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World Bank Working Paper
Figure 5.9. Average number of hours worked per week, by task
Rural health centers
25.3
6.5
Urban health centers
5.2
33
6
30.6
Hospitals
6.9
29.6
All
0
5
10
Patient care
20
Administrative
25 Hours
30
Social mobilization
6
2.4 1.5 1.6
2.1 1.8 1.2
6.5
15
2.9
3.2 2.1
35
40 Training
2.9
45
50
Others
Source: Picazo 2008.
losing a significant number of staff and staff dependents to AIDS-related morbidity and mortality. Illness of health workers or their dependents negatively affects performance and is often reflected in greater absenteeism, late starts, or lowered responsiveness and productivity. The PETS by Picazo (2008) found that 17 percent of health workers reported tardiness caused by tending to sick relatives likely afflicted with HIV/AIDS. There is evidence that HIV/AIDS is a cause of high levels of absenteeism in some facilities. One study evaluating the cost of HIV/AIDS on health service delivery found that in the year prior to death or retirement, workers with AIDS took an average of 42 days of leave and recorded an average of 20 days of sick leave. In the year prior to data collection, by comparison, a healthy worker took an average of 14 days of leave and took no sick leave, a difference of 28 days, or about 10.8 percent of the 260 working days per year, before holiday allowance. In the penultimate year of employment, individuals took an average of 36 days of leave. This compares with 14 days taken by the comparators in the year prior to data collection and 34 days in the year preceding that. This small difference in leave taken in the second to last year of employment (two days) suggests that HIV/AIDS-related morbidity does not lead to a major increase in absenteeism until the last 365 days of service. The observations are also consistent with the researchers’ concerns that some sick leave goes unrecorded and that the volume of AIDS-related illnesses measured may be understated (Feeley and others 2004). Some suggest that one reason for the high rate of HIV/AIDS, particularly in the public sector, is that no adequate HIV/AIDS workplace policy exists. Compared with the commitments of NGOs and larger private sector organizations, the public sector, and in particular the MoH, lags in implementing a comprehensive HIV/AIDS workplace policy and program. Staff sensitization, awareness creation, possibilities for post-exposure prophylaxis, and a comprehensive ART program specifically for employees are poorly developed and structured. Containing HIV/AIDS in the health workforce thus requires greater effort.