Presentation of ROI in Health Research in Bangladesh. 26 Oct 2009, SwedWatch Conference at Stockholm, Sweden.

1.
Health
Solutions
“Effect
of
On-­‐Site
Health
Services
on
Employee
Attitudes
in
a
Bangladeshi
Apparel
Factory”
Joe
Falcone,
Health
Solutions
Email:
joe_y_falcone@yahoo.com
October
26,
2009
Powerpoint
presented
at
CSR
Conference
by
SwedWatch
Stockholm,
Sweden

2. 1.
Why
do
a
study
on“Return
on
Investment”
?
•
Businesses
need
a
“Business
Case”
–
Workplace
Health
programs
seen
as
costly
–
Companies
focus
on
business
and
profit
•
Literature
review
reveals
deficit
of
Health
ROI
studies
in
the
developing
world
context
2.
What
was
our
hypothesis
?
If
you
spend
money
on
providing
an
onsite
health
clinic,
will
you
get
a
“return”
from
savings
due
to
reduced
absenteeism,
reduced
turnover
and
improved
employee
attitudes
?

3. 3.
Where
did
the
study
take
place
?
•
In
apparel
factory
in
Chittagong,
Bangladesh
•
About
450
employees
•
86
%
women
•
Workers
are
Young
(mean
=
22
years)
&
Single
(67%)
•
Key
HR
business
challenge:
high
absenteeism
/
turnover
4.
Design
of
the
health
program
Two
main
components:
1.
On-­‐site
health
services
with
-­‐
A
clinic
open
1
day/week
for
3
hours
-­‐
A
doctor,
nurse
&
nurse
assistant
2.
Group
of
peer
health
educators
trained
to
-­‐
Drive
demand
for
onsite
clinic
-­‐
Carry
simple
health
messages
5.
How
was
the
study
designed
?
• “Audit”
or
analysis
of
attendance
records
• Cross-­‐sectional
survey
conducted
at
the
factory
site
•
Four
focus
group
discussions
-­‐-­‐
eight
employees
each

4. 6.
Who
“invested”
in
this
health
project
?
•
Factory
owner
•
Workers
•
USAID/Essential
Services
Delivery
•
Health
Solutions
7.
What
were
the
overall
findings
18
months
after
service
began
?
– Workers
said
the
availability
of
on-­‐site
health
services
made
them:
i. Less
likely
to
be
absent
from
work
ii. More
likely
to
stay
in
their
current
job
iii. Have
more
positive
attitudes
toward
management
– Analysis
of
records
showed
reduced
absenteeism
(18%)
and
reduced
turnover
(46%)
–
a
3:1
ROI
!
– Better
attitudes
toward
factory
management

5. 8.
Survey
Findings
•
Survey
respondents
divided
into
two
groups:
–
Those
who
used
clinic
(n=126
or
62
%)
–
Non-­‐users
(n=72)
but
were
aware
of
clinic
(5
workers
did
not
know
about
clinic)
•
Both
groups
–
Knew
the
services
offered
by
clinic
–
Felt
quality
was
good
and
met
their
needs
–
Said
availability
of
onsite
service
factor
in
employment
decisions
(absenteeism
and
turnover)
9.
Awareness
of
Clinic
Services
– Referral
to
other
health
care
centers
99%
– General
health
treatments
(asthma,
diarrhea,
etc.)
93%
– Stomach
ailment
related
treatments
91%
– Family
planning
methods
90%
– Family
planning
counseling
81%
– Pregnancy/antenatal
care
71%
– HIV/AIDS
counseling
66%
– Other
health
treatments
related
to
reproductive
health
56%
– STI
treatment
and
counseling
41%

6. 10.
Workers’
Perceived
Effects
on
Absenteeism
?
– Yes
91%
– No
2%
– Unsure
7%
11.
Workers’
Perceptions
on
Effects
on
Turnover
?
– Yes
87%
– No
4%
– Unsure
9%
12.
Worker
Attitudes
Toward
Management
– Better
86%
– No
different
14%
13.
What
were
the
surprises
?
•
Few
women
in
the
survey
reported
seeking
RH
/
FP
services,
but
30%
of
clinic
service
were
related
to
reproductive
health
•
Line
managers
used
the
clinic
and
said
it
increased
their
desire
to
stay
at
the
factory

7. 14.
Conclusions
•
There
is
a
“Business
Case”
for
investing
in
health
in
apparel
factories
•
Workers
clearly
put
a
high
value
on
the
on-­‐site
health
services
–
even
a
minimal
intervention
•
There’s
an
important
link
between
quality
and
scope
of
health
program
and
size
of
ROI
•
It
is
important
to
study
ROI
in
a
range
of
workplace
contexts
for
a
broader
understanding
of
the
business
case
for
health
investments
If
you
have
any
comments
or
questions
on
this
ROI
in
Health
Study
in
Bangladesh
-­‐
“Effect
of
On-­‐Site
Health
Services
on
Employee
Attitudes
in
a
Bangladeshi
Apparel
Factory,”
please
contact:
Joe
Falcone,
Health
Solutions
joe_y_falcone@yahoo.com
Thank
you
!
Health
Solutions