EFFECTS OF IMPLEMENTATION OF HIV/AIDS POLICY AND  AIDS INCIDENCES AMONG STAFF AND STUDENTS IN     HIGHER LEARNING INSTITUT...
DECLARATION              ii
ABSTRACTKenyatta University (KU), a Higher Learning Institution established the KU AidsControl Unit (KU ACU) in March 2001...
Drugs and procurement logistics, Acquisition of medicals Equipments & otherSupplies and Training. 71% of the respondents a...
ACKNOWLEDGEMENTI would like to thank my Research Supervisor Ms. Lucy Kavinda the firm, insightfuland professional guidance...
DEFINITION OF TERMS, ACRONYMS AND ABBREVIATIONSACU- AIDS Control UnitAIDS – Acquired Immuno Deficiency SyndromeANOVA – Ana...
ANOVA (Analysis of Variance) - is a collection of statistical models and theirassociated procedures, in which the observed...
TABLE OF CONTENTS ..................................................................................... PageTITLE . .........
3.1            STUDY DESIGN......................................................................................... 413.2...
Table 4.11: What causes turnover among the Staff and Student after theimplementation of HIV/Aids policy in KU? ..............
CHAPTER ONE1.1       INTRODUCTIONAlthough HIV/Aids affects people of all age structures in the human population, it haspro...
1.2.2 HIV / Aids the Basics1.2.2.1 HIV/Aids Position, Diagnosis, Spread and Impact in the World andKenyaHIV/AIDS in Kenya ...
was higher than that found in most population-based studies in Africa. It implies thatyoung women are particularly vulnera...
accounting for 10% of the HIV infection, while prevalence among the poorestsegment of the population is less than 4% (NACC...
child transmission during pregnancy, birth or through breastfeeding (1.8%),transfusion with infected blood (0.2%), negligi...
need for more awareness creation especially among the youth and the most vulnerablegroups on prevention, care and support ...
Table 1.3: The Number of PLWHAs on ARV in 2006 by ProvinceProvince                                     Total all QuartersC...
data shows an estimated adult HIV prevalence of 5.1% in 2006, compared to 5.9%registered in 2005. The current estimate of ...
renamed Kenyatta University. KU is the second largest after University of Nairobi inKenya. In 1997 it had some 8,000 stude...
government. Eade, 1997, added, however, that for Oxfam capacity building is anapproach to development rather than a set of...
due to Staff turnover (through high mortality rate among the teaching staff), absenceof teachers due to personal or family...
6. To determine if the implementation of HIV/Aids policy programs have led toreduction of the turnover and absenteeism cau...
1.7 CONCEPTUAL FRAMEWORK OF THE STUDYIn the Conceptual Framework figure1:1 below, the KU HIV/Aids Policy Booklet isthe hig...
Also, to address the limitations inherent in the cited study as attested by Researcher.Wekesa, 2006 in Research report wro...
and increase in health communication and promotions activities. The Researcher shalllimit to collect data at KU Main Campu...
CHAPTER TWO2.1 INTRODUCTIONThis chapter is structured as follows: Past Studies, HIV/Aids Policy; Introduction ofCurricula ...
2.2.1.1 Policy statementThe KU HIV/AIDS Policy does not have a policy statement. The Researcher quotesthe TSC which is in ...
to accommodate the staff shortages and the long-term implications of losing juniorlecturing staff, from among whom the fut...
2.2.1.4 Rights and obligations at the UniversityKU has crucial leadership role to play in ensuring that the societies in w...
The public and private sector policies shall be formulated and implemented within theframework of the Constitution of Keny...
2.2.1.5.4 Factories and Other Places of Work Act Cap.514The Government is in the process of repealing the Factories and Ot...
counselling; To create an environment where PLWHAs are safe to reveal their statusand seek appropriate support and counsel...
All staff, at all levels of employment shall have access to counselling, care andsupport provided by the University free o...
redress. Also any unfair discrimination or prejudice will be dealt with by Universityas a breach of employment contract an...
2.2.1.6.14 University HIV/Aids Policy with respect to staffing on StaffassociationsAll staff associations shall be encoura...
containing the spread of the epidemic. KU will work collaboratively and to share itsexperience of best practices and, wher...
policy, the Ministry’s workplace policy, relevant codes of conduct, and working inpartnership with others (especially PLWH...
Recommendations to respond to the Teachers’ Professional Concerns about teachingHIV/Aids are: Ensure adequate teacher prep...
Counselling and Care; HIV and AIDS create the need for counselling for distressededucators and learners, and for counselli...
issues are often missing. When teaching and learning material are poor, not availableand the inappropriate of Teaching met...
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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

  1. 1. 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
  2. 2. DECLARATION ii
  3. 3. 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
  4. 4. 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
  5. 5. 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
  6. 6. 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
  7. 7. 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
  8. 8. 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
  9. 9. 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
  10. 10. 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
  11. 11. 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
  12. 12. 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
  13. 13. 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
  14. 14. 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
  15. 15. 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
  16. 16. 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
  17. 17. 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
  18. 18. 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
  19. 19. 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
  20. 20. 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
  21. 21. 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
  22. 22. 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
  23. 23. 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
  24. 24. 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
  25. 25. 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
  26. 26. 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
  27. 27. 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
  28. 28. 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
  29. 29. 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
  30. 30. 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
  31. 31. 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
  32. 32. 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
  33. 33. 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
  34. 34. 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
  35. 35. 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
  36. 36. 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
  37. 37. 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
  38. 38. 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
  39. 39. 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
  40. 40. 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

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