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Effects of Implementation HIV and AIDs policy in Higher Learning Institutions in Kenya
 

Effects of Implementation HIV and AIDs policy in Higher Learning Institutions in Kenya

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    Effects of Implementation HIV and AIDs policy in Higher Learning Institutions in Kenya Effects of Implementation HIV and AIDs policy in Higher Learning Institutions in Kenya Document Transcript

    • EFFECTS OF IMPLEMENTATION OF HIV/AIDS POLICY AND AIDS INCIDENCES AMONG STAFF AND STUDENTS IN HIGHER LEARNING INSTITUTIONS IN KENYA (A CASE OF KENYATTA UNIVERSITY) BY LUBALE GABRIEL WABUTI D53/OL/14120/05 A RESEARCH PROJECT SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENT FOR THEAWARD OF MASTER OF BUSINESS ADMINISTRATION (HUMAN RESOURCE MANAGEMENT OPTION) SCHOOL OF BUSINESS KENYATTA UNIVERSITY November 2008
    • DECLARATION ii
    • ABSTRACTKenyatta University (KU), a Higher Learning Institution established the KU AidsControl Unit (KU ACU) in March 2001. The KU ACU falls under the ACU of theMinistry of Higher Education, Science & Technology through the ACU ofCommission of Higher Education’ (CHE) that co-ordinates ACU activities among theUniversities. The KU’s ACU was started not only to lead the role in the research andeducation, but also augment other Africa Universities fight HIV/Aids epidemic. Theoverall goal of the KU ACU is to formulate the programmes for control andmanagement of HIV/Aids within the University and its neighborhood.In 2006 KU ACU addressed the HIV/Aids issues within the University by: 1).conducting the baseline survey to determine the socio, economic and academic impactof HIV/Aids among KU students; 2). publishing the first edition of the KU HIV/AidsPolicy and implemented it.This research focused on the KU HIV/Aids policy. The KU HIV/Aids policy isHuman Resource Management (HRM) component under the broad area of personnelpolicy and practice. HRM is defined as the integrated use of procedures, policies, andmanagement practices to plan for necessary staff, and to recruit, motivate, developand retain staff so that the organization can meet its desired goals. The other broadareas in organizational management system are HRM capacity (staffing, budget, andplanning); performance management; training and HRM data.The KU HIV/Aids Policy supports the current KU Strategic plan, the KNASP2005/2010, is in line with Economic Recovery Strategy for Wealth and EmploymentCreation (ERS) of 2003-2007 and other major Kenya National Economic Strategiesand in agreement with UN Commission Declaration on Human Rights, the ILO Codeof Practice on HIV Aids, Republic of Kenya, Department of Personnel Management(DPM) of April 2005 the Public Sector Workplace Policy on HIV/Aids and World ofWork and the Federation of Kenya Employers Code of Conduct.The Objectives of the study were: the general objective was to investigate the effectsof implementation of HIV/AIDS policy and AIDS incidences among staff andstudents in Institutions of Higher Learning in Kenya. The specific objectives were: theHIV/Aids Incidences and the Policy; incorporating of HIV/Aids in the UniversityCurricula; changing the attitude towards people affected/infected with HIV/Aids;healthcare services costs and the quality of services by Health Unit Department /ACUs; Promotions/Communication activities about HIV/Aids and how HIV/Aidspolicy Programs are reducing staff and students’ turnover and Absenteeism caused byHIV/Aids.Key findings from the study showed that 89% of the respondents agreed there areincidences of HIV/Aids among staff and students. 57% of the above respondents onthe scale of 1 to 5 rated ‘high’ the extent the incidences of HIV/Aids. 54 % of therespondents agreed there are changes in the University curricula compliant withHIV/Aids. 73% of the above respondents on the scale of 1 to 5 rated ‘moderate’ theextent the changes in the University curricula.71 % of the respondents agreed there is change in attitude among the staff andstudents towards people affected/infected with HIV/Aids. It means there is reductionin discrimination and stigma. 65% of the above respondents on the scale of 1 to 5rated ‘Moderately Significant’ the extent of the change in attitude. 65% of therespondents disagreed that there is increase in costs of healthcare services. Thefinding is not conclusive because health care are expensive and increase over time.There is need to investigate further, because costs of Hiring of new staff, Purchase of iii
    • Drugs and procurement logistics, Acquisition of medicals Equipments & otherSupplies and Training. 71% of the respondents agreed that there increase inPromotions / Communication activities about HIV/Aids. 38% (13 out of 34)respondents on the scale of 1 to 5 rated ‘moderate’ the extent of the increment in allmedia. The media are Radio, Television, Print both paper & electronic and cinema.The respondents objected to the statement of the reduction HIV/Aids caused turnoverand absenteeism among Staff and Students. The percentages are 58% for turnover and60% for absenteeism. The staff turnover because of HIV/Aids caused by: illness,Death, Termination -Retirement on Medical grounds and Absconding of duty.Whereas the causes of absenteeism are: Sickness, Bereavement, Care for the sick andStigma, Discrimination and Harassment.The Respondents unanimously agreed that HIV/Aids policy programs: Awareness,Prevention and Care and Support. These can reduce turnover and absenteeism amongStaff and students. The respondents rated the extent KU HIV/Aids policy programsthese can reduce turnover and absenteeism caused by HIV/Aid among the Staff andStudents. The findings show that 25 out of 48 the respondents rated ‘Very Great’ theHIV/Aids policy programs. Chapter four gives the data analysis, presentation andinterpretation of results.The recommendations emerged from this survey. First introduce more courses unitscompliant with HIV/Aids in the university curricula and with option to specializeespecially in clinical courses. Second the detailed analysis of the healthcare servicescosts to determine the actual variances. Third analyze the sick-off sheets, otherpersonnel records, interview the KU personnel registry and the Health UnitDepartment to understand the causes of absenteeism and turnover among students andstaff. Fourth expand the services by Health Unit Department and ACU to other KUCampuses. Fifth enhance the HIV/Aids policy programs to tackle the high HIV/Aidsincidences in Higher Learning of Institutions in Kenya and collaborate with specialtyorganizations such as UNAIDS, UNESCO, NASCOP, NACC. iv
    • ACKNOWLEDGEMENTI would like to thank my Research Supervisor Ms. Lucy Kavinda the firm, insightfuland professional guidance on the proposal that culminated into this project report. Mypost Defense Supervisor Mr Shadrack Bett, who kilned my virtue of patience. Thestudy will not have been complete without the critical support of Mrs. JoyceAmuhaya, Omwami Kizito Okumu and the Kenyatta University Staff whoparticipated in the survey. Mr. Nakhali wa Opembe, Omwiiwa Daniel Musungu andProtas Musumba for many things. Marcella Were Mukungu - My ‘big’ sister. MyMBA Classmates and the staff Kenyatta University, Institute of Open Learning (IOL)– Kisumu and Kakamega Centres. Thank you for the moral support particularly Mrs.Dorothy Nyongesa and Mr. Ajuoga.I regret that it is not possible to mention names of all the people who helped meduring my studies. I say ‘asante kubwa’ to all relatives and friends.Last but not least, Thank you to my beloved wife Nancy Lubale and our childrenMichelle Keah and Nugent Wabuti, my mother Mama Kunya Wabuti and Mother in-law Mama Cyrilla Munyendo. You greatly inspired and sacrificed a lot for me. DEDICATIONI dedicate this study to 3 (three) men in my life: Mzee Joseph Wabuti Masasa – myfather, Canisio Omulima Wabuti – my brother and Winston Edmond Musungu – mybrother in-law. v
    • DEFINITION OF TERMS, ACRONYMS AND ABBREVIATIONSACU- AIDS Control UnitAIDS – Acquired Immuno Deficiency SyndromeANOVA – Analysis of VarianceART – Anti Retroviral TherapyARV – AntiretroviralBSS – Behaviour Surveillance SurveyCBS – Central Bureau of StatisticsCoS – Conditions of ServiceCOR – Code of RegulationsCU – Concern InternationalDMS – Director Medical ServicesFKE – Federation of Kenya EmployersGC – General ConferenceHAPC - HIV and AIDS Prevention and ControlHAART – Highly Active Anti-Retroviral TherapyHCD – Human Development CapacityHIV- Human Immunodeficiency VirusHRM – Human Resource ManagementIEC- Information, Education and CommunicationILO – International Labour OrganizationKDHS – Kenya Demography Health SurveyKU – Kenya UniversityKNASP – Kenya National HIV/AIDS Strategic PlanMIR - Minimum Internal RequirementsMTEF - Medium Term Expenditure FrameworkNACC - National AIDS Control CouncilNASCOP- National Aids and Sexually Transmitted Diseases ProgrammeOHSC – Occupational Health Services ConventionOI – Opportunistic InfectionsOVC – Orphans Vulnerable ChildrenPEP - Post Exposure ProphylaxisPLWHAS – People Living With HIV /AidsPS/DPM - Permanent Secretary/Directorate Personnel ManagementSTIs - Sexually Transmitted InfectionsSPSS – Statistical Package for Social SciencesTB – TuberculosisTSC- Teachers Service CommissionUNAIDS – United Nations Programme on HIV/AidsUNESCO – United Nations Education Social Cultural OrganizationUNICEF – United Nations International Children Education FundVCT - Voluntary Counselling and TestingWHO – World Health OrganizationAffected - A person who is feeling the impact of HIV/AIDS through sickness or lossof relatives, friends or colleagues.AIDS - Acquired Immune Deficiency Syndrome: a cluster of medical conditionsoften referred to as Opportunistic Infections (OI). vi
    • ANOVA (Analysis of Variance) - is a collection of statistical models and theirassociated procedures, in which the observed variance is partitioned into componentsdue to different explanatory variables.Care - Promotion of a person’s well being through medical, physical, psychosocial,spiritual and other means.Comprehensive - A range of services offered to HIV positive persons includingtreatment, clinical, physical, nutritional and psychosocial support.Counselling - A session where a person with difficulties is assisted to think throughthe problem and find a possible solutionConfidentiality - The right of every person, employee or job applicant to havehis/her medical or other information, including HIV status kept secret.Evaluation - The assessment of the impact of a programme of a particular point intime.HIV - Human Immunodeficiency Virus: a virus that weakens the body’s immunesystem, ultimately causing AIDS.HIV Screening - A medical test to determine a person’s sero- statusInfected - A person who is living with the virus that causes AIDSManager - An Officer who is in charge of number staff and other resources inhis/her Workplace.Monitoring - Continuous assessment of a programmePandemic An epidemic occurring simultaneously over a wide area and affectingmany people.Policy - A statement setting out a department’s or organization’s position on aparticular issue.Post Exposure - Immediate treatment given to a person who is Prophylaxispresumed to have been exposed to HIV.Prevalence of HIV - The number of people with HIV at a particular point in time,often expressed as a percentage of the total population.Prevention - A programme designed to combat HIV infection and transmission.Support - Services and assistance that are provided to help a person cope withdifficult situations and challenges.Treatment - A medical term describing the steps taken to manage an illness.VCT - Voluntary counselling and Testing: A process that enables people to willinglyknow their sero-status to help them plan their lives and make informed decisions.Workplace - Occupational settings, stations and places where workers spend timefor gainful employment.Programme - An intervention to address a specific issue within the workplace. vii
    • TABLE OF CONTENTS ..................................................................................... PageTITLE . ........................................................................................................................ iDECLARATION ...........................................................................................................iiABSTRACT ..................................................................................................................iiiACKNOWLEDGEMENT ............................................................................................. vDEDICATION ............................................................................................................... vDEFINITION OF TERMS, ACRONYMS AND ABBREVIATIONS ........................ viCHAPTER ONE ............................................................................................................ 11.1 INTRODUCTION ......................................................................................... 11.2 BACKGROUND OF THE STUDY ........................................................................ 11.2.1 Introduction of Background of the Study ............................................................. 11.2.2 HIV / Aids the Basics ........................................................................................... 21.2.3 HIV/Aids Current Background information ......................................................... 71.2.4 Kenyatta University .............................................................................................. 81.2.5 Problems of implementation of Public Policies and the HIV/AIDS Policy ......... 91.3 STATEMENT OF THE PROBLEM .................................................................... 101.4 OBJECTIVES OF THE STUDY ........................................................................... 111.5 RESEARCH QUESTIONS ................................................................................... 121.6 ASSUMPTIONS OF THE STUDY ...................................................................... 121.7 CONCEPTUAL FRAMEWORK OF THE STUDY ............................................. 131.8 JUSTIFICATION AND SIGNIFICANCE OF THE STUDY ..................... 131.9 THE SCOPE OF THE STUDY / LIMITATION OF THE STUDY ..................... 14CHAPTER TWO ......................................................................................................... 162.1 INTRODUCTION ................................................................................................. 162.2 PAST STUDIES .................................................................................................... 162.2.1 HIV/Aids Policy.................................................................................................. 162.2.1.1 Policy statement ............................................................................................... 172.2.1.2 Impact of HIV/AIDS on the University ........................................................... 172.2.1.3 Social commitment by the University.............................................................. 182.2.1.4 Rights and obligations at the University .......................................................... 192.2.1.5 Legal and regulatory framework ...................................................................... 192.2.1.6 The University HIV/AIDS policy .................................................................... 212.2.2 Introduction of Curricula compliant with HIV/Aids .......................................... 262.2.3 Attitude change towards people affected/infected with HIV/Aids -Discrimination and Stigmatization .............................................................................. 302.2.4 Costs of healthcare services ................................................................................ 332.2.4 Costs and the Quality of healthcare services ...................................................... 332.2.5 Promotions/Communication activities about HIV/Aids ..................................... 352.2.6 HIV/Aids Policy Programs and the reduction in turnover and Absenteeismamong Staff and Students ............................................................................................ 362.3 CRITICAL REVIEW............................................................................................. 392.4 SUMMARY OF GAPS TO BE FILLED BY THE STUDY ................................. 40CHAPTER THREE ..................................................................................................... 413.0 RESEARCH METHODOLOGY........................................................................... 41
    • 3.1 STUDY DESIGN......................................................................................... 413.2 TARGET POPULATION ............................................................................ 413.3 SAMPLING DESIGN ................................................................................. 423.4 DATA COLLECTION PROCEDURES/ INSTRUMENTS USED ............ 433.5 DATA ANALYSIS AND PRESENTATION ............................................. 443.6 EXPECTED OUTPUT ................................................................................ 44CHAPTER FOUR ........................................................................................................ 454.0 DATA ANALYSIS AND PRESENTATION OF RESULTS ............................... 454.1 INTRODUCTION TO DATA ANALYSIS .......................................................... 454.1.1 Response Rate ..................................................................................................... 454.2 QUANTITATIVE ANALYSIS ............................................................................. 464.3 QUALITATIVE ANALYSIS ................................................................................ 68CHAPTER FIVE ......................................................................................................... 725.0 SUMMARY OF MAJOR FINDINGS, CONCLUSIONS ANDRECOMMENDATIONS ............................................................................................. 725.1 SUMMARY OF MAJOR FINDINGS .................................................................. 725.2 ANSWERS TO RESEARCH QUESTIONS ......................................................... 735.3 CONCLUSION ...................................................................................................... 765.4 RECOMMENDATIONS ....................................................................................... 786.0 REFERENCES AND APPENDICES INCLUDING QUESTIONNAIRE ........... 806.1 REFERENCES ...................................................................................................... 806.2 APPENDICES INCLUDING QUESTIONNAIRE ............................................... 84APPENDIX A: THE LETTER OF INTRODUCTION ............................................... 84APPENDIX B: THE TARGET POPULATION ......................................................... 85APPENDIX C: QUESTIONNAIRE ............................................................................ 86APPENDIX D: BUDGET............................................................................................ 90APPENDIX E: WORK PLAN .................................................................................... 91LIST OF TABLESTable 1.1: HIV adult (15 – 49 years) Prevalence by Gender, 2005 ............................... 3Table 1.2: HIV Adult Prevalence Trends by Province for Selected Years (%) ............. 4Table 1.3: The Number of PLWHAs on ARV in 2006 by Province ............................. 7Table 4.1: Distribution of Respondents by Gender. .................................................... 46Table 4.2: Distribution of Respondents Highest level of education. ........................... 47Table 4.3: Distribution of Respondents by Designations ............................................ 48Students? ..................................................................................................................... 50Table 4.4: What extent are the incidences of HIV/Aids among the Staff and Students? ................ 50Table 4.5: Does the University have any Policy on HIV/Aids? .................................. 51the incidences of AIDS among the Staff and Students? ............................................. 51Table 4.6: What extent has the University Curricula changed?................................... 52Table 4.7: Rating the increase of the expenditure/Investment items listed here. ........ 56Table 4.8: Rating the services provided by Kenyatta University Health Unit and AidsControl Unit (ACU) after the implementation of HIV/Aids policy. ............................ 58Table 4.9: The increase in Promotions / Communication activities about HIV/Aids. 61Table 4.11: Has the implementation of HIV/Aids policy led to reduction in Staff andStudents turnover? ....................................................................................................... 62 ix
    • Table 4.11: What causes turnover among the Staff and Student after theimplementation of HIV/Aids policy in KU? ................................................................ 63Table 4.12: What causes absenteeism among the Staff and students after theimplementation of HIV/Aids policy in KU? ................................................................ 65Table 4.13: The extent KU HIV/Aids policy programs can reduce the Staff andstudents turnover and absenteeism caused by HIV/Aids. ............................................ 67LIST OF FIGURESFigure 1.1: Conceptual Framework Diagram showing the effects implementation ofHIV/Aids Policy and the incidences of AIDS among the Staff and Students. ............ 13Figure 4.1: Distribution of Respondents by Age bracket in years. .............................. 46Figure 4.2: Distribution of Respondents by Length of Service at KU in years. .......... 49Figure 4.3: Does the University have incidences of HIV/Aids among the Staff andStudents? 50Figure 4.4: Rating the impact of the implementation of HIV/Aids Policy on reducingthe incidences of AIDS among the Staff and Students? .............................................. 51Figure 4.5: Has the implementation of HIV/Aids policy led to any changes in theUniversity Curricula? ................................................................................................... 52Figure 4.6: Has the implementation of HIV/Aids policy led to change in attitudeamong the staff and students towards people affected/infected with HIV/Aids? ........ 53Figure 4.7: Rating the magnitude of the change in attitude among the staff andstudents towards people affected/infected with HIV/Aids?......................................... 54Figure 4.8: Has the implementation of HIV/Aids policy led to increase in costs ofhealthcare services? ..................................................................................................... 55Figure 4.9: Rating the increase of the expenditure/Investment items listed here. ............................ 57 Aids Control Unit (ACU) after the implementation of HIV/Aids policy. .................. 58Figure 4.10: Rating the services provided by Kenyatta University Health Unit andAids Control Unit (ACU) after the implementation of HIV/Aids policy. ................... 59Figure 4.11: Has the implementation of HIV/Aids policy led to increase inPromotions / Communication activities about HIV/Aids? .......................................... 60Figure 4.12: The increase in Promotions/Communication activities about HIV/Aids.62Figure 4.12: The increase in Promotions/Communication activities about HIV/Aids.62Figure 4.13: What causes turnover among the Staff and Student after theimplementation of HIV/Aids policy in KU? ................................................................ 64Figure 4.14: Has the implementation of HIV/Aids policy led to reduction inabsenteeism among the Staff and students? ................................................................. 65Figure 4.15: What causes absenteeism among the Staff and students after theimplementation of HIV/Aids policy in KU? ................................................................ 66Figure 4.16: The extent KU HIV/Aids policy programs can reduce the Staff andstudents turnover and absenteeism caused by HIV/Aids. ............................................ 67 x
    • CHAPTER ONE1.1 INTRODUCTIONAlthough HIV/Aids affects people of all age structures in the human population, it hasprofound impact on the working age population (Mbari, 2002). Of the 37.8 Millionpeople affected with HIV Worldwide, it is estimated that at least three quarters (3/4)of working population are aged 20-49 years old. These are the most productive grouppopulation in the prime of their lives (UNAids, 2003). The HIV/Aids is having adevastating and threatening impact on the workforce.On one hand, HIV/Aids is affecting the employees’ right on confidentiality, loss ofjobs and income, fear of stigmatization and discrimination. On the other handOrganizations’ are faced with the challenges of absenteeism, high staff turnover, lossof / reduction in productivity, increase in operating costs and / or reduction in profits.The Manager is confronted with dilemma of how to effectively handle the issuesemanating from HIV/Aids affecting the very important organization resource – itspeople.The critical roles of the Managers as they execute the management functions ofplanning, organizing, directing, staffing and controlling; is important in the effort toimplement the Strategy to surmount the challenges of HIV/Aids pandemic in theOrganization. Each Manager must perform duties as a team-player with otherFunctional Managers and as per Corporate Strategy of the Organization. BesidesManager must have exemplary people handling skills so as to develop and motivateemployees. Additionally the Manager must be well-informed on matters of medical,legal and culture. Last and not least the Manager’s main objective will be to achievegreater involvement of all and sustainability of HIV/Aids policies and practices in theOrganization1.2 BACKGROUND OF THE STUDY1.2.1 Introduction of Background of the StudyThe Researcher structured the Background of the study on HIV/Aids pandemic intosub-headings: the basics of HIV/Aids, current information on HIV/Aids in World, inKenya and in Kenyatta University, general Problems of implementation of PublicPolicies and specific Problems of implementation of the HIV/AIDS Policy. 1
    • 1.2.2 HIV / Aids the Basics1.2.2.1 HIV/Aids Position, Diagnosis, Spread and Impact in the World andKenyaHIV/AIDS in Kenya and more than 1.5 million have so far died of the disease,leaving behind over 1 million orphans. In addition, a large number of children areliving with parents who are ill; hence the children become the primary care givers fortheir parents, young siblings and other dependants. Over 60% of those infected live inthe rural areas where the socio-economic conditions are worsening due to poverty andunemployment. This has strained the already inadequate and ill-equipped healthfacilities, with over 50% of public hospital beds being occupied by patients withOpportunistic Infections (OI). It is estimated that many more persons living withHIV/AIDS stay at home, are unable to access health care and are overstretching thehouseholds’ ability to cope.Since 1984, when the first case of HIV/AIDS was diagnosed in Kenya, the diseasespread rapidly, reaching an estimated national prevalence rate of 13.4% in 2000(NASCOP, 2001). In 2003, the adult (15 – 49 years) prevalence rate was 6.7%(KDHS, 2003). Urban areas are more devastated by HIV/AIDS than rural areas.However, prevalence rates in urban areas are rising more rapidly than in rural areas.According to KDHS 2003, prevalence rates were 10.0 % in urban areas, and 5.6 % inrural areas. In addition, prevalence rates show marked variations across sub-groups ofthe population. Younger women are particularly more vulnerable than men. Forinstance, among 20-24 year olds, about 9 % and 2.4 % of women and men,respectively, were infected. There are also marked differences in HIV prevalence ratesby province with Nyanza Province exhibiting the highest rate. However, following acomprehensive Multi-Sectoral National Strategy in the fight against HIV/AIDS, theHIV prevalence rate among those aged 15-49 years has declined from 13.4% in 2000to 5.9% in 2005 (NACC, 2006).1.2.2.2 HIV/Aids the Gender and the Geographic BreakdownIn Kenya, like most African countries, the majority of non-paediatric infections occuramong youth, especially young women aged 15-24 years and young men under 30.This proposition is supported by the 2003 Kenya Demographic Health Survey Report,which indicates that the prevalence among women aged 15-49 was nearly 9%, whilefor men 15-54, the prevalence was under 5%. This female-to-male ratio of 1.9 to 1 2
    • was higher than that found in most population-based studies in Africa. It implies thatyoung women are particularly vulnerable to HIV infection, as compared to the youngmen.It has been established that 3% of women aged 15-19 were HIV infected, comparedwith 0.4% of men aged 15-19, while HIV prevalence among women aged 20-24 wasover three times that of men in the same age group (9.0 % and 2.4 % respectively). Asis the case in many countries, the prevalence among women peaks at age 25-29 (12.9%), while among men the prevalence rises gradually with age, to peak at age 40-44(8.8 %). It is only at the age group 45-49 that the HIV prevalence among men (5.2 %t)gets to be higher than that for women (4 %). The observed trend between men andwomen suggests a feminization of the epidemic.HIV is increasingly affecting women, and the main cause of infection is sexualcontact from their partners both casual and spouses. In terms of age, HIV infection isconcentrated in the age group between 20 and 44 years (KDHS, 2003). In 2003, therewere variations in the distribution of HIV infection between Kenyan provinces.Nyanza and Nairobi provinces with a prevalence of 15% and 10% respectively, hadthe highest prevalence rates while Eastern province (4%) and North Eastern (less than1%) had the lowest prevalence rates.Table 1.1: HIV adult (15 – 49 years) Prevalence by Gender, 2005Province Male Female Both Gender AverageNairobi 7.9 12.0 10Central 2.1 7.9 5Coast 5.1 7.0 6.1Eastern 1.3 5.4 3.4North Eastern 1.4 2.6 2Nyanza 8.4 13.2 10.8Rift Valley 3.7 5.6 4.7Western 4 7.7 5.9Source: **NACC, (2006), Kenya HIV/AIDS Draft Data Booklet.Table 1.1, It shows the distribution of HIV adult infection in the country in 2005,analyzed by gender. The Publication the 7th Edition of AIDS in Kenya, It indicatesthat the highest prevalence rate is among the wealthiest quintile of the population 3
    • accounting for 10% of the HIV infection, while prevalence among the poorestsegment of the population is less than 4% (NACC, 2005).Table 1.2: HIV Adult Prevalence Trends by Province for Selected Years (%)Province 2004* 2005** % ChangeNairobi 9 10 11.1Central 5.6 5 -10.7Coast 5.7 5 -12.3Eastern 3.7 3.4 -8.1North Eastern 3 2 -33.3Nyanza 13.1 10.8 -17.8Rift Valley 5 4.1 -18.0Western 4.5 4.7 4.4Total 6.4 5.9 -7.8Source: * NACC, (2005). Kenya HIV/AIDS Data Booklet.** NACC, (2006). Kenya HIV/AIDS Draft Data Booklet.The Table 1.2 shows change in prevalence rates in the provinces between 2004 and2005. The Provincial prevalence has declined significantly from the peak ratesexperienced in the 1990s (Republic of Kenya, 2000). The highest decline inprevalence rates between 2004 and 2005, prevalence rates reported in North Easternprovince (33%), followed by Rift valley (18%) and Nyanza (17.6%).Western, Coastand Nairobi provinces experienced a rise in prevalence, reporting a marginal increaseof 4.4%, 7% and 11.1% respectively. The data further suggests that Nyanza provincecontinues to experience the highest HIV prevalence (10.8%), while the lowestprevalence rate is found in North Eastern (2%). Currently, the national average standsat 5.9% (NACC, 2006)1.2.2.3 HIV / Aids TransmissionThe research on the virus and the patterns of transmission are clear. HIV istransmitted through the exchange of certain body fluids – semen, vaginal fluid, bloodand breast milk. Also the virus is largely non-infectious in saliva, sweat, gastricjuices, vomit and diarhoea. (KU, ACU, 2006, p. 2). The three predominant modes ofHIV transmission in Kenya are through heterosexual intercourse (no data onhomosexual because it is illegal in Kenya) contact (98% of infections), mother-to- 4
    • child transmission during pregnancy, birth or through breastfeeding (1.8%),transfusion with infected blood (0.2%), negligible percentages through intravenousdrugs use or the re-use / prick (by) of needles/scalpels in health facilities or illicit drugabusers or circumcision knives, razor blades used in Female Genital Mutilations(FGM) and Traditional Birth Attendants (TBAs)1.2.2.4 HIV/Aids Awareness, Experience and Behavior ChangeAccording to the KDHS of 2003 majority of the people in the country have a highknowledge about HIV/AIDS and are aware of the prevention measures of Abstinence,Faithfulness and use of the Condoms (ABC). The recorded knowledge and awarenessabout HIV/AIDS is at 98% among women and 99% among men. However, the samecannot be said for men and women aged 15-19 years whose knowledge of preventionis likely to be lower. This could be attributed to lack of information, education andcommunication (IEC) materials especially on sexual and reproductive healthinformation necessary to enable them to avoid infection. The KDHS of 2003 surveyalso found awareness to be lower among non-educated than educated women, 93%and 94% respectively. In Northern Eastern Province the KDHS of 2003 showed 94 %and 86% among the men women respectively and with very small variations betweenthe various age groups.The evidence from KDHS of 2003 data clearly showed that, the more educated therespondents were (both men and women) the more likely they were to haveknowledge about some ways of limiting the risk of infection. It is of great concernthat knowledge about HIV/AIDS is limited among the age group 15-19 years, eitheramong those with limited education or no education and whom are from poverty-stricken backgrounds.In contrast with the KDHS of 2003 results, the knowledge and behaviour indicatorsby Behaviour Surveillance Survey (BSS) of 2005 showed that 98 per cent of womenand 42 per cent of men (aged 15-24 years) could identify at least two preventionmethods and rejected the misconceptions about HIV/AIDS.The large deviation between KDHS and BSS data sources was probably related to themany misconceptions that exist among the youth with regard to HIV/AIDS andcondoms (Njeru et al., 2005). As noted previously, awareness of AIDS in the countryis over 98%, albeit slight variations among women with no education. The challengefor the Government and other Stakeholders is therefore to translate the awareness intobehaviour change so as to sustain the declining prevalence rate. There is therefore 5
    • need for more awareness creation especially among the youth and the most vulnerablegroups on prevention, care and support of the infected and affected, importance ofVCT, as well as support and care of the orphans and other vulnerable groups.1.2.2.5 Anti-Retroviral Therapy, Funding and Service DeliveryWorldwide, there is no vaccine and no cure for HIV infection or AIDS. There are,however, drugs available to cure, boost immunity, fight and prevent OI. Over the past15 years, Virologists and other Researchers have developed antiretroviral (ARV)drugs to fight the virus. The ARVs gradually reduces the viral load and improves theCD4-lymphocyte count, helping the immune system to recover and preventing thedevelopment of OI. For ARV to be effective it must be taken for life and patientadherence to the therapy is critical. If these requirements are fulfilled ARVs cangreatly improve both length and quality of life, but the average duration of thatextension remains uncertain. ARVs as with any other drugs there may be problemswith intolerance, side effects, resistance and toxicity. The major breakthrough intreatment came in 1995 when the triple combination of ARVs (i.e. three drugs takentogether at the same time) called Highly Active Antiretroviral Therapy (HAART) wasintroduced. Because HIV can become resistant, a combination treatment such asHAART is necessary to suppress the virus. HAART has greatly improved the healthof those on this treatment.In Kenya there has been significant progress in the scaling-up of treatment with ARVsand currently there are several health facilities in Private, Mission and Public whichprovide the drugs. The drugs - ARVs and OI in the health facilities and in designatedSites are provided free of charge by the Ministry of Health and are distributedcountrywide by Kenya Medical Supplies Agency (KEMSA) and Mission for EssentialDrugs and Supplies (MEDS). This has been made possible by funding from thePresidential Emergency Plan for AIDS Relief (PEPFAR) and Clinton Foundation, aswell as importation of generic drugs by the Government with support from the GlobalFund for HIV/AIDS, Malaria, and Tuberculosis, Elizabeth Glazier PaediatricFoundation (EGPAF) and USAID. Private health care providers also provide thedrugs, but at a cost. As of December, 2006, there were approximately 120,000 HIV-positive persons in Kenya on ARV. This is far below the population of 263,000people who need to be put on ARV treatment. In the ideal situation, all thoserequiring treatment should be provided with ARV. Table 3 shows the estimatednumber of patients on ARVs. 6
    • Table 1.3: The Number of PLWHAs on ARV in 2006 by ProvinceProvince Total all QuartersCentral 13,543Coast 8,748Eastern 8.379Nairobi 24,737North Eastern 169Nyanza 26,943Rift Valley 27,671Western 9,836Total 120,026Source: Ministry of Health, NASCOP, (2006).The scaling-up on the provision of ARVs in Kenya has been rather slow due tofinancial limitations and problems linked to procurement of the drugs. In terms ofgeographical equity, there were substantially more people in Nairobi and Nyanza whowere accessing ARVs in contrast to the North Eastern, Eastern and Coast provinces.These regional differences can partly be explained by a longer history of ARVprovision, a higher prevalence rate, presence of Research Institutes and a largerpopulation in these provinces. It is however imperative to note that even if progress ismade in enhancing equitable in access to the drugs, there are indications of constraintsto access drugs in rural and urban slum areas and among children. Indeed, informationon number of children who have access to the drugs is not readily available.1.2.3 HIV/Aids Current Background information1.2.3.1 Position, Impact of Intervention Strategies and Emerging ChallengesNew data released by UNAIDS/WHO in November 20007 show global HIVprevalence has leveled off and that the number of new infections has fallen, in part asa result of the impact of HIV/Aids programmes. However, in 2007 thirty three (33)million people were estimated to be living with HIV, 2.5 million people becamenewly infected and 2 million people died of AIDS.There were an estimated 1.7 million new HIV infections in sub-Saharan Africa in2007, a significant reduction since 2001. In Kenya, the national HIV and AIDSprogramme has registered significant progress in the previous one year. The current 7
    • data shows an estimated adult HIV prevalence of 5.1% in 2006, compared to 5.9%registered in 2005. The current estimate of urban prevalence is about 8.3% while ruralprevalence is 4.0%The annual number of adult AIDS deaths, in Kenya, reached a peak of about 120,000in 2003. It would have stayed at that level for the next three years where it not for theincreasing number of people receiving anti-retroviral therapy (ART). Treatment hasreduced the annual number of AIDS deaths to about 85,000 in 2006. In 2006, thenumber of deaths averted due to treatment is estimated at 57,000.Another progress realized is the drop in new infections. Incidences were estimated at55,000 in 2006, a drop from 60,000 in 2005. Most of the new infections are occurringamong young people.Despite all the above achievements, the Kenya remains severely affected. Resultsfrom the derived estimates here indicate that in our healthcare programmes that:In the Reproductive Healthcare services, there are 1.5 million pregnant women needcounselling and testing each year to determine their HIV sero-status and 68,000women need treatment to Prevent Mother-to-Child-Transmission of HIV. In thePaediatric and Medical services there are 23,000 children need ART and 200,000need cotrimoxazole (septrin) prophylaxis. Also 430,000 adults require ART. In thePrimary Healthcare (Public Health) services there are 2.4 million orphans who needcare and support from their extended families and communities. The facts and figuresstill paint a grim picture that new infections have declined to 55,000 per year i.e. 151per day, approximately 6-7 persons per hour, HIV and AIDS related deaths havedeclined to 85,000 per year i.e. 233 per day, approximately 9-10 persons per hour andART has averted about 57,000 deaths since 2001 and 35,000 deaths between 2003and 2006, i.e. 95 per day and approximately 3-4 lives per hour.The Kenya is still faced with more sectoral challenges and emerging issues despite ofthis commendable battle win against war on HIV/Aids pandemic led by NACC.1.2.4 Kenyatta University1.2.4.1 Kenyatta University Inception, Demography and OrganizationThe KU was a colonial military barracks known as the Templer Barracks. In 1965Templer Barracks was converted into Kenyatta University College, primarily ateacher training institution. Kenyatta University College became a constituent collegeof the University of Nairobi in 1970. In 1985 the Kenyatta University College wasincorporated by the Kenyatta University Act of the Parliament of Kenya and was 8
    • renamed Kenyatta University. KU is the second largest after University of Nairobi inKenya. In 1997 it had some 8,000 students. As of 2007, KU had about 21,500Students. Each year KU graduates over 2,000 students. KU has a total of 13 Schools.Namely; the Existing School of Business, School of Education, School of Humanitiesand Social Sciences, School of Pure & Applied Sciences, School of EnvironmentalStudies, School of Applied Human Sciences, School of Health Sciences, the GraduateSchool and the newly established (or to be established) School of Visual andPerforming Arts, School of Economics, School of Agriculture and EnterpriseDevelopment, School of Engineering and Technology and School of Law.1.2.5 Problems of implementation of Public Policies and the HIV/AIDS Policy1.2.5.1 General Problems of implementation of Public PoliciesAccording to Makoa, 2001, the success of any public policy or national developmentplan rests on the capacity to implement it; namely, the availability of resources thatenable the delivery of stated commitments and / or the objectives of the policy.Makoa, 2001, observed that many writers on Development Planning and public policyimplementation emphasize capacity building as a condition for success. The Writersconcur, that capacity building is not a narrow undertaking or endeavour but rather abroad and encompassing project. For example, Jugessur, 1994, analyzed the role ofscience and technology in Africa, stated that the concept incorporates the building ofhuman, institutional, infrastructure, legal and financial capacities. Also Nyiira, 1994,analyzed the experience of Uganda with the use of science and technology – offers asimilar definition, stressing the role of capacity building in economic developmentand growth. Nyiira, 1994, argued that apart from being dependent on science andtechnology, economic growth will be the result of a confluence of the two as well asadequate management institutions and the proper economic and social environment.It is clear that this calls not only for new investment and expenditure but also forattitudinal and institutional change, re-focusing and re-orienting the existinginstitutions and organizations, as the creation of a climate conducive to theperformance of the required tasks.In fact, the concept of capacity building connotes a range of activities, depending onits use. As Eade, 1997, stated most would place capacity-building somewhere on aspectrum ranging from helping people to helping themselves, at a personal, local ornational level, to strengthening civil society organizations in order to fosterdemocratization, and building strong, effective and accountable institutions of 9
    • government. Eade, 1997, added, however, that for Oxfam capacity building is anapproach to development rather than a set of discrete or packaged interventions.As an approach to or an aspect of development, capacity building therefore calls for aconsideration of alternatives or making another policy decision, and developingappropriate political strategies since policy making is about politics. After all, thereality of policies lies in their implementation, when the intentions of the policymakerare put to test. Yet one of the key issues is correct policy choice as effective publicpolicies are dependent upon their appropriateness and the way in which they areimplemented. Policy making alone – or as some analysts would put it, choosingamong alternatives, exploring options and deciding the appropriate course of action –is not enough. Building the capacity to implement the policy is equally important.1.2.5.2 Specific Problems of implementation of HIV/Ads Policy at KenyattaUniversityThe overview or definition of capacity building in this Research Proposal is notdifferent from the above. The Researcher adds though that capacity in relation toKenyatta University should be assessed in terms of the strength of the financialresources, the availability of manpower and the appropriateness of the KU’s structure,systems and processes. The Researcher’s argument is that the Kenyatta Universitywill be able to implement its ambitious anti-HIV/AIDS policy only if it has thenecessary capacity and that if this is lacking or weak, it must be built. Organizationsand/or Countries that have been able to control HIV/AIDS infection rates owe theirsuccess to the capacity they have built or developed as part of the strategy to combatthe spread of the disease. Africa’s exemplary example is Uganda, which has slowedor reduced HIV/AIDS infection rates among her population.1.3 STATEMENT OF THE PROBLEMIt is widely accepted that HIV/Aids has major negative socio-economic impact onindividuals, families, communities and on society as a whole. The Sector reviews inKenya suggest that HIV/Aids undermines development across all Sectors of theeconomy and society. The major effects of HIV/Aids Policy implementation are thedirect cost to provide drugs and medical services, shortage of man-power in theeducational services due to illness and lose of highly trained/experiencedprofessionals in the health services (NACC, KNASP 2005/06-2009/10, 2005, p. 6-7).According to UNESCO, 2005, the HIV/AIDS Impact on Educational Planning thereis evidence that the AIDS epidemic may lead to a decline in the quality of education 10
    • due to Staff turnover (through high mortality rate among the teaching staff), absenceof teachers due to personal or family sickness and associated rise in financial costs.This supports challenges faced by managers in Learning Institutions such as KU.In most Universities including KU a thick cloak of ignorance surrounds the presenceof the HIV/Aids disease on the Campus (KU, ACU, 2006, p.V). There is a lot ofsecrecy, silence, denial and fear of stigmatization and discrimination. KU has aHIV/Aids Policy to help in managing and mitigating adverse socio-economic effectsof HIV/Aids among the Staff and Students.However, it is not clear whether a research has been conducted on the effects ofImplementation HIV/Aids Policy since 2006 when the KU HIV/Aids Policy waspublished, widely circulated, continues to be publicized not only by KU ACU but alsoI Choose Life (ICL)-Africa the Non Governmental Organization (NGO) with residentoffices at the KU. The Researcher will therefore investigate effects of implementationof HIV/AIDS policy and AIDS incidences among staff and students in KU.1.4 OBJECTIVES OF THE STUDYThe objectives of this study include;General ObjectiveTo investigate the effects of implementation of HIV/AIDS policy and AIDSincidences among staff and students in Institutions of Higher Learning in Kenya, thecase of Kenyatta University.Specific Objectives1. To examine the incidences AIDS among staff and students.2. To find out how the HIV/Aids Policy implementation has led to change in theUniversity curricula to mainstream HIV/Aids education into the curricula for allstudents.3. To establish the extent to which implementation of HIV/Aids Policy has led tochange in attitude among the staff and students towards those infected/affected withHIV/Aids.4. To find out the impact of implementation of HIV/Aids policy on the increase incost of healthcare services and improvement in the quality of the services by KUHealth Unit Department / ACU.5. To ascertain if the implementation of HIV/Aids policy has led increase in healthcommunication activities about HIV/Aids. 11
    • 6. To determine if the implementation of HIV/Aids policy programs have led toreduction of the turnover and absenteeism caused by HIV/Aids among the staff andstudents.1.5 RESEARCH QUESTIONS1. Does the University have incidences of AIDS among staff and students?2. Have courses units compliant with HIV/Aids been introduced in the Universitycurricula after the implementation of the HIV/Aids Policy?3. How has the implementation of HIV/Aids Policy led to change in attitude amongthe staff and students towards those infected/affected with HIV/Aids?4. Has the implementation of HIV/Aids Policy led to the increase in costs ofhealthcare services and improvement in the quality of the services by KU Health UnitDepartment / ACU?5. Has the implementation of HIV/Aids Policy led to the increase in healthcommunication and promotion activities about HIV/Aids?6. How has the implementation of HIV/Aids policy programs have led to reduction ofthe turnover and absenteeism caused by HIV/Aids among the staff and students?1.6 ASSUMPTIONS OF THE STUDYIt is assumed that the KU HIV/Aids Policy has been implemented and all the KUManagers are aware of the same. Also that the effects of Implementation of theHIV/Aids Policy are: attitudinal change among the staff and students towards thoseinfected /affected with HIV, introduction of HIV/Aids compliant courses in theUniversity curricula, increase in the costs healthcare services, increase in promotionactivities and the HIV/Aids programs reducing the staff turnover and absenteeism inthe workplace caused by HIV/Aids pandemic. To add on the above assumptionsconfidentiality, care, support and non-discrimination policies when practiced by theKU Managers together with other favorable policies would significantly mitigate theadverse impact of HIV/Aids. 12
    • 1.7 CONCEPTUAL FRAMEWORK OF THE STUDYIn the Conceptual Framework figure1:1 below, the KU HIV/Aids Policy Booklet isthe highest in the hierarchy and the substantive reference document stipulating to theKU Managers what to do when dealing with issues emanating from HIV/Aidspandemic in Workplace. This booklet is in tandem with the Kenyatta University Act,other legislations in Kenya and International Conventions.Figure 1.1: Conceptual Framework Diagram showing the effects implementationof HIV/Aids Policy and the incidences of AIDS among the Staff and Students Independent Variable Dependent Variables Dependent Variable (Intervening) the Introduction of HIV/Aids compliant courses in the University curricula The the incidences the change of attitude among of AIDS HIV/Aids the staff and students towards among the Policy in those infected/affected with Staff and the Implementation HIV/Aids. Students the Higher has led to Learning Institutions the increase in costs of healthcare services and improvement of the Quality of the Service. the increase in health communication and promotions activities about HIV/Aids. the introduction of HIV/Aids Programs thus reduction in turnover and absenteeism among staff and students.Source: Author, 2008 and Kenyatta University ACU, 2006, p.3-p201.8 JUSTIFICATION AND SIGNIFICANCE OF THE STUDYTo assess the situation of the effects of Implementation of HIV/Aids Policy in aTertiary Institution setup, because KU has the higher risk of HIV/AIDS spread in abigger human population with high mobility and drawn from many parts of Kenyaand the World. 13
    • Also, to address the limitations inherent in the cited study as attested by Researcher.Wekesa, 2006 in Research report wrote “the nature of the business calls for (mainly)male workers….. this imbalance of gender of the respondents in the study” (Wekesa,2006, p.6). KU being a Parastatal has a more heterogeneous human populationcomposition in terms of gender. To conduct the research in the Organization withmore complex management structures, systems and processes than Ultimate SecurityManagement Limited.To assess the change and new issues in the HIV/Aids management in Kenya since theStudy was conducted. There has been general increase of HIV/Aids activities to winthe War against HIV/ Aids in Kenya and Worldwide. Wekesa, 2006 observed themanagement challenges caused by HIV/Aids at Ultimate Security ManagementLimited are Absenteeism; Costs and Staff Turnover”. and ART.This type of research that the researcher carried out is a recommendation in the“Kenyatta HIV/Aids Policy… The specific objectives of the HIV/Aids relatedresearch that: First, Better inform the University’s and Society’s efforts to reduce /mitigate the impact and spread of the disease. Second, Generate debate and stimulatecreative responses to epidemic within the University, the State and Civil Society”(KU, ACU, 2006, p.13). The findings of this Research will contribute knowledge inthe area and may help inform ACU at KU and other stakeholders such as Commissionof Higher Education (CHE) and Ministry of Education on how to design proactiveprogrammes targeting the Staffs and prospective employees who are either adverselyinfected or affected by HIV / aids. (KU, ACU, the socio economic impact ofHIV/Aids among KU Students baseline survey, 2006, p.8)1.9 THE SCOPE OF THE STUDY / LIMITATION OF THE STUDYThe Researcher investigated the effects of implementation of HIV/AIDS policy andAIDS incidences among staff and students in Institutions of Higher Learning inKenya, the case of KU. There are many other issues that affect staff and students inthe Universities that are independent of HIV/AIDS. The Researcher shall focus onpolicies and practices about confidentiality; care, treatment and support, non-discriminatory and prevention of new infections. And how these affect staff andstudents turnover and absenteeism, the change of attitude among the staff and studentstowards those infected/affected with HIV/Aids, the introduction of HIV/Aidscompliant courses in the University curricula, increase in costs of healthcare services 14
    • and increase in health communication and promotions activities. The Researcher shalllimit to collect data at KU Main Campus which has reasonable balanced gendercomposition and representative of KU staff and students population. 15
    • CHAPTER TWO2.1 INTRODUCTIONThis chapter is structured as follows: Past Studies, HIV/Aids Policy; Introduction ofCurricula compliant with HIV/Aids; Attitude change towards people affected/infectedwith HIV/Aids - Discrimination and Stigmatization; Costs and the Quality ofhealthcare services; Promotions/Communication activities about HIV/Aids and Staffturnover and Absenteeism caused by HIV/Aids and the HIV/Aids policy programs;Critical Review, Summary of gaps to be filled by the study.2.2 PAST STUDIESThis section presents a review of the available literature on the effects ofimplementation of HIV/AIDS policy in the workplace. Due to paucity of studies inKenya, the researcher shall extend the analysis to literature from Africa and rest ofWorld. The paucity of sector specific and nationwide studies on the effects ofimplementation of HIV/AIDS policy in Kenya calls for more focused andcomprehensive studies if the fight against the pandemic is to be won.2.2.1 HIV/Aids PolicyThe Teachers’ Service Commission of Kenya (TSC) and the then MombasaPolytechnic (now Mombasa Polytechnic University College) are the Higher LearningInstitutions in the Organizational Development levels as Kenyatta University, theResearcher was able to access and review their HIV and Aids Policies documents.According to the Vice Chancellor (V.C) of KU, the KU HIV/Aids Policy providesguidelines to mitigate the impact of HIV/Aids on students, staff and their dependents(the affected and infected). The V.C. confirmed in the preface of the KU HIV/AidsPolicy that the Policy supports the KNASP 2005/2010, is in line with EconomicRecovery Strategy for Wealth and Employment Creation (ERS), 2003-2007 and othermajor Kenya National Economic Strategies and in agreement with UN CommissionDeclaration on Human Rights, the ILO Code of Practice on HIV Aids, Republic ofKenya, Department of Personnel Management (DPM) of April 2005 the Public SectorWorkplace Policy on HIV/Aids and World of Work and the Federation of KenyaEmployers Code of Conduct (KU, ACU, 2006, p.13).The Researcher has compared and synthesized issues from KU HIV/Aids Policy withthe ones of the two institutions. These are excerpts from Kenyatta UniversityHIV/Aids Policy for Staff and Students a 2006 publication. 16
    • 2.2.1.1 Policy statementThe KU HIV/AIDS Policy does not have a policy statement. The Researcher quotesthe TSC which is in the Education sub-sector and clearly captures the spirit of theletter in the KU HIV/Aids policy. “HIV/AIDS pandemic is a national disaster and is impacting greatly on the TSC (also KU) in terms of performance and loss of personnel. The scourge therefore, requires a multi-dimensional attack and hence the TSC shall endeavour to put in place all possible measure geared towards containing the spread and effect of the disease at the workplace. The TSC shall give the necessary care and support for people living with HIV/AIDS among its employees by providing the necessary structures and programmes aimed at ensuring non-discrimination and distigmatization of the infected and affected employees. The TSC is committed in taking bold steps in the management of HIV/AIDS pandemic as well as providing guidance on how to handle those infected and affected. To achieve this the Commission shall establish Minimum Internal Requirements (MIR) for its employees (infected and affected) and endeavour to ensure that all employees enjoy working productively irrespective of their status in a nondiscriminatory environment.”2.2.1.2 Impact of HIV/AIDS on the UniversityKU is a valuable potential vehicle for the provision of a united and effective responseto HIV/Aids; and it is well equipped to make dramatic and long lasting impact on theepidemic. Equally, if it fails to respond to it, the AIDS epidemic will soon beginseriously to affect the following:Mission: KU is to provide high quality education, promote intellectual leadership,develop human resource, advance knowledge through research and enhance technical,economic and social development of Kenya. Death and illness associated withHIV/Aids may undermine Mission Statement.Vision: KU is a centre of excellence in knowledge creation and dissemination,capacity building, instills democratic principles and increases access to highereducation through open and life long learning for sustainable development.HIV/AIDS may cause KU not reach its VisionStaffing: in due course KU will also have to face the consequences of illness anddeath of members of its staff and will be particularly affected. The need in short-termeither to recruit replacement administrative and teaching staff or to redesign curricula 17
    • to accommodate the staff shortages and the long-term implications of losing juniorlecturing staff, from among whom the future intellectual leadership of the Universityis customarily nurtured and developed.Finances: There will be cost implications related to: Additional staff recruitment andtraining/development, the care and counselling of sick and dying staff and students,general health care, benefit and pension schemes, Staff and student loan schemes (inthe event that incapacity or death should occur before a loan is repaid), the availabilityof student bursaries, the drain on funds to medicare; death payments; such fundswould otherwise be available for KU expansion and development.These objectives are likely to be impaired by the impact of HIV/Aids on the staff andstudents. It is self-evidently vital that university graduates remain alive and well for aslong as possible so that they can make a long-term contribution in the workplace andto the society in general. This policy is in favor of developing strategies that ensure,as many members of the university community as possible remain free from infection.KU is also, of course, the nursery of new developments and creative ideas. It thusensures that the society is equipped to face new challenges and to challenge existinginequalities by offering courses on HIV/Aids.2.2.1.3 Social commitment by the UniversityKU employs a large number of staff. It is therefore likely that, whatever the case,there will be at least some (and probably a growing number of) staff in everyDepartment, who have HIV/AIDS. It is thus manifestly in the interests of KU todevelop a comprehensive HIV/Aids policy for its staff.However, the University’s responsibility extends also to creating a safe environmentfor students; and this point to the advisability of developing an HIV/Aids policywhich offers support and protection for students at the same time as positioningHIV/Aids firmly alongside a range of other critical issues such as rape, sexual abuse,violence, drug abuse and the financial concerns of students.Moreover, KU has unique opportunity as a provider of tomorrow’s leaders and ensuretherefore that all shall become acquainted with the implications of HIV/Aids as anemployment issue. If students are made aware of the relevance of managing HIV/Aidsin the workplace and implementing appropriate programmes, it will go some waytowards ensuring that the way in which HIV/Aids is dealt with by future generationswill challenge many prejudices and enable the society to take effective steps againstthe spread of the epidemic. 18
    • 2.2.1.4 Rights and obligations at the UniversityKU has crucial leadership role to play in ensuring that the societies in which theyoperate recognize the human rights of their population and honor their obligations toact such a way as not to infringe those rights. HIV/Aids has proven to be a diseasewith a particular capacity to attract socio-economic injustices such as discriminationand stigmatization on a major scale. It is this pattern of human rights abuses that hascharacterized HIV/Aids and has made it unique and difficult to deal with as opposedto similar incurable diseases.HIV/Aids generates many difficult moral and ethical dilemmas and KU has on thewhole chosen to address these difficult issues.Some religious, cultural and moral beliefs assume that an HIV infection is a directconsequence of ‘improper’ personal behaviour and the effect that those who areinfected are made to feel guilty and ashamed. This, in turn, has contributed to theepidemic’s being driven into and consequently further spread by, patterns of secrecyand denial.There is also the question of confidentiality and the rights of people with HIV andAids not to disclose their HIV status particularly those who are positive. Many peoplein health and educational institutions believe that this fundamental human right toprivacy and confidentiality should be ignored and discarded; there is a presumptionthat where HIV is concerned there is a ‘right’ both to know the status of an infectedperson and to inform others of the infection. That ‘right’ does not exist; it is in fact anabuse of personal human rights and should be challenged.2.2.1.5 Legal and regulatory frameworkThe Researcher also noted that KU HIV/AIDS policy does not have this section onLegal and Regulatory Framework.The Republic of Kenya has a number of Statutes for responding to HIV/AIDS relatedissues in the workplace though the current Acts do not specifically refer to HIV andAIDS. However, it is recognized that an enabling legal and regulatory environment isimperative to create the desired impact in the fight against HIV and AIDS pandemic.In this regard, the Government is committed to continue with legislative reforms,which are responsive to the needs of HIV, and AIDS infected and affected persons.This is in line with international obligations including the ILO’s OHSC and COP. 19
    • The public and private sector policies shall be formulated and implemented within theframework of the Constitution of Kenya and other legislations in place as well as thepending Bills which includes the following:2.2.1.5.1 The Constitution of KenyaThe Constitution of the Republic of Kenya is the supreme law of Kenya and all otherlaws must comply with it. The fundamental rights in Chapter (Cap.) 5 of theConstitution provide every person with the right to equality and non- discrimination.2.2.1.5.2 Service Commissions Act Cap 185 (1985 Revised)The Act prohibits discrimination in appointment promotion and transfer. In particular,the Act provides in regulation 13 of the Public Service Commission (PSC) regulationsthat, the appointment, promotion and transfer of a public officer shall take intoaccount only the merit, ability, seniority, experience and official qualifications of thecandidate.Under regulation 19, the Act provides that if a public officer is incapable by reason ofany infirmity of mind or body of discharging the functions of his public office he/shemay present himself/herself before a Medical Board with a view to it beingascertained whether or not he/she is incapable as aforesaid. Any employee who is illshall seek and obtain permission from the relevant authority for absence from theworkplace on account of the ill health. Absence from duty without permission isactionable in accordance with Code of Regulations (COR) Revised 2006. Furtherunder part IV of the PSC Regulations, an officer must be informed and given a chanceto respond and appeal to the Public Service Commission of Kenya (PSCK) inaccordance with the provisions laid down in the COR in respect of disciplinaryproceedings or any termination of employment. No punishment shall be inflicted onany public officer, which would be contrary to any law.2.2.1.5.3 The Employment Act Cap.226The Employment Act sets out the minimum standards applicable for conditions ofemployment relating to wages, leave, health and contracts of service includingtermination of the contract. Under the Act, the employer shall provide properhealthcare for his employees during serious illness. The employer can only dischargethis function if the employee notifies the employer of the illness. The Act implies thatthere shall be no discrimination on the grounds of HIV and AIDS status. 20
    • 2.2.1.5.4 Factories and Other Places of Work Act Cap.514The Government is in the process of repealing the Factories and Other Places ofWork Act. Cap 514 with a view to enact a new law which will provide for safety,health and welfare of persons employed and all persons lawfully present atworkplaces and for matters incidental thereto and connected therewith purposes. TheAct requires of the employer, as far as it is reasonably practicable, to create a safeworking environment for the employees. The implication of the Act regarding HIV isthat the employer needs to ensure that the risk of possible infection in the workplaceis minimized.2.2.1.6 The University HIV/AIDS policy2.2.1.6.1 Principles of HIV/Aids PolicyThe Principles that guide this policy are in accordance with international conventions,national laws, policies, guidelines and regulations. These principles are: People withHIV and Aids, their partners, families and friends shall not suffer from anydiscrimination; Staff and students living with HIV/Aids will have the same humanrights and obligations as other staff and students; People living with HIV/Aids will beaccorded the same respect as those suffering from other life-threatening conditions;Members of the University community including those with HIV/Aids shall beinvolved, where possible, in the development of all prevention, intervention and carestrategies; All University Departments shall be involved in the fight against HIV/Aidseducation, prevention and care shall be viewed in broad social context;Confidentiality shall be strictly observed vis-à-vis the HIV sero status of any staff orstudent member; and the University will aim to achieve “best practice” standards inall HIV/Aids interventions.2.2.1.6.2 The Goals and Objectives of the HIV/Aids PolicyUnder education and prevention of HIV/AIDS in the University the goals are: Toprevent the transmission of HIV through the provision of education and information;To raise the level of understanding of members of the University communityregarding HIV and AIDS in all aspects of the work of the Institution; To identify anddisseminate the available resources to be used in the fight against HIV/AIDS and Toempower both women and men to make responsible sexual decisions.Under Care and Support of PLWHAs in the University the goals are: To help thosepeople who are uninfected to remain free from infection; To provide HIV/AIDS 21
    • counselling; To create an environment where PLWHAs are safe to reveal their statusand seek appropriate support and counselling;To equip the University communitywith skills that will enable them to live and work in societies with increasing rates ofHIV infection and To provide care to those infected and affected by HIV and AIDS.2.2.1.6.3 University HIV/Aids Policy with respect to staffing on Employment andpromotionThere will be no restrictions placed on the employment of a person with HIV/Aids, aslong as that person’s health status enables him / her to perform the duties stipulated inhis /her employment contract. Prospective members of staff shall be required to havemedical tests prior to appointment. No staff member shall be required to undergo anHIV test as a condition of employment, promotion, or provision of further training.Staff members with HIV shall be treated no differently from other staff with otherlife- threatening illnesses. A staff member shall not be dismissed, retrenched orrefused employment on the basis of HIV status.2.2.1.6.4 University HIV/Aids Policy with respect to staffing on Testing andconfidentialityNo staff is obliged to reveal his/her HIV/Aids status except where a staff memberworks in an environment where his / her illness may create a risk to him /herself or toother members of the University or the public. Staff members will be encouraged toconsider revealing their HIV or AIDS status (if known to be positive) to anappropriately professionally trained person in the support services. All persons withHIV have the legal right to confidentiality about their HIV or AIDS, except inexceptional circumstances and where legally otherwise indicated. Should a staffmember have HIV test, the result of the test remains confidential between the staffmember and the individual giving the result.2.2.1.6.5 University HIV/Aids Policy with respect to staffing on Counselling, careand supportSupport and counselling can help to mitigate the effects of the epidemic. Counsellingcan have a positive influence on attitudes, on persuading people to consider disclosingtheir status, and on motivating them to change their sexual behavior. It also helpspeople to feel more comfortable about informing their sexual partners and familymembers of their infection; and it is an important means of helping staff to cope withthe deaths that this epidemic brings about. 22
