PharmAccess Foundation, Center for Poverty-related Communicable Disease, Academic Medical Center, Amsterdam, The Netherlands.
J Int AIDS Soc. 2009 Nov 11;12:32. doi: 10.1186/1758-2652-12-32.
With an estimated adult HIV prevalence of 15%, Namibia is in need of innovative health financing strategies that can alleviate the burden on the public sector. Affordable and private health insurances were recently developed in Namibia, and they include coverage for HIV/AIDS. This article reports on the efficacy of HIV workplace surveys as a tool to increase uptake of these insurances by employees in the Namibian formal business sector. In addition, the burden of HIV among this population was examined by sector.
Cross-sectional anonymous HIV prevalence surveys were conducted in 24 private companies in Namibia between November 2006 and December 2007. Non-invasive oral fluid-based HIV antibody rapid tests were used. Anonymous test results were provided to the companies in a confidential report and through presentations to their management, during which the advantages of affordable private health insurance and the available insurance products were discussed. Impact assessment was conducted in October 2008, when new health insurance uptake by these companies was evaluated.
Of 8500 targeted employees, 6521 were screened for HIV; mean participation rate was 78.6%. Overall 15.0% (95% CI 14.2-15.9%) of employees tested HIV positive (range 3.0-23.9% across companies). The mining sector had the highest percentage of HIV-positive employees (21.0%); the information technology (IT) sector had the lowest percentage (4.0%). Out of 6205 previously uninsured employees, 61% had enrolled in private health insurance by October 2008. The majority of these new insurances (78%) covered HIV/AIDS only.
The proportion of HIV-positive formal sector employees in Namibia is in line with national prevalence estimates and varies widely by employment sector. Following the surveys, there was a considerable increase in private health insurance uptake. This suggests that anonymous HIV workplace surveys can serve as a tool to motivate private companies to provide health insurance to their workforce. Health insurance taken up by those who are able to pay the fees will alleviate the burden on the public sector.
纳米比亚的成人艾滋病毒感染率估计为 15%，需要创新的卫生融资策略来减轻公共部门的负担。最近在纳米比亚开发了负担得起的私人医疗保险，其中包括艾滋病毒/艾滋病的保险。本文报告了艾滋病毒工作场所调查作为一种工具的功效，以提高纳米比亚正规商业部门员工对这些保险的接受率。此外，还按部门检查了这一人群的艾滋病毒负担。
2006 年 11 月至 2007 年 12 月期间，在纳米比亚的 24 家私营公司进行了横断面匿名艾滋病毒流行率调查。使用了非侵入性的口腔液基艾滋病毒抗体快速检测。将匿名的检测结果以机密报告的形式提供给公司，并通过向管理层介绍这些结果，讨论了负担得起的私人医疗保险的优势和可用的保险产品。在 2008 年 10 月进行了影响评估，评估了这些公司新的健康保险参保情况。
在 8500 名目标员工中，有 6521 人接受了艾滋病毒筛查；平均参与率为 78.6%。总体上，15.0%（95%置信区间为 14.2-15.9%）的员工艾滋病毒检测呈阳性（各公司的范围为 3.0-23.9%）。采矿业的艾滋病毒阳性员工比例最高（21.0%）；信息技术（IT）部门的比例最低（4.0%）。在 6205 名以前没有保险的员工中，截至 2008 年 10 月，有 61%的人参加了私人健康保险。这些新保险的大多数（78%）只涵盖艾滋病毒/艾滋病。
纳米比亚正规部门艾滋病毒阳性员工的比例与全国流行率估计相符，并且按就业部门差异很大。调查后，私人医疗保险的参保人数大幅增加。这表明匿名艾滋病毒工作场所调查可以作为一种工具，激励私营公司为其员工提供健康保险。有能力支付费用的人所购买的健康保险将减轻公共部门的负担。
