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An assessment of the Needs of Teachers and Education Workers

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An assessment of the Needs of Teachers and Education Workers

    FINAL REPORT

    Ghana National Association of Teachers (GNAT)

    &

    Teachers And Educational Workers’ Union (TEWU) Of

    Ghana Trades Union Congress

An Assessment of the Awareness of HIV/AIDS in the Education

    Sector and the Needs of Teachers and Educational Workers

    Living with HIV/AIDS in Ghana

    Survey Results

    Compiled by

    Anthony Yaw Baah

    Luise Jarl

    Kwabena Nyarko Otoo

    August 2007

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    FINAL REPORT

CONTRIBUTORS

    This study was conducted by the Policy & Research Department of the Ghana Trades Union Congress on behalf of the Ghana National Association of Teachers (GNAT) and Teachers and Educational Workers‟ Union (TEWU) of the Ghana Trades Union Congress.

    The report was compiled by Dr. Anthony Yaw Baah (Head of Department) with Luise Jarl (Researcher and Intern from the University of Aarhus in Denmark) and Kwabena Nyarko Otoo (Researcher). Mrs. Harriet Botchwey (Research Assistant) helped in the data entry. Mr. Franklin Owusu Ansah (Researcher, Health Services Workers‟ Union) assisted in the interviews.

The members of the Project Management Team were:

    ; Ms. Helena Awurusa (GNAT) - Project Coordinator

    ; Mr. M.S. Bogobiri (TEWU) Member

    ; Mr. Johnson Boh (GNAT) Member

    ; Dr. Anthony Yaw Baah (Research Consultant)

The Project Management Team was under the supervision of:

    ; Ms. Irene Duncan-Adanusah (General Secretary, Ghana National Association of

    Teachers) and

    ; Mr. Daniel Ayim Antwi (General Secretary of Teachers and Educational Workers‟

    Union)

The Study was sponsored by Education International.

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    Contents

Part 1.................................................................................................................... 7

    Introduction and background ....................................................................................... 7

    HIV/AIDS .............................................................................................................................................................. 7

    Consequences of HIV/AIDS ................................................................................................................................ 7

    The Impact of HIV/AIDS in Africa (UNAIDS)...................................................................................................... 8 HIV/AIDS in Ghana .............................................................................................................................................. 9

    Purpose of the Study ........................................................................................................................................... 9

    Methodology ........................................................................................................................................................10

    Brief Profile of respondents ................................................................................................................................10

    Research Issues .................................................................................................................................................11

    Structure of the paper .........................................................................................................................................11

    Part 2.................................................................................................................. 12

    HIV awareness, Access to VCT Services, and Prevention Methods ........................................ 12

    Sources of information on HIV/AIDS .................................................................................................................12 Acquaintance with persons living with HIV/AIDS..............................................................................................13 Education and counselling .................................................................................................................................15

    Testing/Knowledge of HIV Status ......................................................................................................................19 Prevention ...........................................................................................................................................................20

    Summary of Findings ..........................................................................................................................................21

    Part 3.................................................................................................................. 21

    Experiences and Needs of Teachers and Educational Workers Living with HIV/AIDS .................. 22

    (a) