects of some industries and the lowering of entry barriers in others has seen a proliferation of small and medium enterprises (SMEs), many of whom operate on the margins of the economy. Resource-constrained SMEs often perceive facilitating workers' access to health services as "an unaffordable luxury".

The Siyakhana Health Trust's innovative "SME Project" brings health services to workers in SMEs at a nominal cost to the company, at no cost to the individual, and with minimal disruption to production. Services are extended to family and dependents - these are accessed off-site, but also at no cost to the individual.

What began as an HIV/AIDS voluntary counselling and testing service has evolved into a fully-fledged workplace health service. The resultant service offering is unique in that it supports the government's objectives relating to worker health across multiple legislative, policy, and strategic domains. (These include, among others, the Labour Relations Act, the Occupational Health and Safety Act, the National Strategic Plan on HIV/AIDS and TB, WHO & ILO Health at Work conventions).

Our innovative approach aims to keep healthy workers at work in health-promoting workplaces.

Describe how your innovation model is distinct from any other organization in your field?

Our innovation model is distinct in 4 ways:
1) To our knowledge, there are no other citizen sector non-profits providing mobile occupational and general health services to SMEs

2) While there are a number of private sector service providers in the field, they tend to focus on either Occupational Health OR Primary Health Care OR HIV/AIDS. Siyakhana, by contrast, offers an holistic set of services ranging from general health screening to occupational health policy planning, on a not-for-profit basis.

3) Most service providers require workers to leave their workplace to attend off-site clinics. Siyakhana's mobile facility takes services to workplaces

4) No other service provider extends services to workers' dependents at no cost to the individual

What type of operating environment and internal organizational factors make your innovation successful?

The operating environment in which Siyakhana has located itself is influenced by a number of "streams", primarily legislative, economic, social, and health. In many ways, Siyakhana operates at the intersection of these "streams". A positive intersection exists right now since there is a growing realisation of the inextricable link between the health of workers, the profitability of the companies they work for, and the strength of the economy. The external environment is increasingly aware of the need for the services we offer.
Success depends on our agility in responding to varied needs of companies. We thus utilise a flexible staffing model that allows us to deploy expertise where and when necessary. Funding security influences the extent to which the innovation can be replicated.

How do you make sure you constantly innovate in light of (potential) external challenges, or your growth plan?

Having utilised a partnership delivery model from the outset has ensured that Siyakhana is always able to source and introduce cutting edge thinking and developments, via our funding and technical partners.
Open engagement with government has also ensured that we have contributed, not only responded, to changes in policy at a national, provincial and regional level.
At times when policies have proven to be a hindrance, rather than a facilitator, to our work, we have worked with communities to access innovative alternative services, such as our network of private sector general practitioners who deliver HIV/AIDS treatment.
Our mobile facility is fitted with state-of-the-art equipment, requiring staff to be up-to-date with the latest screening techniques at all times.

Organization Country

, EC, East London

Business Model
The systemic challenge you are trying to overcome (select one)

Bring accessible healthcare to communities in emerging markets

Health area (target market) where the need is [select only one]

Primary healthcare services

Categories along the health continuum you are covering [select all that apply]

Prevention, Detection, Intervention, Follow-up, Long-term care, Social integration.

Stage that best applies to your solution [select only one]

Piloting (a pilot that has just begun operating)

Core strategies of your business model [select all that apply]

Approaches to behavioral change at the individual level, Patient-centered design, New approaches to distribution of health products and services, Unconventional partnerships (between traditional healthcare players and players outside healthcare).

If other, specify here:
Most relevant tools you are using to implement the strategies outlined above [select only two]

Technology, Education/training, Others.

If other, specify here:

Clinical expertise; Public Health expertise; Occupational Health expertise

What is your value proposition?

We deliver world class, mobile workplace health services to small and medium enterprises in and around Buffalo City in the Eastern Cape. Our mobile, on-site services minimize down-time, optimize worker health and safety, and support productivity and profitability.
Our services are available at nominal cost to qualifying SMEs, and are extended to all employees and their dependents at no cost to individuals.
All services are delivered in the strictest confidence; while individuals are counselled to reveal their HIV status if they have tested positive, they are supported in whatever decision they make regarding disclosure.