    • All staff, at all levels of employment shall have access to counselling, care andsupport provided by the University free of charge. Every effort will be made to trainsufficient counselors to ensure that care and support is provided to all those who needthem. The University will ensure that all records connected with the counselling andsupport services are kept confidential. In addition where peer counselors are involved,trained professional staff will be availed to supervise them. Staff who are offeringcounselling and support services will be required to have had training in bereavementcounselling; and will themselves have access to counselling and support. TheUniversity will encourage the establishment of support groups for staff with HIV/Aids and for their families and colleagues. The University shall make condomsaccessible to members of the University community who decide to use them.2.2.1.6.6 University HIV/Aids Policy with respect to staffing on Education andtrainingAll staff members shall have access to HIV/Aids education and to information aboutsuch HIV/Aids related issues. Such education and information should, in long term,have a positive influence on social attitudes and on the development of appropriateintervention strategies.2.2.1.6.7 University HIV/Aids Policy with respect to staffing on Individualpersonal conductStaff members have an obligation to act as role models and as intellectual leaders.Staff members with HIV/Aids have special obligations and responsibilities to ensurethat they behave in such way as to pose no threat of infection to any other person. Allstaff members will be expected to respect the rights of other staff and students at alltimes. Staff members will be expected to set an example in ensuring that they displayno prejudicial or discriminatory attitudes or behaviour towards PLWHAS, and thatthey challenge prejudice and discrimination at all times. The University will tolerateneither sexual harassment, sexual abuse nor the use of sexual favors by those inpositions of power.2.2.1.6.8 University HIV/Aids Policy with respect to staffing on Day-to-daymanaging of PLWHAS issuesA staff member who is PLWHAS has the same rights and responsibilities as otherstaff members and shall be treated in a just, humane and life-affirming way. No staffmember has the right to refuse to work with PLWHAS. In event that unfairdiscrimination occur PLWHAS, he/ she has recourse to agreed mechanisms for 23
    • redress. Also any unfair discrimination or prejudice will be dealt with by Universityas a breach of employment contract and, if appropriate, a disciplinary action inaccordance with COR will be held.2.2.1.6.9 University HIV/Aids Policy with respect to staffing on StaffDevelopment and Capacity building to deal with HIV/AidsAll staff in managerial positions will be provided with appropriate training in themanagement of staff with HIV/Aids. All staff shall have access to education aboutHIV/Aids, with special reference to related legal and ethical issues.2.2.1.6.10 University HIV/Aids Policy with respect to staffing on Terms ofemploymentAt KU, continued employment, including promotion and training opportunities willnot be affected by a staff member’s HIV/Aids status, provided that the staff memberis able to perform his or her duties. When a staff member becomes too ill to performthe duties as set out in his/her job description, alternative work may be offered, ifavailable. At all times, fair procedures of employment principles will be applied.2.2.1.6.11 University HIV/Aids Policy with respect to staffing on EmployeebenefitsKU staff members with HIV or Aids are entitled to the standard allocation of sickleave as contained in their conditions of service. Request for additional sick leaveshall be negotiated with Deputy Vice Chancellor (DVC) - Administration and or theVice Chancellor.2.2.1.6.12 University HIV/Aids Policy with respect to staffing on PerformanceAppraisalHIV/Aids shall not be used as justification for non-performance or failure to achievetargets. When a staff that is PLWHAS is assessed and his/her performing is belowexpectations the normal disciplinary procedures shall be followed.2.2.1.6.13 University HIV/Aids Policy with respect to staffing on Termination ofemploymentHIV-positive employees will continue to be employed until they become medicallyincapacitated or it is medically advisable that they stop working. At this stage, generalUniversity rules and relevant legislations governing ill-health retirement will apply.Any decision regarding termination of employment will be made in fu;; consultationwith the staff member concerned, his/her choice of medical practitioner. 24
    • 2.2.1.6.14 University HIV/Aids Policy with respect to staffing on StaffassociationsAll staff associations shall be encouraged to make themselves aware of theimplications of HIV/Aids and to put policies in place for their members who areinfected with HIV/Aids. These policies should not be in conflict with the policy of theUniversity and should be based on principles of non-discrimination and support.2.2.1.6.15 University HIV/Aids Policy with respect to staffing on Conditions ofserviceAll staff members will be informed of the University’s HIV/Aids policy, and all newstaff will be informed of this policy on appointment. Existing conditions of servicewill be amended if necessary to take cognizance of the HIV/AIDS policy.2.2.1.6.16 University HIV/Aids Policy with respect to staffing on financialimplicationsKU shall conduct an audit as to the likely financial implications of HIV and Aids.These include the costs of extra staff recruitment and training, the impact of changingenrolments of students, the provision of healthcare and counselling support, thepotential burden on the benefit schemes (sickness and retirement) and possibledefaults on staff and student loans.The University will determine and allocate an adequate budget to ensure a fair andeffective HIV/Aids management programme. The University will establish anHIV/Aids Control Unit, accountable to the Senate, for effective programme planningand implementation.2.2.1.6.17 University HIV/Aids Policy with respect to staffing on Research andintellectual leadershipKU has an obligation to provide leadership in the battle to combat HIV and Aids andto ensure that programmes are effective and successful. Specific encouragement willbe given to HIV/Aids related research that: To better inform the University’s andsociety’s effort to reduce / mitigate the impacts and spread of the disease; Generatedebate and stimulate creative responses to the epidemic within the University, thestate and the civil society.2.2.1.6.18 University HIV/Aids Policy with respect to staffing on civilresponsibility and community serviceKU will ensure that it collaborates with its local / regional community in striving toachieve best practice in the care and support of people living with HIV/Aids, and in 25
    • containing the spread of the epidemic. KU will work collaboratively and to share itsexperience of best practices and, where practicable, its skills and resources, with itssister Universities in the Commonwealth regionally, nationally and internationally.2.2.2 Introduction of Curricula compliant with HIV/AidsAccording Kelly, July 2007, in the paper titled Teacher Formation and DevelopmentInternational Institute for Educational Planning (IIEP) has a programme that providestraining for teachers in order to equip them with knowledge and skills to protectthemselves, their colleagues and students from HIV infection. In many of thecountries where the programme is being implemented, governments are not providingsuch training opportunities to teachers, in spite of the obvious and urgent need for it.Training plans and a long-term and systematic approach from the national educationauthorities are currently lacking in the majority of countries. Greater emphasis needsto be put on HIV and AIDS in teacher training and formation, both at the pre-serviceand in-service stages.The General Principles for Teacher Formation and Development are: Authenticlearning engages the individual in a way that leads to personal knowing, changes inattitudes and the adoption of values. This is important to develop teacher capacity toreflect critically on the epidemic in ways that engage the whole person and promotemotivation. Teacher formation programmes need to help teachers get in touch withwhat HIV/AIDS means in their lives so that they can deal with it from a personalperspective. This helps teachers to take charge of their own lives and to guide thelives of the young people entrusted to them in an ethical human response to the crisis.Teachers who have reflected upon their own attitudes, feelings, beliefs, experiencesand behaviors regarding HIV will be more effective as communicators with youngpeople.Major areas that should be addressed in programmes for teacher education becausethey should also appear in the school curriculum include: Information andunderstanding this make teachers well-informed about all aspects of HIV/AIDS andits impacts. Context and vulnerability these help teachers understand the situationsthat prevent individuals from freely choosing the most responsible course of action.Life skills this build the capabilities of teachers to teach students critical competenciesand need also to familiarise the teachers with the education sector HIV and AIDS 26
    • policy, the Ministry’s workplace policy, relevant codes of conduct, and working inpartnership with others (especially PLWHAS).Goals of Teacher Formation Programmes are: Provide accurate information aboutHIV, AIDS and human sexuality; Develop effective classroom communication skills;Advise on teaching materials and methods; Develop personal comfort with HIV,AIDS, reproductive and sexual health issues; Provide information on education sector,workplace, school and community policies and Promote reflection on personalattitudes, feelings, beliefs, experiences, and behaviors regarding HIV, AIDS andsexuality.The key Roles of the School in Relation to HIV and AIDS are the following:Preventing HIV; The provision of care and support; facilitating access to ARVtreatment and mitigating the effects of the epidemic on individuals and society. TheSchool plays these roles in two ways namely; through education as education, that is,by providing opportunities for young people in school to experience authenticlearning and acquire basic learning skills and Through what it teaches and how itteaches, that is, through the curriculum. Adjusting the Curriculum in Schools andTeacher Preparation InstitutionsCurriculum adjustments at school level are usually thought of in terms ofincorporating HIV/AIDS, sexual & reproductive health, and life skills education.Adjustments of the school curriculum in these ways demand correspondingadjustments in teacher formation programmes. Both new and serving teachers shouldbe able to incorporate these areas into their teaching. As a matter of proper planning,teachers should be well prepared for these areas before they are required to teach themin schools.The International Institute for Educational Planning (IIEP) findings how Teachers feelabout HIV/AIDS in the Curriculum are: Teachers often feel hopelessly incompetentwhen confronted with questions posed on HIV and AIDS; They avoid difficultquestions to which they often simply do not have the answers; They tell their unionleaders about their lack of training and the poor supply of teaching and learningmaterials; Education authorities are providing teachers with books but not the trainingthey need to be able to diffuse the knowledge contained in them and Teachers saythey often face resistance from parents and even the education authorities themselvesto teaching on HIV and AIDS related issues 27
    • Recommendations to respond to the Teachers’ Professional Concerns about teachingHIV/Aids are: Ensure adequate teacher preparation; Develop a suitable curriculumthat will be an integral, required and examinable component of programmes at bothschool and teacher training levels; Develop and disseminate large quantities ofsuitable teaching-learning materials; Establish this teaching area as a subject in itsown right, on a par with other disciplines, and receiving the same kind of back-upsupport that they do; Work in collaboration with various partners, especiallyrepresentatives of parent and community groups.Recommendations to respond to the Teachers’ Personal Concerns about teachingHIV/Aids are: Seeking the support of parents, community leaders, governing boards;Establishing a strongly supportive school/college environment; Disseminatingresearch evidence that teaching about sex leads to more responsible behaviour and itdoes not lead to promiscuous behaviour and Professionalize the subject area so thatteachers can deal with it more dispassionately.Schooling and HIV/Aids Prevention, there is strong evidence that school-based sexand HIV education interventions do not increase sexual activity among participants onthe contrary it has been reported that sexual activity are delay; Reduced participants’number of sexual partners, Reduced participants’ frequency of sexual activity andIncreased participants’ use of condoms.In the Pre-Service Programmes and where HIV prevalence is high (>1%) or rising.We need to provide a separate, required, examinable subject in the curriculum for thepreparation of teachers at all levels; considering the possibility of additional optionalcourses that deal with many of the areas in greater depth.In the Pre-Service Programmes and where HIV prevalence is low (<1%) and stable.We need that every teacher to acquire a minimum level of AIDS competence; achieveby means of required and examinable modules as part of other subject areasWhile the In-service Programmes for teachers: Design comprehensive and systematictraining programme; Provide intensive and extensive training to a core group oftrainers Develop a large quantity of materials, many of them suitable for self-study;Organize teachers at school cluster or zone levels for the sake of peer-group study andsupport; Ensure follow-up on training activities by support visits to participants intheir schools and colleges; Provide incentives and acknowledgement for teachers whoexercise in their classrooms the AIDS-competencies developed during trainingprogrammes; Establish and implement monitoring and evaluation procedures for 28
    • Counselling and Care; HIV and AIDS create the need for counselling for distressededucators and learners, and for counselling, care and support in response to the needsof orphans and vulnerable children; Not possible for every teacher to be qualified inthese areas and But necessary that every teacher be sensitive to the problems andneeds. Hence the importance of treating these issues in teacher education programmes(pre-service and in-service).There are Teaching Methodology in the curriculum namely: A judicious combinationof teacher-led and learner-centred methodologies, Scope in certain areas for wholeclass teaching in formal settings, Scope and need also for interactive processes ofteaching and learning, Considerable scope for activities that engage the whole person– emotionally and affectively as well as cognitively and rationally, More reliance onnon-traditional teachers – peers, parents, religious leaders, community figures,persons living with HIV and Responsibility of pre-service and in-service programmesto promote life skills and how to teach them.Panchaud, July 2007 in the paper Curriculum response to HIV and AIDS, theUNESCO-Geneva)/ International Bureau of Education (IBE) aims to: SupportMember States in curriculum design and implementation, Improve practical skills ofcurriculum specialists and Promote international dialogue on educational policies.Existing contract between society, the State and educational professionals with regardto the educational experiences that learners should undergo during a certain phase oftheir lives: Why to learn; What to learn; When to learn; Where to learn; How to learnand With whom to learn.Panchaud, July 2007 observed that the curriculum is the product of a technical processand of complex political, social and cultural processes. The introduction of a newtopic in the curriculum requires a comprehensive diagnosis that is the presentsituation, problems to be solved, resources and weaknesses and so forth.Panchaud, July 2007 in the plenary discussed issues and /or challenges aboutHIV/Aids curriculum as follows: why HIV and AIDS education is added to alreadycrowded curricula? Why not enough time is specifically allocated to HIV/aids. Whenpart of the curriculum either concentrates on technical or scientific aspects(knowledge-based)? How the curriculum overlooks aspects of values, attitudes andbehaviours. When sensitive issues are not addressed (sexuality, substance abuse,violence…? When stigma and discrimination are not adequately challenged? Whyculture, local values and customs are not addressed and questioned? Why gender 29
    • issues are often missing. When teaching and learning material are poor, not availableand the inappropriate of Teaching methods are not appropriate. Other challenges are:Résistance from teachers, parents, communities, local leaders and lack of support andleadership at all administrative levels of the education system (MOE, decentralizededucation authorities, school principals, and colleagues).Panchaud, July 2007 recommended that the important changes in curricula are neededto respond to HIV and AIDS quality of education these are: First focus on lifeskillsand provide opportunities to model skills either in the classroom or in real lifesituations. Second Provide clear and straighforward messages on sexuality and othersensitive issues, adapted to youth needs. Third Help learners to personalize risks, andavoid stigma and discrimination. Fourth explore where to ask for help and support andprovide youth friendly services. Fifth Address resistance from parents and communitytowards sexuality education in school. Sixth provide a safer and more supportiveenvironment for children (child-friendly schools). Seventh Provide a safer and moresupportive environment for school staff at all levels.Panchaud, July 2007 observed that the main factors affecting integration of HIV andAIDS education into curricula are: Stage of curricular reform, Structure or frameworkof the design of curriculum that is either centralised or decentralised.Panchaud, July 2007 said that main approaches for integrating the curricula are: as anew stand-alone subject, integrated in an already existing main carrier subject, as across-curricular issue (3-5 subjects), infused throughout the curriculum (all subjects)and Extra- or co- curricular activities may complement HIV and AIDS education or insome cases, they may be the only HIV-related activities in schools.Panchaud, July 2007 in addition observed that HIV and AIDS education should beintegrated rather than add it into an already crowded curriculum and cautioned assesswell the advantages and the drawbacks of the different options.2.2.3 Attitude change towards people affected/infected with HIV/Aids -Discrimination and StigmatizationAccording to Nkinyangi, June 2005, Kenya Association of Positive Teachers(KENEPOTE) was formed in 2003 as a network to unite HIV-positive teachers inKenya in their fight against HIV and AIDS. The KENEPOTE promotes positiveliving with the virus to prolong life and ensure continued productivity. KENPOTE hasgrown in membership to 1,500 HIV-positive teachers from Nursery to University. Itsmembers come from across the country and are living positively with HIV/AIDS. 30
    • During the Fourth UNESCO Nairobi Cluster Consultation: HIV/AIDS and the Role ofEducation Service Commissions held in Mombasa. The Chairperson, KENEPOTE,gave an uplifting and heart-warming presentation. It is stigma and discrimination, saidChairperson, “from all quarters – the students, the parents, the church and colleaguesalike – that kill teachers faster than HIV and AIDS. If we do not kill denial, self-stigma, stigma and discrimination even ART will be null and void.” The Chairpersonspoke vividly of students who refuse to take instruction from an HIV-positive teacher.Some (students) do not want to hand their books to the teacher for fear ofcontamination. Some say, “Good morning, teacher virus.” Some parents withdrawtheir children from classes and recommend that the HIV-positive teacher to betransferred to another school far away. The head teacher also rejects you, said theChairperson. The Chairperson asked the audience to look at the neighbor and posedthe question do they look like a scare crow. The HIV-positive teacher is also strippedof her/his position in the church. People start ‘over-loving’ you for what you own.They say that they will take care of your children.The Executive Director, KENEPOTE, reported that her association aims: to intensifyits lobbying for the protection of the rights of teachers living with HIV/AIDS throughsupport groups across the country; to reduce stigma and discrimination within theeducation system and elsewhere and to inspire HIV and AIDS positive teachers toknow their status and be aware that they have a network to support them.KENEPOTE collaborates with all concerned stakeholders including the Ministry ofEducation, TSC, KNUT, Kenya Union of Post-Primary Education Teachers(KUPPET), Members of Parliament and development partners such as USAIDthrough its POLICY project and the AFT. Executive Director, KENEPOTEemphasized working with HIV positive teachers as a way of stemming the spread ofAIDS. Executive Director, KENEPOTE also remarked that the AIDS CoordinatingUnit (ACU) at the Kenya TSC has been particularly helpful when working with HIVpositive teachers Executive Director, KENEPOTE appealed to the TSC and otherpartners to offer a more conducive workplace for HIV-positive teachers and considerkey concerns such as teacher transfers to convenient locations, reducing teacherworkload in cases of chronic illness, providing rules to protect teachers, and observingrights. The participation of members of KENEPOTE in the Mombasa consultationwas an inspiration and a sign of hope for a more tolerant and caring educationworkplace. 31
    • According to Ochanda, July 2007, HIV/ Aids Stigmatization and Discrimination havegreater consequences on the education sector. Ochanda, July 2007, observed AIDS-related stigma and discrimination remains one of the biggest barriers to effectivelymanage the AIDS epidemic. Stigma destroys self-esteem, families, disruptscommunities and renders the individual hopeless. Ignorance and fear of HIV andAIDS play a major role in enhancing stigma and discrimination.Ochanda, July 2007, also observed that Stigma and Discrimination at the Workplaceand at home. For instance workers are sometimes dismissed because of their HIVstatus which may be real or perceived, employment is sometimes denied on the basisof the candidate’s actual or assumed HIV status, breaches of confidentiality(employer, colleague, friends and even family members). In addition families areostracized because one of them is ailing. This leads to loneliness and worsens thesituation for the sick. Often family members have been known to chase away theinfected member.Ochanda, July 2007 further reported that Orphans Vulnerable Children (OVC). TheOVC’s educational needs of those born with or are infected with HIV are ignored.These are children without a future – education is an investment for the future andperpetrates poverty and ignorance. Children are sometimes denied access to schoolbecause they come from an AIDS-affected family. Children are isolated in school asothers do not want to play with them. Other parents stigmatize the orphans and advisetheir own children not to play with them or even withdraw their children totally fromthe class/school.Ochanda, July 2007 commented that Stigmatization and Discrimination causes angerin the individual and can lead to violence; Lowers morale and productivity of theinfected/affected; Enhances lack of interest in learning/working on the part of theaffected/infected; Children feel helpless as school demands cannot be met by an ailingparent; Lowers prioritization of education within families and society, especially forthe girl child; Hinders the implementation of policies and some of the set goals forexample Education For All (EFA) goal. EFA will continue to be an illusion unless theeducation managers, policy makers and all those in the education sectors recognizeHIV and AIDS epidemic to be a local regional and global emergency and reactaccordingly. 32
    • 2.2.4 Costs and the Quality of healthcare servicesA growing body of research on the impact of HIV on the world of work stronglysupports the ‘business case’ for HIV prevention, care and treatment. A study of theimpact of HIV on the financial performance of companies concluded that companiesbenefit from taking their own action in relation to HIV. A key finding was that basedon projections in a high-prevalence setting the value of the venture was more than 5%higher when a treatment programme was provided for employees than without it.HIV issues are of particular relevance in the following environments: Health care (dueto the risk of occupational exposure to infected blood), Work sectors with higher HIVprevalence than the general population (due to higher risk-taking among workers suchas the military, sugarcane factories, Tea farms, mining and truck drivers), In highprevalence countries (where HIV prevention and care interventions should reachworkers in all work places).Furthermore, the ILO Office Code of Practice (COP) on AIDS and the World ofWork provides guidelines with which countries can develop workplace-relatedpolicies and interventions at national, community and company levels. The COP isbased on consensus between employers, employees and government and recommendsthat all policies related to the workplace be developed using similar collaborativeprocesses.While the COP addresses workplaces in the formal economic sector, many workers inlow- and middle-income countries have their livelihoods in the informal economicsector. The ILO recommends that governments, employers and workers extend andadopt HIV prevention programmes to such workers and that government extendincome generation and social protection to them. Agriculture is the economicmainstay of many low- and middle-income countries, both in its subsistence role andits contribution to the formal economy. Many HIV mitigation programmes aim todirectly or indirectly support HIV-affected rural households – this may includepromoting alternative income generating activities. Often, some of the most effectivelabour-saving solutions are closer to home, namely those which reduce the timewomen spend on three tasks: fetching water, collecting firewood and preparing food.The limited literature that has addressed the impact of HIV/AIDS on health systemsshows that there is an increased demand for health services as a result of the epidemic.The epidemic is crowding out patients suffering from other medical conditions.Health service providers at public facilities are overburdened and require additional 33
    • skills to deal with the changing disease burden. Simultaneously, the epidemic isdecreasing the number and productivity of health service providers as they are lost totheir own illness and death as well as factors such as stress and demands from familymembers who die from the disease (Tawfik & Kinoti, 2003). The authors also foundthat HIV/AIDS affects the performance of health systems by increasing demand forservices in both quantity and complexity and by reducing the supply of services by itsimpact on the numbers and performance of the health workforce. These processeslead to increased costs to the health sector.Similar findings are suggested by the Centre for International Economics (2002).Futures (1999) notes that AIDS will affect the health sector for two reasons: it willincrease the number of people seeking services and health care for AIDS patients ismore expensive than for most other conditions.According to Nkinyangi, June 2005, the Honourable Professor George Saitoti, KenyaMinister for Education, Science and Technology while officiating the openingceremony referred to global estimates that call for US$ 1 billion (Kshs 68 Billion)annually to cover additional costs due to HIV/AIDS including those related to teacherabsenteeism, teacher deaths and incentives to keep orphans and other vulnerablechildren in school. There are projections that Kenya, for example, would lose 1.8% ofits teachers annually during the present decade unless deliberate interventions are putin place. Moreover, the cost of providing care and social services to orphans andvulnerable children would require substantial financial resources.In addition during the same Meeting the Chairman of Kenya Teachers ServiceCommission (TSC) cautioned against complacency indicating that the little economicgains made over the years were being reversed by the HIV/AIDS epidemic withdevastating and far-reaching effects on the education sector. For example, theestimated HIV prevalence rate in Kenya is 7% with about 2.9 million people affected.It is estimated that some 16,450 teachers are infected by the virus.The following recommendations were made: First, the education/teacher servicecommissions will identify and forward to the relevant authorities in governmentspecific provisions within the context of HIV/AIDS that require review and havefinancial implications (such as sick leave, relief teachers, early retirement on medicalgrounds, HIV-testing etcetera.) for incorporation within the existing legal frameworkof the country. Secondly, through support from UNESCO’s International Institute for 34
    • Educational Planning (IIEP), research will be undertaken on the cost of teacherabsenteeism and financing of relief/substitute teachers.2.2.5 Promotions/Communication activities about HIV/AidsGovernment of Kenya (GOK) has established the National AIDS and STDs (SexuallyTransmitted Diseases) Control Programme (NASCOP). NASCOP was set up to createpublic awareness, to strengthen laboratory services for HIV testing, to collect data andinformation, and to train health workers on the management of HIV/AIDS and STIs.Also In 1999, the GOK created the National AIDS Control Council (NACC) tomobilize and coordinate resources and activities to fight HIV/AIDS. Under theumbrella of NACC AIDS Control Units (ACUs) have been established in lineministries and key institutions such as the TSC and Kenyatta University.Nkinyangi, June 2005, report of the proceedings of Fourth UNESCO Nairobi ClusterConsultation. The Secretary/Chief Executive of the Kenya TSC, referred to the majoraccomplishments of the fight against HIV/Aids to date as: 95% awareness of thedisease among the general population. While updating the consultation on activitiesand programmes in Kenya, the TSC Secretary said that sensitization workshops foremployees had been conducted on HIV and AIDS and these have covered key areasincluding: facts about HIV/AIDS, modes of transmission, signs and symptoms of thedisease, coping mechanisms including nutrition among others. A series of capacity-building workshops have also been conducted on the management of HIV and AIDSat the workplace. A guidance and counseling programme is in place at the TSCHeadquarters in Nairobi and a training workshop for trainer of trainers has beenconduced on the management of HIV/AIDS.Speaking more on gains since the Kampala consultation in June 2003, TheSecretary/Chief Executive of the Kenya TSC reported that 95% of the TSCHeadquarters employees have been sensitized on HIV/AIDS. TSC Commissioners,senior management, provincial directors of education and district education officershave similarly participated in capacity-building workshops on the management ofHIV/AIDS at the workplace. TSC District Staffing Officers (DSOs) have been trainedon the management of HIV/AIDS at the workplace and each of the districts in thecountry now has a sub-ACU that is managed by the DSO and the District HumanResource Officer (DHRO) both of whom are in daily contact with head teachers andClassroom teachers in their districts. The TSC has engaged two professionalcounselors within its ACU and has also trained ‘peer leaders’ at the TSC 35
    • Headquarters to provide guidance to their colleagues on HIV/AIDS issues.Information, education and communication materials (IEC) have been disseminated tomost of the TSC District Units across the country. An innovative way of HIV/AIDSsensitization has been the posting of messages and key information on the monthlypay slips of all teachers and other TSC employees. TSC is also in the process ifproducing a bi-annual magazine on HIV/AIDS for distribution to all schools. Lastly,the TSC actively participated in the development of the Kenya Public Sector Policyon HIV/AIDS at the Workplace and the National HIV and AIDS Strategic Plan for2005-2010.Among the challenges facing the TSC in Kenya are slow changes in behaviour andattitudes despite sensitization workshops compounded by strong cultural andindividual beliefs. As result, stigma and discrimination are still prevalent at theworkplace. Further, there is the lack of up-to-date information on the impact of HIVand AIDS at the workplace and this makes it difficult to plan for specific interventionsthat may be required. There are financial constraints that have made it difficult to runprogrammes that can reach all the 240,000 teachers employed by the TSCcountrywide. A major problem of the TSC is teacher absenteeism associated withchronic OIs. Since many teachers still fear to disclose their HIV-status, the TSC maybe forced to interdict and apply disciplinary measures when a teacher absconds fromduty without appropriate justification.2.2.6 HIV/Aids Policy Programs and the reduction in turnover and Absenteeismamong Staff and StudentsAccording to Kimutai, 2008, the middle level managers bridge the gap between thetop management team and lower level workers. These managers implement strategyand organizational changes, keeping other workers engaged during both good and badeconomic cycles. Kimutai, 2008 quoted a 2007 Accenture survey (done by WhartonExecutive Education Thomas Colligan) around the world, 20 percent reporteddissatisfaction with their current organization and that same percentage reported werelooking for another job. The report found that one of top reason cited causingdeparture was lack of prospects for advancement. Many companies are seeingsignificant turnover and hence lack of ability to execute strategy. Top managementcan spend all their time creating strategy, but without someone there to implement it.The strategy will yield no results for the Organization. 36
    • In addition to strategy implementation issues, the cost of turnover is extremely highfor companies. Wharton Executive Education Thomas Colligan noted that one largepartnership facing 20 percent turnover rate did a calculation in which it concluded thatfor each 1 percent reduction in the staff turnover, it would increase partner earningsby USD 80,000.According to Caillods, 2007, Absenteeism is very high in many African countriesindependently of HIV and AIDS. HIV and AIDS have transformed it in a very seriousissue in Eastern and Southern Africa. It is a threat to quality, potentially endangeringthe possibility of reaching education for All (EFA) goal. Handling teacherabsenteeism is a management issue.There is a great deal of controversies on factors that contribute most to learning; Butthere is general agreement among researchers that: Learning depends on opportunitiesto learn (time on task), Students achievements decline drastically if they do notreceive lectures that is when learners and/or teachers are absent, Teachers are one ofthe most important factors that contribute to learning, There is a correlation betweenteachers frequent absences and students discipline problems (bad behaviour and classskipping).Here some data on absenteeism. Uganda: Each teacher misses on average between 4to 8 days per month (Actionaid, 2005). Namibia: 3 percent of teachers are absent formore than 15 days per year ( Kinghorn, 2002), 72 percent of heads report that teacherabsences disrupt learning ( ibid), In several rural schools in the north of the countryhalf of the teachers were absent on average at any one time ( 2006), South Africa :more than 15 percent of schools reported that teachers were absent more than 30consecutive days, Between 1.5 and 2.5 percent of teachers in tow provinces wereabsent for more than consecutive days.It is difficult to measure the phenomenon as absences are badly recorded and it is notpossible to single out the effect of HIV and AIDS. When a teacher is absent these arepossibilities: The children remain idle in the class, they play in the courtyard, thechildren go and attend another class (leading to large classes; content may also bedifferent), and merging classes is more difficult at secondary level: the subject is noteffectively taught also learning is disrupted.The Causes of frequent absenteeism have been identified to be: Teachers having asecond job for economic reasons, Teachers travelling to cash their salaries, Teachershaving been transferred and not replaced, Pregnancies, Sicknesses, In service courses 37
    • and Bad discipline and bad school leadership. HIV and AIDS pandemic has increasedabsenteeism in two ways. First directly: Teachers absent themselves to receivetreatment, Teachers who developed AIDS are too weak to teach, Teachers die and ittakes a long time to replace them. Second indirectly: Teachers attend funerals andTeachers attend to a sick relative(s) and friend(s)’ sickness and lastly death increaseteachers’ stress.Furthermore some teachers are present in the school but do not teach, several researchreport problems of teacher misbehaviour (alcoholism), There are not enoughsupervisors and they rarely visit the schools, Head teachers do not know the rules andregulations (workplace policy) and do not apply it, No relief system are in place toreplace missing teachers, Health service are badly distributed and rarely available inrural areas, Regulations do not encourage teachers to announce their foreseeableabsences, After 30 to 90 days of consecutive unauthorized absences, teachers can bedischarged from public service, Substantial decline in salaries occur in case of earlyretirement (for chronic illness) and low responsiveness of the medical Board.Handling absenteeism: a management problem. For Example in Northern NamibiaHigh HIV prevalence rate in the two northern regions lead to high level of teacherabsences. Numerous absences are related to funeral attendance (compassionate leaveand personal convenience) and to teachers’ sickness. The numbers of days forauthorized leave are fixed; many absences over the threshold are not recorded, manyhead teachers do not exercise their authority, strong link has been identified betweenhead teacher leadership skills and the degree of teachers (and students) absenteeism.Among the 7 schools with complete information 3 schools had high disciplineproblems and high number of teacher absences. Those schools shared the followingcharacteristics: Principals were new in the school or had little experience, Inspectorsdid not visit them frequently and Schools Boards were not functioning properly.The other 3 schools in high prevalence areas had low number of teacher absences.Those schools shared the following characteristics: Principals were experienced andhad received management training, Principals were capable to communicate with theteachers, the school board and the inspector had found solutions by consensus to theschool’s problems and Schools Boards were functioning properly and providingsupport. 38
    • These are the recommendations for handling absenteeism. A series of bottlenecks inthe management of the problem of absenteeism must be cleared at these levelsCentral, District and School.At Central Level, the measures to address the problem include: Reviewing the normsand procedures (improve the protocol for early retirement for chronically ill teachers;establish a system of relief teachers; allow schools to recruit voluntary teachers),Provide free treatment for sick teachers and their families, Increasing accountabilitytowards the school board and the community, Modernising and computerising theinformation system, Principals should receive training on how to lead a school and onpedagogical management (develop a guideline for headmasters).At district level, better management practices at local level can help mitigate theimpact of HIV/Aids. The measures to address these include: Organizing for in-servicetraining, including workshops, at a time that least disrupts the teaching process;Supervisors to support headmasters and take quick action on their request andencourage headmasters to apply the rules.At School level, the recommendations for handling absences are Better managementpractices at level can help mitigate the impact measures to address these include:Keeping good records, Creating awareness among head teachers and teachers of thedamage that their absences cause to learners, Creating a “contingency fund” to pay forexternal teachers to replace those who are absent, Giving lighter working load tochronically sick teachers (this may run the risk of stigmatization of victim),Strengthening School boards through opportunities for training and close technicalassistance, School board members should receive support in learning “how to do theirjob” and Parents can be of great assistance in replacing teachers (reinforcingknowledge).2.3 CRITICAL REVIEWThe Workplace Policy guidelines as per Occupational Health Services Convention(OHSC) Number 161 of 1985. The International Labour Organization (ILO) OHSCoutlines a set of national principles, policies and practices designed to protect thehealth and safety of workers. While the OHSC does not specifically address HIV, itprovides the basis for direction to Members on how to protect workers from work-related HIV transmissions and to address the rights and needs of workers living withHIV. The OHSC was adopted by the General Conference (GC) of the ILO, at its 71st 39
    • session in 1985. The GC comprises delegates from each Member State who representGovernment, Employers’ Federation, and Central Workers’ Union in that State.Ministries of Labour, Employers’ Federation and Central Workers’ Union and theirrepresentatives all have a significant stake in successful HIV prevention, care,treatment and mitigation measures. Illness removes skilled personnel from theworkforce and deprives both the public and private sector of their skills, knowledgeand experience.The underlying and most important factor is that implementing HIV/Aids policies inthe workplace: saves lives, maintains enterprise production and complements publichealth services. The Managers are responsible for several functions duties whichinclude Human Resource Management at Kenyatta University. For the purpose of thisresearch these are: Confidentiality, Non-discrimination and Care, Treatment Supportand Prevention of new HIV infections. These will interact to first improve the qualityof life, secondly mitigate the negative socio-economic impact of HIV/Aids and thirdlyreduce the prevalence rates among the employees in KU and the wider Community –Kenya as a Nation and members of the Global human race. These three are thePriority themes of Kenya HIV& Aids Research Coordinating Mechanism(KARSCOM); this is the HIV Aids Research Strategy Coordination, ResourceMobilization and Dissemination Organization under the Office of the President.2.4 SUMMARY OF GAPS TO BE FILLED BY THE STUDYTo investigate the effects of implementation of HIV/AIDS policy and AIDSincidences among staff and students in Institutions of Higher Learning in Kenya, thecase of Kenyatta University. Moreover to make recommendations on the basis of dataand literature reviewed on this big issue of HIV/Aids pandemic in the workplace. 40
    • CHAPTER THREE3.0 RESEARCH METHODOLOGYINTRODUCTIONThis chapter deals with research design and methodology employed in the study.These include the study design, target population, sampling procedure, researchinstruments and procedure of data collection and data analysis method.3.1 STUDY DESIGNThe researcher used the descriptive research design. This involves observing anddescribing the behavior of a subject without influencing it in any way. Many socialscientists and Market researchers use this method to obtain a general overview of thesubject, observe natural behaviors, judge the customers behaviors and assess thestaff/employee motivation.Descriptive research design is also effective where it is not possible to test andmeasure the large samples needed for more quantitative types of experimentation.Descriptive research design has the limitation that its results can in no way be used asa definitive answer(s) or to disprove a hypothesis (es). Not only has the researcherconsidered the design still a useful tool in this research but, also cheaper in cost andless time-consuming than other quantitative research designs.3.2 TARGET POPULATIONThe management of day-to-day affairs of KU is by Chancellor and the ViceChancellor (V.C) assisted by other KU officers. Under the rank of VC, there are threeDeputy Vice Chancellors (DVCs) namely DVC Academic, DVC Administration andDVC Finance, Planning and Development. Below the rank of each DVC there is aRegistrar with same designation and the ranking cascades to other lower ranks in KU.For purpose of this study, the cut-off for a managerial post is at the staff holding thedesignations described in chapter four.KU operates both the centralization and decentralization management systems. Thematters of finance, accounting and healthcare are centralized whereas matters ofacademics are decentralized. On one hand the information on costs of budget itemssuch as the number of staff, healthcare, and reason for granting off-duty, recruitmentand etcetera. This can be provided on the “need –to-know” basis by the Departmental 41
    • staff working in Administration, Finance, Planning and Development. On the otherhand, information on staff performance, absenteeism, employee relationships andgeneral academic work can be provided by any Manager.The Researcher investigated all the KU Managers. The Researcher determined thatthe target population to be 132 officers from Kenyatta University Internal TelephoneDirectory 2006/2007.Table 3.1: The Target PopulationCategory of Staff Population Frequency Percentage (%)Top Level Managers 19 14Middle Level Managers 26 20Lower Level Managers 87 66Total 132 100Source: Author, 20083.3 SAMPLING DESIGNThe sample size 65 out of the 132 target population was taken. The samplingtechniques used are described below. The target population is heterogeneous andutilized a ratio of 0.65, see the Table 3.2: The Sample Size.Table 3.2: The Sample SizeCategory of Staff Population Frequency Population Ratio Sample SizeTop Level Managers 19 0.14 3Middle Level Managers 26 0.20 5Lower Level Managers 87 0.66 57Total 132 1 65Source: Author, 2008The Researcher used both probability and non- probability types of sampling methodsto select the sample size from the Target population.Under the Probability type of sampling Methods the researcher employed: SystematicSampling method, this is where the 1st, 3rd and nth odd Manager as per listingsequence in the KU Internal Telephone Directory 2006/2007 was selected to form theSample size. Stratified sampling method, the target population in KU embraces two 42
    • distinct categories; namely the Academic and the Administration, Finance, Planningand Development divisions. The sample frame organized the two categories intoseparate "strata." A sample was then selected from each "stratum" separately,producing a stratified sample. The reasons for using a stratified sampling design are toensure that particular groups within the target population are adequately representedin the sample and to improve efficiency by gaining greater control on the compositionof the sample.Under the Non-probability type of sampling methods the researcher employed:Convenience sampling – Some Managers of the target population were chosen basedon their relative ease of access. Judgmental or Purposive sampling - The researcherchoose the sample based on who they thought was appropriate for the study, becausea limited number of people that have expertise or the information in the area beingresearched. For example in a Centre or a Programme where there is only onemanagerial post as a case of the KU Aids Control Unit (ACU), the Director wassampled.3.4 DATA COLLECTION PROCEDURES/ INSTRUMENTS USEDQuestions were applied to gather categorical data (that is ‘yes’ or ‘no’), numericaldata and narrative text. The Researcher incorporated Likert scale into some questions.A Likert scale is a psychometric scale in questionnaires. When responding to a Likertquestionnaire item respondents specify their level of agreement to a statement or rateit on scale.The study questionnaire was pre-tested at KU Mombasa Campus. The post-testedquestionnaires were either posted or hand-delivered to the sampled Respondents atKU, Mombasa Campus and at KU, Main Campus in Nairobi. The period for datacollection was stipulated in the introduction letter as from 11th to 30th September2008. The Respondents after filling in the questionnaire surrendered it at their School/ Department / Centre reception desk for collection. There was low response becausemost respondents wanted detailed information beyond the scope provided to the DataCollectors. The Researcher followed up, provided the required information andcollected the filled in questionnaires from some of the respondents. Also the Head ofData Collectors collected other questionnaires. 43
    • 3.5 DATA ANALYSIS AND PRESENTATIONThe Researcher coded all the returned questionnaires. The quantitative and qualitativedata captured in the questionnaires was organized, edited, classified and tabulated.Editing involved checking the raw materials gathered for accuracy, usefulness andcompleteness. The responses have been collated into frequency tables, pie chartgraphs bar chart graphs, notes and central tendency summarized by the mode and themean. The researcher used the computer program known as Microsoft Excel (aspreadsheet) and not Statistical Package for Social Sciences (SPSS) as indicated in theResearch proposal was used to analyze the research statistics.3.6 EXPECTED OUTPUTThis research contributed knowledge in the area of policy and practice in StrategicHRM on the basis of research conducted at KU on the effects of implementation ofHIV/AIDS policy and AIDS incidences among staff and students in Higher LearningInstitutions in Kenya. The synopsis and review of literature on past studies and /ordiscourses on the big issue of HIV/Aids pandemic in the workplace provide aninsightful reading. 44
    • CHAPTER FOUR4.0.0 DATA ANALYSIS AND PRESENTATION OF RESULTSThis chapter of the report presents how the conclusions for the study have beenlogically arrived at using the information from the data collected. The samplepopulation is measured up against each variable and precise position ascertained.4.1 INTRODUCTION TO DATA ANALYSISThis analysis gives a presentation of the extent to which the sample population ispositive and active to each of the following main variables in study;1. The KU Managers distribution of the personal details in terms of gender, age,highest level of education, designations and length of service.2. The extent of incidences of HIV/Aids among KU staff and students afterimplementation of the KU HIV/Aids policy.3. The implementation of the KU HIV/Aids policy led to changes in the KU Curriculacompliant with HIV/Aids.4. The implementation of the KU HIV/Aids policy led to favorable change in attitudeamong the KU staff and students towards people affected/infected with HIV/Aids.The Change has reduced discrimination and stigmatization.5. The implementation of the KU HIV/Aids policy led to increase in the costs ofhealthcare services and improvement in the quality of the services by KU Health UnitDepartment / ACU.6. The implementation of the KU HIV/Aids policy increased the healthcommunication/ promotion activities about HIV/Aids.7. The implementation of the KU HIV/Aids policy led to HIV/Aids programs thathave reduced turnover and absenteeism caused by HIV/Aids among the KU staff andstudents.The sample population was evaluated on each of the above variable using bothquantitative and qualitative analysis techniques.4.1.1 Response RateThe sample size comprised of 65 KU Managers. The study successfully obtained datafrom 48 out of 65 respondents the response of 74 %. The data is adequate, reasonableand representative of the sample population. Also the data is reliable and dependable 45
    • for the purpose of this research. The non-compliance of 26 % respondents will notsignificantly impact on the conclusions of the research work.4.2 QUANTITATIVE ANALYSIS4.2.1.0.0 KU Managers, the Respondents Personal detailsTable 4.1: Distribution of Respondents by Gender. Responses Number of Respondents PercentageMALE 28 58%FEMALE 20 42%Total 48 100%Source: Author, 2008Table 4.1 above presents a summary of responses by the Gender. The findings showthat 58% are men and 42 % are Women. It means that 6 out of 10 KU Managers arewomen.Figure 4.1: Distribution of Respondents by Age bracket in years Distribution of Respondents by Age in years. ABOVE 65 YEARS 0% 56-65 YEARS UNDER 36 4% YEARS 14% 46-55 YEARS 40% 36-45 YEARS 42%Source: Author, 2008 46
    • Figure 4.1above pie chart graph presents a summary of responses of Respondents byAge bracket in years. The results show that 42% are aged between 36 years old and45 years old, 40% are aged between 46 years old and 55 years old, 14% are aged lessthan 35 years old, 4% aged between 56-65 years old and there is no respondent agedabove 65 years old. It implies in 9 years KU will have 8 out of 10 Managers agedabove 45 years old.Table 4.2: Distribution of Respondents Highest level of education % Number Number of ofHighest Education Level Respondents Respondents PRIMARY SCHOOL 0 0%SECONDARY SCHOOL 0 0%DIPLOMA COLLEGE (Inclusive of ordinary Diploma& equivalents) 2 4%UNDERGRADUATE (Bachelors, CPA (K),Specialized Nurses - Clinical Officers & HND) 10 21%POSTGRADUATE (Inclusive of CERTIFICATES,DIPLOMA, MASTERS & PHD) 36 75%Total 48 100%Source: Author, 2008Table 4.2 above presents a summary of responses by the highest level of education forrespondents. The findings show that 75% have the attained postgraduate educationlevel, 21% Undergraduate education level, 4% Diploma education level and 0%secondary and primary education level. This means 9 out of 10 KU Managers havestudied at a University College. 47
    • Table 4.3: Distribution of Respondents by Designations KU, Designations in the Number of Sample % Respondents toManagement Level Level Respondents Size the Sample size Chancellor, Vice Chancellor, Deputy Vice Chancellors, Registrars,Top Level Finance Officer andManagers Deputy Registrars. 0 3 0% Legal Officer, Deans, Chief Security Officer, Directors, Head of Health Unit, Principal Officer, Sacco Manager, LibrarianMiddle Level and Senior AssistantManagers Registrars 11 5 23% Deputy Chief Security Officer, Chief Internal Auditor. Human Resource Manager, Transport Manager, Estate Manager, Deputy Dean of Students, Chairmen of Department, Coordinators, Medical Officers, Pharmacist, Senior Games Tutors,Lower Level Cybercafé Manager,Managers Hostel Manager 37 57 77%Total 48 65 100%Source: Author, 2008Table 4.3 above presents a summary of responses by Designations. The results showthat 77% are lower level Managers, 23% middle level Managers and 0% Top levelManagers. It means that it was not possible to collect data from the Top Managerswho are also key policy makers. 48
    • Figure 4.2: Distribution of Respondents by Length of Service at KU in years. Length of Service at KU in years for Respondents Under 1 Year 23% Over 7 Years 44% 2-3 Years 23% 6-7 Years 4-5 Years 10% 0%Source: Author, 2008Figure 4.2 above pie chart graph presents a summary of responses by length of serviceat KU. The findings show that of the Managers: 44% have over 7 years of service, atie for those below 1 year of service and between 2 years of service and 3 years ofservice at 23%, 10% between 6-7 years of service and 0% between 4-5 years ofservice. 49
    • 4.2.1.1.0 The Incidences of HIV/Aids and the HIV/Aids PolicyFigure 4.3: Does the University have incidences of HIV/Aids among the Staff andStudents? Does the University have incidences of HIV/Aids among the Staff and Students? NO 11% YES 89%Source: Author, 2008Figure 4.3 above pie chart graph presents a summary of categorical responses ofeither yes or no for incidences of HIV/Aids among staff and students at KU. Thefindings show that 89% said ‘yes’ and 11% said ‘no’. The respondents agreed thatthere are incidences of HIV/Aids.Table 4.4: What extent are the incidences of HIV/Aids among the Staff and Students? 1.Very 2. High 3. Fairly 4. Low 5. Very High High Low % Number of 0% 10% 57% 33% 0% RespondentsSource: Author, 2008Table 4.4 above presents a summary the responses on the scale of 1 to 5,where 1=Very High and 5=Very Low. The group of ‘Yes’ respondents rated theextent for incidences of HIV/Aids among staff and students at KU. The findings showthe % mean for the group extent of incidences of HIV/Aids is: 0% Very High, 10 %‘High’57%, ‘Fairly High’, 33 % ‘Low’ and 0% ‘Low’. 50
    • Table 4.5: Does the University have any Policy on HIV/Aids? Responses Number of Respondents Percentage Yes 40 83% No 8 17% Total 48 100%Source: Author, 2008Table 4.5: above table presents a summary of categorical responses of either yes or noto knowledge of the existence of KU HIV/Aids policy. The findings show that 83%said yes and 17% said no. It means that 40 out of 48 Managers are aware of thePolicy.Figure 4.4: Rating the impact of the implementation of HIV/Aids Policy on reducingthe incidences of AIDS among the Staff and Students? HIV/Aids Policy has reduced incidences of HIV/Aids among Staff and Students Very Low 0% Very Great Low 0% 23% Great 32% Very Great Great Moderate Low Very Low Moderate 45%Source: Author, 2008Figure 4.4 above pie chart presents a summary the responses on the scale of 1 to 5,where 1= Very Great and 5= Very Low. The category of ‘Yes’ respondents rated theimpact of KU HIV/Aids policy to reduce incidences of HIV/Aids among staff and 51
    • students at KU. The findings show the % group’s mean of is: 45% Moderate, 32%Great, both Very Great & Very Low at 0% and 23% Low.4.2.1.2.0 Introduction of Curricula compliant with HIV/AidsFigure 4.5: Has the implementation of HIV/Aids policy led to any changes in theUniversity Curricula? HIV/Aids Policy Implementation led to changes in the University Curricula NO 46% YES 54%Source: Author, 2008Figure 4.5 above pie chart presents a summary of categorical responses of either yesor no to changes in the University curricula compliant with HIV/Aids afterimplementation KU HIV/Aids policy. The findings show that 54 % said yes and 46%said no.Table 4.6: What extent has the University Curricula changed? 1.Very 2. Great 3. Moderate 4. Low 5. Very Great Low % Number of 0% 20% 73% 7% 0% RespondentsSource: Author, 2008Table 4.6 above presents a summary the responses on the scale of 1 to 5,where 1=Very Great and 5=Very Low. The category ‘Yes’ respondents rated theextent of changes in the University curricula compliant with HIV/Aids after 52
    • implementation KU HIV/Aids policy. The findings show the % mean for the group ofis: Very Great 0%, 20% Great, 73% Moderate, 7% Low and Very Low 0%.4.2.1.3.0 Attitude change towards people affected/infected with HIV/Aids -Discrimination and StigmatizationFigure 4.6: Has the implementation of HIV/Aids policy led to change in attitudeamong the staff and students towards people affected/infected with HIV/Aids? Has the implementation of HIV/Aids policy led to change in attitude among the staff and students towards people affected/infected with HIV/Aids? NO 29% YES 71%Source: Author, 2008Figure 4.6 above pie chart graph presents a summary of categorical responses ofeither yes or no. The change in attitude among the staff and students towards peopleaffected/infected with HIV/Aids after implementation KU HIV/Aids policy. Thefindings show that 71% yes and 29% no. It means there is reduction in discriminationand stigma because 34 out of 48 respondents agreed to the statement. 53
    • Figure 4.7: Rating the magnitude of the change in attitude among the staff andstudents towards people affected/infected with HIV/Aids? the Magnitude of change of the University Curricula Very Low ly Significant 0% Very Highly Significant Low ly Significant 0% 5% Highly Significant 30% Very Highly Significant Highly Significant Moderately Significant Low ly Significant Very Low ly Significant Moderately Significant 65%Source: Author, 2008Figure 4.7 above pie chart graph presents a summary the responses on the scale of 1to 5, where 1=Very Highly Significant and 5=Very Lowly Significant. The category‘Yes’ respondents rated the magnitude of change in attitude among the staff andstudents towards people affected/infected with HIV/Aids after implementation KUHIV/Aids policy. The findings show the % mean for the group of is: 65% ModeratelySignificant, 30% Highly Significant, 0% for both Very Highly Significant & VeryLowly Significant and 5% Lowly Significant. It means 31 out of 48 respondentsagreed to the statement and gave a score of 3. 54
    • 4.2.1.4.0 Costs and Service Quality of Healthcare ServicesFigure 4.8: Has the implementation of HIV/Aids policy led to increase in costs ofhealthcare services? Has the implementation of HIV/Aids policy led to increase in costs of healthcare services? YES 35% NO 65%Source: Author, 2008Figure 4.8 above pie chart presents a summary of categorical responses of either yesor no to increase in costs of healthcare services after implementation KU HIV/Aidspolicy. The findings show that 35% yes and 65% no. It means the costs healthcareservices in KU have either decreased and / or remained the same. 55
    • Table 4.7: Rating the increase of the expenditure/Investment items listed here.Cost Items and % Number of 1.Very 2. High 3. Fairly High 4. Low 5. VeryRespondents High LowHiring of new staff (e.g. 33% 11% 22% 0% 33%Counselors, nurses, ClinicalOfficers, Social Workers) orenrichment of the Job Descriptionsfor existing staffPurchase of Drugs and procurement 22% 33% 22% 11% 11%logistics (e.g. ARVs, Septrin,Painkillers)Acquisition of medicals Equipments 22% 33% 22% 0% 22%& other Supplies (e.g. CD4 count, testkits, reagents, uniform, Fridges)Training (e.g. ART management, VCT, 22% 33% 33% 0% 11%CMEs, PDE, Injection Safety, WasteManagement & Disposal)% Mean 25% 28% 25% 3% 19%Source: Author, 2008Table 4.7 above presents a summary the responses on the scale of 1 to 5,where 1=Very High and 5=Very Low. The category ‘Yes’ respondents rated theincrease of the expenditure/Investment items after implementation KU HIV/Aidspolicy. The expenditure/Investment items are Hiring of new staff, Purchase of Drugsand procurement logistics, Acquisition of medicals Equipments & other Supplies andTraining. The findings show the % mean for the group of the items is: 25% VeryHigh, 28% High, 25% Fairly High 3% Low and 19% Very Low. 56
    • Figure 4.9: Rating the increase of the expenditure/Investment items listed here. Increase of expenditure items due HIV/Aids Policy 35% 30% 25% Hiring of new staff % of Respondents 20% Purchase of Drugs and procurement logistics Acquisition of medicals Equipments & other Supplies 15% Training 10% 5% 0% Very High High Fairly High Low Very Low RatingsSource: Author, 2008Figure 4.9 above bar graph presents a summary the responses on the scale of 1 to 5,where 1=Very High and 5=Very Low. The category ‘Yes’ respondents rated theincrease of the expenditure/Investment items after implementation KU HIV/Aidspolicy.. The findings show mean for the group items is: 4 out of 17 respondents VeryHigh, 5 out of 17 respondents High, 4 out of 17 respondents Fairly High, 1 out of 17respondents Low and 3 out of 17 respondents Very Low. The mode is ‘high’. 57
    • 4.2.1.4.1 The Service Quality of K U Health Unit Department and Aids ControlUnit (ACU)Table 4.8: Rating the services provided by Kenyatta University Health Unit and AidsControl Unit (ACU) after the implementation of HIV/Aids policy.Specific Aspects and % Number 1.Very 2. Poor 3. Fair 4. Good 5. Excellentof Respondents PoorReception Services 10% 10% 14% 62% 5%Quality of Drugs & Services 0% 14% 38% 43% 5%Service by the Staff 10% 10% 25% 45% 10%Comfort of the Recuperation room 5% 5% 29% 57% 5%Cleanliness of washroom 5% 0% 38% 43% 14%Helpfulness of Staff 5% 14% 10% 57% 14%% Mean 6% 9% 26% 51% 9%Source: Author, 2008Table 4.8 above presents a summary the responses on the scale of 1 to 5,where 1=Very Poor and 5=Excellent. The respondents rated the quality of servicesprovided by Kenyatta University Health Unit and Aids Control Unit (ACU) afterimplementation KU HIV/Aids policy. The services are Reception, Drugs & Services,Staff, Comfort of the Recuperation room, Cleanliness of washroom and Helpfulnessof Staff. The findings show the % mean for the group is: 6% Very Poor, 9% Poor,26% Fair, 51% Good and 9% Excellent. 58
    • Figure 4.10: Rating the services provided by Kenyatta University Health Unit andAids Control Unit (ACU) after the implementation of HIV/Aids policy. Services by KU Health Unit and ACU 70% 60% 50% Reception Services % of Respondents Quality of Drugs & Services 40% Service by the Staff Comfort of the Recuperation room 30% Cleanliness of w ashroom 20% Helpfulness of Staff 10% 0% Very Poor Poor Fair Good Excellent RatingsSource: Author, 2008Figure 4.10 above bar graph presents a summary the responses on the scale of 1 to 5,where 1=Very Poor and 5=Excellent. The respondents rated the quality of servicesprovided by Kenyatta University Health Unit and Aids Control Unit (ACU) afterimplementation KU HIV/Aids policy. The findings show the mean for the group ofservices is: 3 out of 48 respondents ‘Very Poor’, 4 out of 48 respondents ‘Poor’, 12out of 48 respondents ‘Fair’, 24 out of 48 respondents ‘Good’ and 4 out of 48respondents ‘Excellent’. 59
    • 4.2.1.5.0 Promotions/Communication activities about HIV/AidsFigure 4.11: Has the implementation of HIV/Aids policy led to increase inPromotions / Communication activities about HIV/Aids? Has the implementation of HIV/Aids policy led to increase in Promotions/Communication activities about HIV/Aids? NO 29% YES 71%Source: Author, 2008Table 4.11 above pie chart graph presents a summary of categorical responses ofeither yes or no to increase in Promotions / Communication activities about HIV/Aidsafter implementation KU HIV/Aids policy. The findings show that 71% said ‘yes’ and29% said ‘no’. It means there increased Promotions/Communication activities aboutHIV/Aids. 60
    • Table 4.9: The increase in Promotions / Communication activities about HIV/AidsMedia and % Number of 1.Very 2.Great 3.Moderate 4.Low 5.VeryRespondents Great LowRadio 17% 44% 28% 0% 11%Television 22% 6% 50% 11% 11%Print both paper and electronic (e.g. 39% 22% 33% 0% 6%Brochures, Newsletters, Handouts,Posters, Billboards, Websites, E-mails)Cinema (With HIV/Aids themes on 28% 17% 39% 11% 6%VCD, DVD, Video tapes, liveperformances, environmentalawareness)% Mean 27% 22% 38% 6% 9%Source: Author, 2008Table 4.9 above table presents a summary the responses on the scale of 1 to 5,where 1=Very Great and 5=Very Low. The respondents rated the extent of increase inPromotions / Communication activities about HIV/Aids in Radio, Television, Printboth paper and electronic and cinema after implementation KU HIV/Aids policy. Thefindings show the % mean for the group of is 27% Very Great, 22% Great, 38%Moderate, 6% Low and 9% Very Low. 61
    • Figure 4.12: The increase in Promotions/Communication activities about HIV/Aids. the extent of Promotions/Communications Activities about HIV/Aids 60% 50% % of Respondents 40% Radio Television 30% Print both paper and electronic Cinema 20% 10% 0% Very Great Great Moderate Low Very Low RatingsSource: Author, 2008Figure 4.12 above bar graph presents a summary the responses on the scale of 1 to 5,where 1=Very Poor and 5=Excellent. The respondents rated the extent of increase inPromotions / Communication activities about HIV/Aids in Radio, Television, Printboth paper & electronic and cinema after implementation KU HIV/Aids policy. Thefindings show the % mean for the group is: 9 out of 34 respondents Very Great, 7 outof 34 respondents Great, 13 out of 34 respondents Moderate, 2 out of 34 respondentsLow and 3 out of 34 respondents Very Low.4.2.1.6.0 HIV/Aids Policy Programs and the reduction in turnover andAbsenteeism among Staff and StudentsTable 4.11: Has the implementation of HIV/Aids policy led to reduction in Staff andStudents turnover? Responses Number of Respondents Percentage Yes 20 42% No 28 58% Total 48 100%Source: Author, 2008 62
    • Table 4.11: above presents a summary of categorical responses of either yes or no toreduction in Staff and Students after implementation KU HIV/Aids policy. Thefindings show that 42% said ‘yes’ and 58% said ‘no’. It means the turnover amongstaff and students has either increased and / or remained the same. There is need toinvestigate further this is because common phenomenon in the World according toother researches is decrease when HIV/Aids programs are implemented.Table 4.11: What causes turnover among the Staff and Student after theimplementation of HIV/Aids policy in KU?Causes of Staff and Students turnover 1.Very 2.High 3.Moderate 4.Low 5.Veryand % Number of Respondents High LowIllness 0% 21% 21% 36% 21%Death 7% 14% 14% 36% 29%Termination (Retirement on Medical 0% 21% 0% 36% 43%grounds)Absconding of duty 0% 0% 21% 36% 43%% Mean 2% 14% 14% 36% 34%Source: Author, 2008Table 4.11: above table presents a summary the responses on the scale of 1 to 5,where 1=Very High and 5=Very Low. The respondents rated the causes of HIV/Aidsturnover among the Staff and Student after implementation KU HIV/Aids policy. Thefindings show the % mean for the group causes of turnover is: 2% Very High, 14%High, 14% Moderate, 36% Low and 34% Very Low. 63
    • Figure 4.13: What causes turnover among the Staff and Student after theimplementation of HIV/Aids policy in KU? HIV/Aids Causes of turnover among staff and students 45% 40% 35% Illness % of Respondents 30% Death 25% 20% Termination (Retirement on Medical grounds) 15% Absconding of duty 10% 5% 0% Very High High Moderate Low Very Low RatingsSource: Author, 2008Table 4.13 above bar graph presents a summary the responses on the scale of 1 to 5,where 1=Very High and 5=Very Low. The respondents rated the causes of HIV/Aidsturnover among the Staff and Student after implementation KU HIV/Aids policy. Thefindings show the mean for the group causes of turnover is: 0 out of 20 therespondents Very High, 3 out of 20 the respondents High, 3 out of 20 the respondentsModerate, 8 out of 20 the respondents Low and 6 out of 20 the respondents VeryLow. The single cause of turnover is death. 64
