June 2003

Doing the Right Thing for Employees
In Thailand, study finds worker health is greatest incentive to adopt HIV/AIDS workplace policies

Employers and company managers have an important role to play in creating work environments free from AIDS-related stigma and discrimination. Implementing HIV/AIDS policies in the workplace can curb unfair employment practices, such as compulsory HIV testing, and encourage employers to accommodate the needs of people living with HIV/AIDS.

In Thailand, a recently completed Horizons study examined the role of financial and other forms of incentives in encouraging companies to adopt workplace policies that reduce HIV/AIDS-related stigma and discrimination. The research was conducted in partnership with American International Assurance (AIA), Thailand’s largest insurance provider, the Thailand Business Coalition on AIDS (TBCA), and AusAID.

Researchers investigated company managers’ responses to different recruitment incentives, including financial enticements and public recognition. For example, AIA offered its member companies reductions of 5 to 10 percent off their group life insurance premiums for employees if they agreed to implement the HIV/AIDS workplace policies identified by the initiative known as the AIDS-response Standard organization (ASO) (see sidebar). As the initiative evolved, researchers introduced the additional incentive of a certificate endorsed by the Ministry of Public Health and awarded at a high-profile public ceremony.

The research team assessed the HIV/AIDS programs and policies of each company that agreed to participate, which determined an evaluation score. TBCA then offered practical assistance to help each company improve its score, which most of the companies accepted. This included leaflets on HIV/AIDS prevention and where to seek help, videos and a mobile exhibition to show employees, condoms for distribution to employees, peer education training, advice, referrals to support groups, and assistance with writing company HIV/AIDS policies.

Obstacles to Participation

Between August 2000 and May 2001, 857 companies in the Bangkok and Chiang Mai metropolitan areas were invited to join ASO. After publicizing the initiative at a press conference, TBCA staff provided company managers with information and nurtured relationships with them, including one-on-one meetings to explain and promote the advantages of ASO.

But six months after the start of the project, it become clear that recruiting companies was going to be more difficult than expected. Participation was then extended to companies without AIA life insurance policies that could thus not benefit from the insurance premium reductions but would receive the certificate honoring their actions. A total of 125 companies, including factories, hotels, and commercial and professional firms, signed up; of these, 42 companies (34 percent) held AIA group life insurance policies and were entitled to the insurance reduction.

To find out why more companies had not joined during the recruitment process, researchers sent out surveys to managers from all the companies that had either accepted or declined the invitation to join and received responses from 245 firms.

Why Participate?

An examination of the incentives offered to employers revealed some surprising results. Researchers found that neither the financial incentive nor the certificate had motivated most managers to sign on to the initiative. Only 11 percent of managers said that they had joined ASO for its financial benefits.

Thai workers get hands-on experience during a condom use demonstration. Photo credit: TBCA

In fact, the actual amount of potential savings proved insufficient to act as an incentive, considering the time and effort required to implement the policies. With life insurance coverage costing employers an average premium of 250 baht (US$5.85) per employee, the maximum reduction available was 25 baht ($.60) per employee. AIA member companies joining ASO ranged from five to 1,600 employees, with possible annual premium reductions ranging from under $2 to $937.

“To be honest, it is only a small amount,” said the manager of a large company that did not join ASO. “It would be time consuming and complicated.”

Nor did the certificate provide sufficient motivation for even a single manager to participate in ASO.

“Our hotel has so many [certificates] that I do not know where to put them,” said the manager of a large company that joined ASO. “I am not interested in the certificate unless it came from someone really important.”

According to some respondents, one way to improve the appeal of the certificate could be to secure the sponsorship of the Thai royal family or of a prestigious patron, such as the United Nations or the International Labor Organization, to distinguish the certificate from many similar awards.

Doing the Right Thing

For most of the companies surveyed, the most important incentive was an altruistic one: the opportunity to act in the best interests of their employees. Nearly 60 percent of the managers whose companies joined ASO explained that they participated because they felt a sense of responsibility to both their workers and to the wider community in which their companies operate.

“The incentive for private enterprises to be involved in the fight against AIDS is not simply about money or certificates, but about us giving our workers greater knowledge and providing them with additional training,” said one manager of a large company that joined ASO.

Another motivation to join the initiative was that it would allow companies to find out how their HIV/AIDS policies and programs compare to those of other companies, and, more fundamentally, better understand the disease and how their employees’ behavior puts them at risk.

“Managers are very concerned about whether they are doing the right thing for their workers in relation to HIV/AIDS and have many questions,” said Dr. Anthony Pramualratana, executive director of TBCA. “These managers are keen to listen to us, and once we provide them with information about the disease, they develop policies and programs to help their workers.”

TBCA has received funding from the Global Fund to Fight AIDS, Tuberculosis, and Malaria to expand ASO into workplaces in 25 provinces, in cooperation with local nongovernmental organizations. A final report on the study will be available later in 2003.

This article was written by Katie Schenk in collaboration with members of the research team, including Anthony Pramualratana, Surachai Panakitsuwan, Suparat Suksakulwat, and Sikarat Moonmeung of the Thailand Business Coalition on AIDS; Philip Guest of the Population Council/Thailand; Simon Baker of Horizons/PATH; and Patchara Rumakom and Srisuman Sartsara of Horizons/Population Council.

© 2003 The Population Council, Inc.

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19 October 2007