Who is your customer(s)?

Our customers are resource-constrained small and medium enterprises employing fewer than 200 people in any industrial sector.
The beneficiaries of our services include the workplaces (employers), employees, and employees' dependents.
Our services are available to non-qualifying businesses on a fee-for-service basis.

What approaches to you use to reach your customers?

Since inception, Siyakhana has partnered with the Border-Kei Chamber of Business. As members (and beneficiaries) of the Chamber, we make use of quarterly newsletters to place advertorials and news items. The Chamber also actively promotes our services to its members.
We use a zero-level channel to sell our services to potential clients / members. Potential members are approached through flyer distribution, email campaigns, direct calls, and word-of-mouth.
Our mobile clinic is very visibly branded, and therefore doubles as a mobile advertising board.

What are your primary activities?

The Mobile Clinic / clinical teams move between workplaces to provide on-site services.
Clinicians provide medical surveillance and integrated health screening.
Once SHT has established the occupational hygiene profile of a workplace, or the health status of an individual, appropriate remedial responses are activated in consultation with the SME / employee (as appropriate).
All employees (or their dependents) who test positive for HIV are referred into our treatment programme.
Health promotion literature, management training, & policy development are all included in the nominal SME membership fee.
Working directly with Buffalo City Health, Provincial and District health services, Siyakhana also carries out health promotion activities in communities throughout the Border-Kei region.

What other challenges - individual, organizational, or environmental – are you currently facing or might hinder future success of your business, and how do you plan to overcome those?

The biggest challenge we are facing as an organisation is financial sustainability. Siyakhana has always been generously supported by corporate and donor funding, through MBSA in particular. Funders' own exit strategies require that recipients develop financial independence.
To this end, Siyakhana has formalised a resource diversification strategy, coupled with a marketing strategy. Conscious effort is being applied to identify and nurture new funders, create opportunities to generate fee-revenue (by selling our services to non-qualifying businesses on a fee-for-service basis), and to expand our client base. We are also paying attention to our cyber-presence, and intend to establish a social media profile.

Briefly describe your growth strategy going forward

Growth will take place on 3 levels:
1. Service range
SHT's service offering is regularly updated in response to client needs, but remains within the envelope of our area of expertise
2. Geographic reach
Through innovations such as the addition of a mobile clinic, we are able to grow beyond existing geographic boundaries
3. Client profile
With fee-for-service options, we can service non-SMEs

What dimensions for growth are you currently targeting for your innovation [select all that apply]

New customer group(s), New regions(s).

What makes your business "ready" for growth?

We have expanded our service offering, and recently become more accessible through our mobile clinic. This means that constraints to our services have been minimised, so we are able to service SMEs in a wider geographic range, and offer them more services.
The pressure on us to generate own revenue provides further impetus for expansion.

What are your key growth objectives?

We seek to recruit more companies to the project so that more people are made aware of common health risks, are screened for these risks, and, if vulnerable or affected, have access to quality treatment and remain healthy and economically active for longer.
Based on the economic profile of our area of operation, we expect growth in the Agricultural, Mining, Construction and Manufacturing sectors

Organization's Country of Operation

, EC, East London

Social Impact
What methods for quantification of social impact are you applying (if at all)?

Campaign statistics (as presented above) are generated and analysed, both for our own purposes and to feed into the applicable Provincial and National registers.

Siyakhana subjects itself to regular evalutations, which serve to maintain funder and stakeholder confidence on one hand, and ensure the maintenance of best practice on the other. The next evaluation is scheduled for 2014.

Could your solution work in other geographies or regions? If so, where?

Yes.
The solution is not circumscribed by geography, but rather by the willingness of partners to contribute.
The solution can be rolled out anywhere that public private partnerships are viable delivery vehicles.
Using the partnership methodologies refined in the delivery of HIV/AIDS services, and later general health screening and awareness, Siyakhana was able to introduce new workplace health services in 2012. The new services focus on occupational health at the shop floor level.

What is your projected impact over the next 1-3 years?

The HIV/AIDS indicators detailed above will continue to be tracked, and are expected to improve incrementally as our growth targets are met. In terms of the Workplace Health Services (occupational health focus) expansion of our service offering, we anticipate that the improved health of workers will improve regional productivity. Furthermore, legal compliance with the OHS Act and decreased absenteeism (resulting from our comprehensive occupational and general health services) will directly, positively impact the economic prospects of the area.

Sustainability
Elaborate on your current financing strategy

Siyakhana was established as a public benefit organisation; a non-profit trust. This organisational model assumes that at least 80% of all income will be in the form of grants or deeds of donation. The organisation is entitled to generate only 20% of all revenue through direct sale of services.
To date, the bulk of the funding supporting Siyakhana has been provided by Mercedes-Benz South Africa (MBSA). This funding will taper off over the next three years. Efforts to replace this primary source have been undertaken over the past year.
In addition to current donor funds, the organisation has retained sufficient reserves to fund its operations for a year.
The partnership model utilised by Siyakhana has seen a number of partners making critical contributions to the delivery of services without directly funding the operations of the organisation. For example, the formalised collaboration with the Department of Health provides for all laboratory testing and some drug therapies at no cost to the Project.

Share of revenue generation in total income of organization (in percent)

2

Direct sales to patients or other beneficiaries (in percent)

2

Of the possible sources of these sales listed below, check all that apply to your current strategy

Private businesses.

Licensing fees, e.g., for technology/franchise model (in percent)
Of the possible sources of these licensing opportunities listed below, check all that apply to your current strategy

Service contract with organizations, e.g., government, NGOs (in percent)

2

Of the possible sources of the service contracts listed below, check all that apply to your current strategy

Private businesses, Regional government, National government.

Explain your revenue generation strategy in more detail

Qualifying SMEs are invited to join the project as members. A service level agreement is established with each individual SME for a 2-year period. Each SME makes a nominal membership contribution which is calculated according to the number of people they employ. To date, membership fees have accounted for less than 2% of annual income. With the addition of Occupational Health Services, the membership contribution will increase progressively towards the 20% threshold for cost recovery.
The balance of the 20% own revenue will be made up through fee-for-service, competitive sales of services to non-qualifying companies.

Share of philanthropy in total income of organization (in percent)

80

Philanthrophy strategies you are using

Diversified strategy.

Explain your philanthropic approach in more detail

All contributions to the SHT are tax deductible.
Dependence on a limited funding base has been identified as a limitation to the sustainability of the organization, and a comprehensive resource diversification strategy has been developed. Key features of the strategy are detailed in the section titled "Future Financing Strategy".

Expand on your selections; explain how you will sustain funding over the next 1-3 years.

Our future philanthropic approach has four dimensions:
1) Nurture existing funders: through sharing our work, reporting proactively on the utilisation of resources, and providing independent evaluations of our achievements, we aim to retain good faith relations with existing supporters
2) Develop new corporate and donor funders: we have prepared a detailed organisational strategy which forms the basis of submissions and appeals to new funders
3) We have begun to develop channels for individual giving (off our website, for example) and intend to establish relationships with people and companies who are interested in small donations
4) Smart investing of grants received will enable Siyakhana to benefit from investment (interest) income as well.

Years in Operation

Operating for more than 5 years

Has the organization received awards or honors? Please tell us about them

In 2010 Mercedes-Benz South Africa received the coveted Stevie International Business Award for the Best Corporate Social Responsibility Programme of the Year in Africa and Middle East on account of the Siyakhana SME Project.

Comments

I am really proud to be associated with this ground-breaking project!

To promote the current health care system we have found that several health care experts and organizations are used to deliver different type of health care service in several regions. Therefore here we have witnessed Siyakhana Health Trust offers a number of health care programs in affordable cost to the localities that ultimately solve various health care problems in the surrounding.
urgent care Arizona

SMEs require a solution that simplifies access to health services for employees, encourages health-savvy behaviour among workers, and facilitates compliance with the law. Continual Health