    • Figure 4.14: Has the implementation of HIV/Aids policy led to reduction inabsenteeism among the Staff and students? Has the implementation of HIV/Aids policy led to reduction in absenteeism among the Staff and students? YES 40% NO 60%Source: Author, 2008Figure 4.14 above pie chart presents a summary of categorical responses of either yesor no to reduction in absenteeism among the Staff and students after implementationKU HIV/Aids policy. The findings show that 40% yes and 60% no.Table 4.12: What causes absenteeism among the Staff and students after theimplementation of HIV/Aids policy in KU?Causes of absenteeism and % 1.Very 2.High 3.Moderate 4.Low 5.VeryNumber of Respondents High Low 0% 29% 14% 43% 14%SicknessBereavement 0% 21% 21% 29% 29%Care for the sick 0% 14% 21% 21% 43%Stigma, Discrimination and 0% 14% 29% 21% 36%Harassment% Mean 0% 16% 24% 24% 36%Source: Author, 2008 65
    • Table 4.12 above table presents a summary the responses on the scale of 1 to 5,where 1=Very High and 5=Very Low. The respondents rated the causes of HIV/Aidsabsenteeism among the Staff and Student after implementation KU HIV/Aids policy.The findings show the % mean for the group causes of absenteeism is: 0% Very High,16% High, 24% Moderate, 24% Low and 36% Very Low. The single cause ofabsenteeism is sickness.Figure 4.15: What causes absenteeism among the Staff and students after theimplementation of HIV/Aids policy in KU? HIV/Aids Causes of absenteeism among staff and students 45% 40% 35% 30% % of Respondents Sickness 25% Bereavement Care for the sick 20% Stigma, Discrimination and Harassment 15% 10% 5% 0% Very High High Moderate Low Very Low RatingSource: Author, 2008Table 4.15 above bar graph presents a summary the responses on the scale of 1 to 5,where 1=Very High and 5=Very Low. The respondents rated the causes of HIV/Aidsabsenteeism among the Staff and Student after implementation KU HIV/Aids policy.The findings show the mean for the group causes of absenteeism is: 0 out of 19 therespondents Very High, 2 out of 19 the respondents High, 5 out of 19 the respondentsModerate, 5 out of 19 the respondents Low and 7 out of 19 the respondents VeryLow. 66
    • Table 4.13: The extent KU HIV/Aids policy programs can reduce the Staff andstudents turnover and absenteeism caused by HIV/Aids.Program and % Number of 1.Very 2.Great 3.Moderate 4.Low 5.VeryRespondents Great LowAwareness 50% 30% 10% 0% 10%Prevention 60% 25% 10% 0% 5%Care and Support 50% 40% 5% 0% 5%% Mean 53% 32% 8% 0% 7%Source: Author, 2008Table 4.13 above table presents a summary the responses on the scale of 1 to 5,where 1=Very Great and 5=Very Low. The respondents rated the extent KUHIV/Aids policy programs to reduce turnover and absenteeism among the Staff andStudents. The programs are awareness, Prevention and Care and Support. Thefindings show the % group’s mean of HIV/Aids policy programs to reduce the Staffand students turnover and absenteeism caused by HIV/Aids is: 53% Very Great, 32%Great, 8% Moderate, 0% Low and 5% Very Low.Figure 4.16: The extent KU HIV/Aids policy programs can reduce the Staff andstudents turnover and absenteeism caused by HIV/Aids. HIV and Aids programs that reduce turnover and absenteeism among staff and Students 70% 60% 50% % of Respondents 40% Aw areness Prevention 30% Care and Support 20% 10% 0% Very Great Great Moderate Low Very Low RatingSource: Author, 2008Table 4.16 above bar graph presents a summary the responses on the scale of 1 to 5, 67
    • where 1=Very Great and 5=Very Low. The respondents rated the extent KUHIV/Aids policy programs to reduce turnover and absenteeism among the Staff andStudents. The programs are awareness, Prevention and Care and Support. Thefindings show mean for the group of HIV/Aids policy programs to reduce the Staffand students turnover and absenteeism caused by HIV/Aids is: 25 out of 48 therespondents Very Great, 15 out of 48 the respondents Great, 4 out of 48 therespondents Moderate, 0 out of 48 the respondents Low and 3 out of 48 therespondents Very Low. Also singly care and support is the rated ‘very Low’ to reduceturnover and absenteeism among Staff and students turnover. This is may be due tothe fact that many time PLHWAS need care and support at the during the full blownAIDS stage.4.3 QUALITATIVE ANALYSIS4.3.1.0.0 Introduction of Curricula compliant with HIV/AidsIt was observed that KU Curricula is compliant with HIV/Aids because a compulsorycourse Unit on a HIV/aids and drugs was introduced for all freshmen. Also that thepositive activities related to HIV/Aids have resulted in the decline in STIs andpregnancy among students and staff. These activities are believed to reduce the spreadof HIV/Aids in the KU Community.The other areas that should be added to KU curricula to help in the implementationHIV/Aids Policy are: teaching on alcoholism, drug abuse and the adverse effects suchas addiction and time management. During the counselling sessions componentknowledge of child play therapy must be incorporated. It was observed that the staffand students should be provided with relevant literature on the subject for exampleMiracle of Remera by Francis Imbuga, The last Plague by Meja Mwangi.4.3.1.1.0 Attitude change towards people affected/infected with HIV/Aids -Discrimination and StigmatizationIt was observed that because we are all infected and / or affected in one way oranother with HIV/Aids. This has resulted in people to accept the HIV/Aids reality.Also people now discuss about HIV/Aids, this has reduced discrimination andstigmatization among students and staff. In addition people are aware that they cantbe victimized because of their HIV statuses even if they have signs of HIV Positive. 68
    • This led to some staffs and students to come out openly. In spite of some still want tokeep their statuses confidential due to stigma.Staff and students know and take advantage of the annual HIV Testing Day and alsothey know there is a VCT within KU, Campus.These are the suggested strategies to enhance the change in attitude among the staffand students towards people affected/infected with HIV/Aids: expand the AidsControl Unit (ACU)/Health Unit services to the other newly created Campuses andalso establish Comprehensive Care Centre (CCC) clinic. These services should beextended to retired /discontinued staff and students; increase the mentoringprogramme activities; give equal opportunity to those infected; vigorous campaignsthrough Workshops, seminars, posters, billboards, souvenirs with messages onHIV/Aids, KU radio, Community Service for example visiting Hospital wards withHIV/Aids patients to educate about HIV/Aids; involve and encourage the PLWAS tojoin I choose Life Club for information and support.4.3.1.2.0 Costs and Service Quality of healthcare servicesThe major cost items in healthcare services are hiring of new staff or Job Descriptionsenriched with commensurate pay increase for existing staff, Purchase of Drugs andprocurement logistics, Acquisition of medicals Equipments & other Supplies andTrainingIt was observed that high costs of healthcare for Public Institutions should besubsidized by Central Government particularly the purchase of equipments, drugs andtraining that go with HIV/Aids. For instance the advent of HIV/Aids caused theabolition of KU staff medical scheme because it had become too expensive to the KUManagement. The staff medical scheme budget was transferred to an InsuranceCompany that provides medical cover insurance. The Insurance Company has apredetermined benefit ceiling ranging from Shs1Million to Shs 2 Million for theLecturer, Senior Lecturer, Associate Professor and Professor.It was also observed that the number of staff at the Health Unit has increased, incasethe drugs and / or the requisite services are not available people are referred to othermajor Hospitals and / or other health service providers. 69
    • 4.3.1.2.1 The Service Quality of K U Health Unit Department and ACUThe Researcher categorized services provided by KU health Unit and ACU asfollows: Reception Services, Quality of Drugs & Services, Service by the Staff,Comfort of the Recuperation room, Cleanliness of washroom and Helpfulness of Staff The ratings is based on the respondent’s kind of experiences in past at Health Unit/ACU. It was observed that reimbursement process is cumbersome; the staffs arerequired to pay for medical expenses and thereafter lodge a refund. It was observedthat the time taken to receive drugs is too long after you report to the clinic. Itrecommended that Health Unit needs to stock ARVs.The professional standards have deteriorated and there is need for this to beaddressed. The staff training in patients care and service should be done. This shallmake PLWAS to feel part and parcel of the KU Community.These are the suggested services to support the implementation of HIV/Aids policythat: All campuses should have a Health Care Units Clinics with, adequate medicalsupplies – including ARVs and qualified, competent staffs specialized in HIV/Aidsmanagement experience and skills. The referrals of HIV cases to other HealthFacilities to collect ARVs should be minimized and stand-by an Ambulance full-timeservice for referral or emergency transport; The KU Health Unit management shouldemphasis quality customer care service and good public relations, team work betweenstaff and students, KU HIV/Aids policy booklets should be placed in the Library orcommon reading areas for ease accessibility, the personnel employed should attendprofessional development education (PDE) or continuous medical education (CME),establish a well managed Comprehensive healthcare service (CCC) clinic, incorporatethe activities of the KU Centre for Policy on Gender Based Violence & SexualHarassment in the ACU and Health Unit Department services..4.3.1.3.0 Promotions/Communication activities about HIV/AidsIn addition to these media enumerated Radio; Television; Print both paper andelectronic (e.g. Brochures, Newsletters, Handouts, Posters, Billboards, Websites, E-mails); Cinema (With HIV/Aids themes on VCD, DVD, Video tapes, liveperformances, environmental awareness).The respondents recommended to help in the implementation of the KU HIV/AidsPolicy: the use PLWHAS or the survivors of their the living testimonies, the Peer to 70
    • peer counselling, the faith-based organization approach for example Church Summon,Sheikh preaching in the Mosque, Road shows wearing t-shirts with HIV/aidsmessages.4.3.1.4.0 HIV/Aids Policy Programs and the reduction in turnover andAbsenteeism among Staff and StudentsBesides Awareness, Prevention and Care and Support programs in KU HIV/Aidspolicy.These are other programs recommended to improve in the implementation of the KUHIV/Aids Policy: Provide ARVs and other drugs to manage Opportunistic Infections(OI), support Home-based care (Institutional care) - Do not abandon staff when theyexhaust their maximum Insurance benefit, It was observed that repealing maximumbenefit or the policy exempting the HIV/Aids conditions from limit rule, Expand Peercounselling by Increasing the number of peer counselors among the students,Organize for talk shows and involve HIV/ Aids Experts from NACC, NASCOP CDC,UNESCO, provide free ARVs at Health Unit, make HIV/aids policy a must-havedocuments issued to students and staff for future reference during orientation/induction, avail and increase funding from KU and other donors for HIV/Aids relatedactivities, Increase the programmes activities on gender issues, drugs use and abusesand relationships between staff, students and the external public (vulnerability matrix) 71
    • CHAPTER FIVE5.0 SUMMARY OF MAJOR FINDINGS, CONCLUSIONS ANDRECOMMENDATIONSThis Chapter presents a summary of the study findings, a conclusion andrecommendations based on the study results.5.1 SUMMARY OF MAJOR FINDINGS1. 89% of the respondents agreed there are incidences of HIV/Aids among staff andstudents at KU. 57% of the above respondents on the scale of 1 to 5 rated the extentthe incidences of HIV/Aids at score 3 which translates to ‘Fairly High’.2. 54 % of the respondents agreed there are changes in the University curriculacompliant with HIV/Aids. 73% of the above respondents on the scale of 1 to 5 ratedthe extent the changes in the Kenyatta University curricula at score 3 which translatesto ‘Moderate’.3. 71 % of the respondents agreed there is change in attitude among the KU staff andstudents towards people affected/infected with HIV/Aids. It means there is reductionin discrimination and stigma. 65% of the above respondents on the scale of 1 to 5rated the extent of the change in attitude at score 3 which translates to ‘ModeratelySignificant.4. 65% of the respondents disagreed that there is increase in costs of healthcareservices. There is need to investigate further this because costs of Hiring of new staff,Purchase of Drugs and procurement logistics, Acquisition of medicals Equipments &other Supplies and Training are expensive and increase over time. The respondentsrated the quality of services provided by KU Health Unit and Aids Control Unit(ACU) 24 out of 48 respondents ‘Good’ and 4 out of 48 respondents ‘Excellent’.5. 71% of the respondents agreed that there is increase in Promotions /Communication activities about HIV/Aids. 38% (13 out of 34) respondents on thescale of 1 to 5 rated the extent of the increment at score 3 which translates to‘moderate’ in all media. The media are Radio, Television, Print both paper &electronic and cinema.6. The respondents objected that after implementation KU HIV/Aids policy there isreduction in turnover and absenteeism among Staff and Students. The percentages are58% for turnover and 60% for absenteeism. The staff turnover because of HIV/Aids 72
    • caused by: illness, Death, Termination-Retirement on Medical grounds andAbsconding of duty. Whereas the causes of absenteeism are: Sickness, Bereavement,Care for the sick and Stigma, Discrimination and Harassment.7. Most respondents agreed that HIV/Aids policy programs: Awareness, Preventionand Care and Support. These programs can reduce turnover and absenteeism amongStaff and students. The respondents rated the extent KU HIV/Aids policy programsthese can reduce turnover and absenteeism caused by HIV/Aid among the Staff andStudents. The findings show that 25 out of 48 the respondents rated the HIV/Aidspolicy programs as ‘Very Great’ at a score of 5.5.2 ANSWERS TO RESEARCH QUESTIONSThe research aimed to investigate effects of Implementation of HIV/Aids Policy andIncidences among Staff and Students in Higher Learning Institutions in Kenya, thecase of Kenyatta University. Based on this statement, data collected and analyzed, thefindings answer the research questions as follows:Does the Kenyatta University have incidences of AIDS among the staff andstudents?The results of the study showed that 89% of the respondents agreed that there areincidences of HIV/Aids among the staff and students at Kenyatta University.However 11% of the respondents disagreed that there are incidences of HIV/Aidsamong the Staff and students. When asked to rate the extent of incidences ofHIV/Aids among the staff and students, 57% of the ‘yes’ respondents on the scale of 1to 5 rated the extent the incidences of HIV/Aids at score 3 which translates to ‘FairlyHigh’ meaning it is high.Have courses units compliant with HIV/Aids been introduced in the KenyattaUniversity curricula after the implementation of the HIV/Aids Policy?The results of the study showed that 54 % of respondents said that course unitscompliant with HIV/Aids were introduced in the Kenyatta University curricula. But46% said that no course units compliant with HIV/Aids have been introduced.Some respondents observed that a compulsory course unit on a HIV/aids and drugswas introduced for all Kenyatta University freshmen. Also that the positive activitiesrelated to HIV/Aids may have resulted in the decline in STIs and pregnancy amongthe staff and students. These activities are believed to reduce the spread of HIV/Aidsin the KU Community. 73
    • How has the implementation of Kenyatta University HIV/Aids Policy led tochange in attitude among the staff and students towards those infected/affectedwith HIV/Aids?The results of the study showed that 71 % of the respondents agreed that there is achange in attitude among the staff and students towards people infected/affected withHIV/Aids. In spite of this 19% of the respondents have not seen or believed there isany change in attitude. Some respondents observed that because we the humanpopulation is all infected or affected in one way or another with HIV/Aids epidemic.This has resulted in people to accept the reality. Also people now discuss aboutHIV/Aids freely, this reduced discrimination and stigmatization among students andstaff. In addition people are aware that they cant be victimized because of their HIVstatuses even if they have signs of HIV Positive. This led to some staffs and studentsto come out openly during annual HIV Testing Day, many visit the Main CampusVCT and join I choose Life Club. Still some want to keep their statuses confidentialdue to stigma.Has the implementation of Kenyatta University HIV/Aids Policy led to theincrease in costs of healthcare services and improvement in the quality of theservices by Kenyatta University Health Unit Department / ACU?The results of the study showed that 35% of the respondents agreed that there isincrement in the costs of healthcare service. Though 65% of the respondentsdisagreed that there increase in costs of healthcare services. There is need toinvestigate further this because costs of Hiring of new staff, Purchase of Drugs andprocurement logistics, Acquisition of medicals Equipments & other Supplies andTraining are expensive and increase over time.The researcher’s opinion is that cost items in healthcare services are hiring of newstaff or Job Descriptions enriched with commensurate pay increase for existing staff,Purchase of Drugs and procurement logistics, Acquisition of medicals Equipments &other Supplies and Training. Some respondents observed that because of the highcosts of healthcare for Public Institutions such as Kenyatta University should besubsidized by Central Government particularly in the purchase of equipments, drugsand training that go with HIV/Aids. For instance the advent of HIV/Aids caused theabolition of KU staff medical scheme because it had become too expensive to the KUManagement. The staff medical scheme budget was transferred to an InsuranceCompany that provides medical cover insurance. The Insurance Company has a 74
    • predetermined benefit ceiling ranging from Shs1Million to Shs 2 Million for theLecturer, Senior Lecturer, Associate Professor and Professor.Some respondents also observed that the number of staff at the Health Unit hasincreased, incase the drugs and or the requisite services are not available people arereferred to major Hospitals and / or other health service providers. Some of hospitalare profit-making organization that will definitely charge higher than KU if it hadprocured from the Main distributors or Agents.The Researcher categorized services provided by KU health Unit and ACU asfollows: Reception Services, Quality of Drugs & Services, Service by the Staff,Comfort of the Recuperation room, Cleanliness of washroom and Helpfulness ofStaff. The ratings is based on the kind of experiences the respondents in past atHealth Unit /ACU. It was observed that reimbursement process is cumbersome; thestaffs are required to pay for medical expenses and thereafter lodge a refund. It wasobserved that the time taken to receive drugs is too long after you report to the clinic.It recommended that Health Unit needs to stock ARVs.It was observed that the professional standards have deteriorated and there is need tobe addressed. The staff training in patients care and service should be done. This shallmake PLWAS to feel part and parcel of the KU Community.Overall, most the respondents rated the quality of services provided by KU HealthUnit Department and Aids Control Unit (ACU), 24 out of 48 respondents rated‘Good’ and 4 out of 48 respondents rated ‘Excellent’ meaning the services haveimproved and are of acceptable quality to the KU Staff and students.Has the implementation of Kenyatta University HIV/Aids Policy led to theincrease in health communication and promotion activities about HIV/Aids?The results of the study showed that 71% of the respondents agreed that there increasein Promotions / Communication activities about HIV/Aids in Radio, Television, Printboth paper and electronic media and Cinema. Nonetheless 29% of the respondentsdisagreed that there is increase in communication activities about HIV/Aids.13 out of 34 respondents on the scale of 1 to 5 rated the extent of the increment ofhealth communication and promotion activities about HIV/Aids and scored 3 whichtranslates to ‘moderate’ in all media, meaning it high. 75
    • How has the implementation of Kenyatta University HIV/Aids policy programshave led to reduction of the turnover and absenteeism caused by HIV/Aidsamong the Kenyatta University staff and students?The results of the study showed that 42% of respondents agreed that implementationof HIV/Aids policy has led to reduction in turnover. But 58% disagreed that theimplementation HIV/Aids policy has caused any reduction in turnover. It means theturnover among staff and students has either increased and / or remained the same.The staff and students turnover caused by HIV/Aids is: illness, Death, Termination-Retirement on Medical grounds and Absconding of duty.The results of the study showed that 40% of respondents agreed that implementationof HIV/Aids policy has led to reduction in absenteeism. But 60% disagreed that theimplementation HIV/Aids policy has caused any reduction in absenteeism. It meansthe absenteeism among staff and students has either increased and / or remained thesame. The staff and students absenteeism caused by HIV/Aids is: Sickness,Bereavement, Care for the sick and Stigma, Discrimination and Harassment.Besides HIV/Aids programs of Awareness, Prevention and Care and Supportprograms in KU HIV/Aids policy. These are other programs recommended toimprove in the implementation of the KU HIV/Aids Policy: Provide ARVs and otherdrugs to manage Opportunistic Infections (OI), support Home-based care(Institutional care) - Do not abandon staff when they exhaust their maximum benefit,It was observed that repealing maximum benefit or the policy exempting theHIV/Aids conditions from limit rule, Expand Peer counselling by Increasing thenumber of peer counselors among the students, Organize for talk shows and involveHIV/ Aids Experts from NACC, NASCOP CDC, UNESCO, provide free ARVs atHealth Unit, make HIV/aids policy a must-have documents issued to students andstaff for future reference during orientation/ induction, avail and increase fundingfrom KU and other donors for HIV/Aids related activities, Increase the programmesactivities on gender issues, drugs use and abuses and relationships between staff,students and the external public (vulnerability matrix)5.3 CONCLUSIONThe researcher concluded this study by posing the question. How does the researchconducted at Kenyatta University, mirror the effects of implementation of HIV/Aidspolicy and the incidences of AIDS among staff and students in other Institutions of 76
