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Journal of the International AIDS Society

, 12:32

First Online: 11 November 2009Received: 09 February 2009Accepted: 11 November 2009


BackgroundWith an estimated adult HIV prevalence of 15%, Namibia is in need of innovative health financing strategies that can alleviate the burden on the public sector. Affordable and private health insurances were recently developed in Namibia, and they include coverage for HIV-AIDS. This article reports on the efficacy of HIV workplace surveys as a tool to increase uptake of these insurances by employees in the Namibian formal business sector. In addition, the burden of HIV among this population was examined by sector.

MethodsCross-sectional anonymous HIV prevalence surveys were conducted in 24 private companies in Namibia between November 2006 and December 2007. Non-invasive oral fluid-based HIV antibody rapid tests were used. Anonymous test results were provided to the companies in a confidential report and through presentations to their management, during which the advantages of affordable private health insurance and the available insurance products were discussed. Impact assessment was conducted in October 2008, when new health insurance uptake by these companies was evaluated.

ResultsOf 8500 targeted employees, 6521 were screened for HIV; mean participation rate was 78.6%. Overall 15.0% 95% CI 14.2-15.9% of employees tested HIV positive range 3.0-23.9% across companies. The mining sector had the highest percentage of HIV-positive employees 21.0%; the information technology IT sector had the lowest percentage 4.0%. Out of 6205 previously uninsured employees, 61% had enrolled in private health insurance by October 2008. The majority of these new insurances 78% covered HIV-AIDS only.

ConclusionThe proportion of HIV-positive formal sector employees in Namibia is in line with national prevalence estimates and varies widely by employment sector. Following the surveys, there was a considerable increase in private health insurance uptake. This suggests that anonymous HIV workplace surveys can serve as a tool to motivate private companies to provide health insurance to their workforce. Health insurance taken up by those who are able to pay the fees will alleviate the burden on the public sector.

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Autor: Ingrid de Beer - Hannah M Coutinho - Peter J van Wyk - Esegiel Gaeb - Tobias Rinke de Wit - Michèle van Vugt


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