    • Higher Learning (Universities) in Kenya? That is the generalized or the extrapolatedcase in Jomo Kenyatta University College of Agriculture and Technology (JKUAT),University of Nairobi (UoN), Egerton University (EU), Moi University (MU),Maseno University, Catholic University of East Africa (CUEA) among otherUniversities.The research results in KU showed that there are high incidences of AIDS; hence thiswill be case in other universities because the catchment for staff and students area issame for all Universities. Also the research results in KU showed that there is a courseunit compliant with HIV/Aids introduced in its curricula; therefore because allUniversities revise their curricula regularly after a period of academic years. WhenKU amended hers, the other Universities may have amended theirs as well. Mark you,the few specialized curricula developers are either involved as internal lecturers orexternal lecturers / examiners in the curricula revision process.The research results in KU showed that there is high level awareness of the existenceof HIV/Aids policy. The HIV/Aids policy is an HRM component under the personnelpolicy and practice area. When KU formulated and implemented its HIV/Aids policyother Universities must have done the same, because they all operate in one geo-political and socio-economic region. Also all other Universities would want tostrategically manage their key resource – people. Also the research results in KUshowed that there is great change in attitude among the staff and students towardspeople infected or affected with HIV/Aids. The change reduced stigma and eliminateddiscrimination on the basis of real or perceived HIV/Aids positive statuses among thestaff and students. The change in attitude is an indicator of the acceptable ofHIV/Aids epidemic like any other terminal diseases such as diabetics and cancer bythe staff and students. This change is likely to be same in other Universities becausethe staff and students come from the same communities.The research results in KU showed that there is increase in the cost of healthcareservices. This is likely to be case in other universities, because the economic factorsof high inflation rate, high interest rates and unfavorable foreign exchanges in Kenyaaffect all individuals’ costs of living that include medical services. The observedimprovement in quality services is a competition issue (customers are the monarch inthe market place) that all service providers have complied with. Also the researchresults in KU showed that the HIV/Aids programs of Awareness, Prevention and Care& Support are rated very great in reducing absenteeism and turnover among the staff 77
    • and students caused by HIV/Aids. This programs when they were implemented in KUhad this effect among the staff and students, they will also bring about the sameresults in other Universities.The research results in KU showed that there is an increase in the healthcommunication and promotion activities about HIV/Aids. The audience targeted bythe media houses or other mass communication practitioners are the same, thereforethe observed increment in KU is replicated in other Universities.Lastly, the overall goal of implementing the KU HIV/Aids policy was to mitigate thenegative socio-economic impact of HIV/Aids epidemic among KU staff and studentsand the neighborhood. The research results in KU showed that the great task has beenpartly tackled and it is the case in other Universities that have implemented similarHIV/Aids policies.5.4 RECOMMENDATIONSFrom the study the researcher recommends that:1. The Curricula developers to introduce more courses units compliant with HIV/Aidsin the university curricula and with option to specialize especially in clinical courses.It is does not give HIV/Aids the deserved significance being a course unit.2. The Human Resource Department to do the detailed analysis of the healthcareservices costs to determine the actual variances.3. The KU Management to expand and sustain the quality the services by Health UnitDepartment and ACU to other KU Campuses. Also develop the KU HIV PostExposure Prophylaxis (PEP) policy. This will strengthen the activities of KUHIV/Aids policy.4. The KU Management to integrate the Health Unit Department services and KUACU with Gender Based Violence & Sexual Harassment centre and Mentoringprogramme activities. It is more synergic to do so.5. The KU Management to enhance the HIV/Aids policy programs to tackle the highHIV/Aids incidences in University. The University must collaborate with specialtyorganizations such as UNAIDS, UNESCO, NASCOP, NACC. The further of greatsuccess in the global arena is partnership with like-minded organizations. 78
    • 5.5 SUGGESTIONS FOR FURTHER STUDYThe researcher suggests that:1. This research should be validated by sampling other KU respondents. The possibletarget populations of respondents are: the students (this KU, HIV/Aids Policyincluded them), staff below the designations of lower level managers and the topmanagers (because it was not possible to collect data from them in this research).2. To investigate how the HIV/Aids compliant course units (Common Units) in theKenyatta University curricula are selected by the Undergraduate students and theacademic backgrounds for the lecturers teaching the same. The research revealed thatthe HIV/Aids compliant Common Units is an elective course and not compulsory forall KU undergraduate students.3. A research to determine the prevalence rates for KU staff and students because theresearch has revealed that the extent of incidences of HIV/Aids is high.4. To investigate the Problems of implementation of HIV/AIDS Policy in the HigherLearning Institutions in Kenya, the case of Kenyatta University. This research hasexposed that there are generic problems in the implementation of policies (plans).5. A research to investigate the socio-economic impact of HIV/Aids among KenyattaUniversity Staff, baseline survey. The researcher in the literature discovered that astudy on socio-economic impact of HIV/Aids among Kenyatta University studentswas completed. This will provide the balance on both the staff and students. 79
    • 6.0 REFERENCES AND APPENDICES INCLUDING QUESTIONNAIRE6.1 REFERENCESCaillods, F. (July 2007). Handling teacher absenteeism. Paper presented atEducational Planning and Management in a World with Aids Training of TrainersWorkshop of United Nations Educational Scientific and Cultural Organization(UNESCO - Nairobi)/ International Institute for Educational Planning (IIEP).Nairobi.Central Bureau of Statistics (CBS), Ministry of Planning and National Development.Kenya Population Census 1999: Analytical Report, VII, Population projections.Nairobi: Ministry of Planning and National Development.Daimler, C. (2003). HIV/Aids workplace project 2001-2003, South Africa pty Ltd.,Fox et al., (2003). The Impact of HIV/AIDS on Labour Productivity in Kenya. CenterforInternational Health and Development, Boston University School of Public Health.Mimeo.Eade, D. (1997).Capacity-building: An approach to people centred development,Oxfam, Oxford,The Global Business Council, (2001). Employers & HIV/Aids – Action forDiscussion Leaders, Graytor Primity Inc., Lyndhurst, New JerseyGoliber, T.J. (2000). Exploring the Implications of the HIV/AIDS Epidemic forEducational Planning in Selected African Countries: The Demographic Question.Futures Group International for the World BankGovernment of Kenya, CBS (2003). Kenya Demographic and Health Survey. NairobiGovernment of Kenya, (2003). Economic Recovery Strategy for Wealth andEmployment Creation, 2003-2007, Nairobi.Government of Kenya, (2003). Kenya Demographic and Health Survey, Ministry ofPlanning and National Development, preliminary report, Nairobi.Hancock J., D. Nalo, M. Aoko, R. Mutemi, and S. Forsythe, (1996). TheMacroeconomic Impacts of AIDS in Kenya. Washington, DC: Family HealthInternational.ILO, (2001), An ILO code of practise on HIV/AIDS in the World of work, ILO,GenevaJugessur, S. (1994).Capacity-building for science and technology in Africa, in Sciencein Africa: The challenges of capacity-building, American Association for theAdvancement of Science, Washington DC. 80
    • Kelly, M. J. (July 2007). Teacher Formation and Development. Paper presented atEducational Planning and Management in a World with Aids Training of TrainersWorkshop of United Nations Educational Scientific and Cultural Organization(UNESCO - Nairobi)/ International Institute for Educational Planning (IIEP).Nairobi.Kenyatta University Aids Control Unit, (2006). HIV/Aids policy. (ed. Owino, P.O.),Nairobi.Kenyatta University, (2007). Kenyatta University Internal telephone directory2006/2007Kenyatta University Aids Control Unit, (2006). The socio economic impact ofHIV/Aids among Kenyatta University Students, baseline survey 2006. (ed. Owino,P.O.), Nairobi.Kenyatta University Office of the Vice-Chancellor, (2008). Kenyatta UniversityNewsletter, Vol.4, Issue 3. (ed. Otolo,M), Nairobi.Makoa, F.K. (January 2001).Aids policy in Lesotho implementation challenges,Journal of Social Development in Africa 16(1),Kimutai, C. (ed.). (2008). Human Resource Developing and retaining middlemanagers. Kenya Institute of Management (KIM) Management Journal. August, 28-30.Mbari, D. (2002), Role of employers and employees in the prevention andmanagement of HIV/Aids, UNDP/FKE, Nairobi.Management Science for Health (MSH), (2003). human resource management rapidassessment tool for HIV/Aids environments, MSH, United States of America.Ministry of Health, NASCOP, (2002). Aids in Kenya, NairobiMinistry of Health, NASCOP, (1998). AIDS in Kenya: Background Projections,Impact Interventions. Ministry of Health and National Council for PopulationDevelopment,The Mombasa Polytechnic, (undated). The Mombasa Polytechnic HIV/AIDS Policy.MombasaNACC, (2002). Financing Framework for the HIV/AIDS Strategic Plan, Nairobi.NACC, (2003). Report on the implementation of the Kenya National HIV/AIDSStrategic Plan. Office of the President.NACC, (2005). Kenya National HIV/AIDS Strategic Plan (KNASP) 2005/06-2009/10, (A Call to Action), Nairobi.http://www.nacc.or.ke/downloads/KNASP_2005-2010_Final_Report.doc 81
    • NACC, (2006). Final report on assessment of the socio-economic impact of HIV andAIDS on key sectors in Kenya, Nairobi.NACC, (2007). Speech by Prof. Miriam K. Were, chairman, national aids controlcouncil during the commemoration of the world aids day at the KICC, December 1,2007, Nairobi. Source: http://www.nacc.or.ke/2007NACC, (2005). Kenya HIV/AIDS Data Booklet.NACC, (2006). Kenya HIV/AIDS Draft Data BookletNACC, (2007).HIV AND AIDS research strategy coordination, resource mobilizationand Dissemination, The Chancery Building, NairobiNjeru, E.H.N., & Kioko,U. (2004), The Impact of HIV/AIDS on Primary Education inKenya. IPAR Discussion Paper Series.Njeru, E.H.N., Mwangi, P. and Nguli, M.N., (2004). Gender aspects in HIV/AIDSInfection and Control in Kenya. IPAR Discussion Paper SeriesNyiira, S.M. (1994).Science in Africa: The challenges of capacity-building, inScience in Africa: The challenges of capacity-building, American Association for theAdvancement of Science, Washington DC.Nkinyangi, S. (June 2005). HIV/AIDS and the Role of Education ServiceCommissions. Fourth UNESCO Nairobi Cluster Consultation. Mombasa.UNESCO-Nairobihttp://hivaidsclearinghouse.unesco.orgOchanda, A. A. (July 2007). Stigmatization and Discrimination Consequences foreducation.Paper presented at Educational Planning and Management in a World withAids Training of Trainers Workshop of United Nations Educational Scientific andCultural Organization (UNESCO - Nairobi)/ International Institute for EducationalPlanning (IIEP).Nairobi.Panchaud, C. (July 2007). Curriculum response to HIV and AIDS. Paper presented atEducational Planning and Management in a World with Aids Training of TrainersWorkshop of United Nations Educational Scientific and Cultural Organization(UNESCO-Geneva)/ International Bureau of Education (IBE). Nairobi.Republic of Kenya, (2001). Poverty Reduction Strategy Paper for the Period 2001-2004. Ministry of Finance and Planning.Republic of Kenya, (April 2005). Public sector workplace policy on HIV/Aids.Directorate of personnel Management. Source: www.dpm.go.ke/indexTawfik L. and Kinoti, S.N. (2003). The Impact of HIV/AIDS on Health Systems andthe Health Workforce in Sub-saharan Africa. USAID, Nairobi 82
    • Teachers Service Commission, (Undated). Sub-sector workplace policy onHIV/AIDS, Nairobi.Tournier, B. (July 2007). Measuring absenteeism. Paper presented at EducationalPlanning and Management in a World with Aids Training of Trainers Workshop ofUnited Nations Educational Scientific and Cultural Organization (UNESCO -Nairobi)/ International Institute for Educational Planning (IIEP).Nairobi.UNAIDS/WHO, (1999). AIDS epidemic update: December 1999UNAIDS, (2004), Global estimates of HIV/Aids as of end 2003UNAIDS (2007), Key facts by region – update 2007 AIDS Epidemic update:UNAIDS, http://www.unaids.org/epidemic_update/report/Epi_report.htmUNAIDS, (1997b). “Learning and Teaching AIDS at School. UNAIDS technicalupdate best-practice collection. Geneva.UNAIDS, (2000). Report on the global HIV/AIDS epidemic. June 2000. GenevaUSAID Research & Reference services project, (2000). Support of HIV/Aids onHuman Resource, Center for Development Information & Evaluation, WashingtonDC,http://www.ilo.org/public/english/protection/tool/aids/why/index.htm2005UNESCO, (2005). International Institute for Educational Planning, HIV/AIDS Impacton Education Clearinghouse, France, 4http://hivaidsclearinghouse.unesco.orgWekesa, S. (2006). The Hiv/Aids pandemic in the workplace: challenges for humanresource managers. A case of Ultimate Security Management. Unpublished AcademicResearch project proposal. Kenyatta University. Nairobi.http://en.wikipedia.org/wiki/Kenyatta_University as at January 10, 2008.http://en.wikipedia.org/wiki/Likert_scale. 83
    • 6.2 APPENDICES INCLUDING QUESTIONNAIREAPPENDIX A: THE LETTER OF INTRODUCTION School of Business, Kenyatta University P.O. Box 43844 - 00100 Tel. 810901/811622 Ext.57519 Nairobi Cellphone: 0726 934 441 Email: gabriellubale@yahoo.com 11 September 2008THEKENYATTA UNIVERSITYP.O. BOX 43844 - 00100,NAIROBIDear Sir or Madam,Re: MBA RESEARCH PROPOSAL QUESTIONNNAIREI am a bona fide Postgraduate Student at School of Business pursuing a Master ofBusiness Management (MBA). I have completed the Course Work units and I’m nowdoing the Research Project Course Units. I’m also a Civil Servant – an ImmigrationOfficer stationed at the Coast Region.I am conducting the research entitled the EFFECTS OF IMPLEMENTATION OFHIV/AIDS POLICY AND AIDS INCIDENCES AMONG STAFF ANDSTUDENTS IN HIGHER LEARNING INSTITUTIONS IN KENYA (A CASEOF KENYATTA UNIVERSITY) as a requirement for award of the Degree. Theinformation collected will be treated confidentially and shall be used for academicpurposes only. I also shall highly appreciate the assistance accorded to me.Please RETURN the filled in Questionnaire to your Front Office Desk/ReceptionArea from where I shall collect it. Kindly note, the PERIOD FOR DATA collectionis from 11th September to 30th September 2008.Thank you,Yours Faithfully,LUBALE GABRIEL WABUTIStudent Reg. No. D53/OL/14120/05 84
    • APPENDIX B: THE TARGET POPULATIONTable 6.1: The Kenyatta University Managers Job Title No. of Officers Chancellor 1 Vice Chancellor (VC) 1 Deputy VCs (DVCs) 3 Registrars 3 Deputy Registrars 11 Senior Assist. Registrars 17 Chief Security officer 1 Deputy Chief Security officer 1 Chief Internal Auditor 1 Human Resource Manager 1 Legal Officer 1 Transport Manager 1 Estate Manager 1 Finance Officer 1 Deans 8 Deputy Dean of Students 3 Chairmen of Departments 39 Directors 11 Deputy Directors 3 Coordinators 10 Librarian 1 Head of the Health Unit 1 Medical Officers 5 Pharmacist 1 Senior Games Tutors 2 Cybercafé Manager 1 Principal Officer 1 SACCO Manager 1 Hostel Manager 1Total Managers 132Source: Author, 2008 and Kenyatta University Internal Telephone Directory2006/2007 85
    • APPENDIX C: QUESTIONNAIREThis study entails to investigate the EFFECTS OF IMPLEMENTATION OFHIV/AIDS POLICY ON THE REDUCTION OF AIDS INCIDENCES AMONGSTAFF AND STUDENTS IN HIGHER LEARNING INSTITUTIONS IN KENYA(A CASE OF KENYATTA UNIVERSITY). Please answer all the questions asaccurate as possible and to your utmost belief to be true.1.0.0 KU Managers, the Respondents Personal details1. Your Gender. (Please tick one).A. MALEB. FEMALE2. Your Age bracket in years. (Please tick one).A. UNDER 36 YEARSB. 36-45 YEARSC. 46-55 YEARSD. 56-65 YEARSE. ABOVE 65 YEARS3. Your highest level of education. (Please tick one).A. PRIMARY SCHOOL CERTIFICATEB. SECONDARY SCHOOL CERTIFICATEC. DIPLOMA CERTIFICATE (inclusive of ordinary Diploma & equivalents)D. UNDERGRADUATE (Bachelors, CPA (K), Specialized Nurses - Clinical Officers & HND)E. POSTGRADUATE (INCL.of CERTIFICATES, DIPLOMA, MASTERS & PHD)4. Your Designation as per the Letter (s) of Appointment or Confirmation or latestPromotion inclusive of temporary Acting (Ag.) Authority. (e.g. Co-ordinator,Chairman, Dean, Director, Assistant Registrar etc).5. What is your length of Service at KU in years? (Please tick one).A. LESS THAN 1 YEARB. MORE THAN 1 YEAR TO 3 YEARSC. MORE THAN 3 YEARS TO 5 YEARSD. MORE THAN 5 YEARS TO 7 YEARSD. MORE THAN 7 YEARS1.1.0 The Incidences of HIV/Aids and the HIV/Aids Policy6. Does the University have incidences of HIV/Aids among the Staff and Students?(Please tick one).A. YES B. NO7. If Yes, to what extend? (Please tick one).1.Very High 2. High 3. Fairly High 4. Low 5. Very Low8. Does the University have any Policy on HIV/Aids? (Please tick one).A. YES B. NO 86
    • 9. If yes, please rate the impact of the implementation of HIV/Aids Policy on reducingthe incidences of AIDS among the Staff and Students? (Please tick one).1.Very Great 2. Great 3. Moderate 4. Low 5. Very Low1.2.0 Introduction of Curricula compliant with HIV/Aids10. Has the implementation of HIV/Aids policy led to any changes in the UniversityCurricula? (Please tick one).A. YES B. NO11. If yes, to what extent has the University Curricula changed? Please tick one).1.Very Great 2. Great 3. Moderate 4. Low 5. Very Low12. Please explain your rating.13. Which other areas would you like to be added to the University Curricula to helpin the implementation of the HIV/Aids Policy?1.3.0 Attitude change towards people affected/infected with HIV/Aids -Discrimination and Stigmatization14. Has the implementation of HIV/Aids policy led to change in attitude among thestaff and students towards people affected/infected with HIV/Aids? (Please tick one).A. YES B. NO15. If yes, how would you rate the magnitude of the change? (Please tick one).1.Very Highly 2. Highly 3. Moderately 4. Lowly 5. Very LowlySignificant Significant Significant Significant Significant16. Please explain your rating.17. Give suggestions of strategies to enhance the change in attitude among the staffand students towards people affected/infected with HIV/Aids?1.4.0 Costs and Service Quality of Healthcare Services18. Has the implementation of HIV/Aids policy led to increase in costs of healthcareservices? (Please tick one).A. YES B. NO19. If yes, please rate the increase of the expenditure/Investment items listed here.(Ranging from 5=Very High to 1=Very Low) (Please tick one in each row).Items 5. 4. 3. 2. 1.Hiring of new staff (e.g. Counselors, nurses, Clinical Officers,Social Workers) or enrichment of the Job Descriptions forexisting staffPurchase of Drugs and procurement logistics (e.g. ARVs,Septrin, Painkillers)Acquisition of medicals Equipments & other Supplies (e.g. CD4count, test kits, reagents, uniform, Fridges)Training (e.g. ART management, VCT, CMEs, PDE, InjectionSafety, Waste Management & Disposal) 87
    • 20. Please explain your rating.1.4.1 The Service Quality of K U Health Unit Department and ACU21. Please rate the services provided by Kenyatta University Health Unit and AidsControl Unit (ACU) after the implementation of HIV/Aids policy. (Please tick one ineach row).Specific Aspects 1.Very 2. 3. 4. 5. Poor Poor Fair Good ExcellentReception ServicesQuality of Drugs & ServicesService by the StaffComfort of the RecuperationroomCleanliness of washroomHelpfulness of Staff22. Please explain your rating.23. Give suggestions on how these services can be improved to support theimplementation of HIV/Aids policy.1.5.0 Promotions / Communication activities about HIV/Aids24. Has the implementation of HIV/Aids policy led to increase inPromotions/Communication activities about HIV/Aids? (Please tick one). A. YES B. NO25. If yes, to what extent have the Promotions/Communication activities aboutHIV/Aids? (Please tick one in each row).Media 1.Very 2. 3. 4. 5. Great Great Moderate Low Very LowRadioTelevisionPrint both paper and electronic (e.g.Brochures, Newsletters, Handouts, Posters,Billboards, Websites, E-mails)Cinema (With HIV/Aids themes on VCD,DVD, Video tapes, live performances,environmental awareness)26. Which other Promotions/Communication activities would you recommend to beadded to help in the implementation of the HIV/Aids Policy? (Please tick one).1.6.0 HIV/Aids Policy Programs and the reduction in turnover and Absenteeismamong Staff and Students27. Has the implementation of HIV/Aids policy led to reduction in Staff and Studentsturnover? (Please tick one). A. YES B. NO 88
    • 28. Please rate the following causes of Staff and Student turnover after theimplementation of HIV/Aids policy in KU. (Ranging from 5=Very High to 1=VeryLow). (Please tick one in each row).Causes of Staff and Students turnover 5. 4. 3. 2. 1.IllnessDeathTermination (Retirement on Medical grounds)Absconding of duty29. Has the implementation of HIV/Aids policy led to reduction in absenteeismamong the Staff and students? (Please tick one) A. YES B. NO30. Please rate the following causes of absenteeism after the implementation ofHIV/Aids policy in KU. (Please tick one in each row).Causes of absenteeism 1.Very 2. 3.Moderate 4.Low 5. Very High High LowSicknessBereavementCare for the sickStigma, Discrimination andHarassment31. Please rate the following programs in the KU HIV/Aids policy; to what extent doyou think they can reduce the Staff and students turnover and absenteeism caused byHIV/Aids. (Please tick one in each row).Program 1.Very Great 2. Great 3.Moderate 4.Low 5. Very LowAwarenessPreventionCare and Support32. Give suggestions of other programs that can help to improve the implementationof HIV/Aids policy in KU.The End, Thank you. 89
    • APPENDIX D: BUDGET1) Proposal Writing a) Typing, printing, photocopy and binding Shs 4,500 b) Sources of literature Review Shs 2,0002) Material & Research Instruments c) Acquiring, organizing & Implementing (Typing, printing and photocopy) Shs. 4,000 d) Pre-testing of Tool Shs. 1,0003) Data Collection (Research – Honoraria) Shs. 3,0004) Data Management and Analysis e) Data Entry Shs. 5,000 f) Data Analysis Shs. 5,0005) Thesis Preparation g) Typing, printing and photocopy Shs. 7,000 h) Seminar material & binding Shs. 10,0006) Transport Cost Shs. 5,000Total Shs. 46,500 90
    • APPENDIX E: WORK PLANActivities in Year 2007-2008 /Month Sept Oct Nov Dec Jan Feb Mar Apr May Jun July Aug Sept Oct NovProject Proposal Development xxx *** *** ---- ---- *** *** *** ---- ---- ---- ---- ----Defense of Project Proposal xxx ---- ---- ---- ---- ---- ---- ---- ---- *** ---- ---- ---- ----Correction and Approval xxx ---- ---- ---- ---- ---- ---- ---- ---- *** *** ---- ---- ----Change of Supervisor from Dr. Khayota to *** ---- ---- ---- ---- ---- ---- ---- ---- ---- ---- ----Ms. KavindaApplication for permission to carry out a xxx *** ---- ---- ---- ---- ---- ---- *** ---- ---- ----ResearchPre-Testing of Questionnaire xxx *** ---- ---- ---- ---- ---- ---- *** *** ---- ----Data Collection xxx ---- ---- ---- ---- ---- ---- ---- ---- *** *** *** ----Data Analysis xxx ---- ---- ---- ---- ---- ---- ---- ---- *** *** *** ----Research Project Writing and Binding xxx xxx xxx xxx *** *** *** *** *** *** *** *** *** *** ***Research Project hand in xxx ---- ---- ---- ---- ---- ---- ---- ---- ---- ---- ***LegendXXX Represents planned activities under Dr. Khayota’s supervision.---- No activity or No planned Activity (During the post 2007 General Election skirmishes, waiting for Defense date to be set)*** Represents planned activities under Ms. Kavinda’s supervision 91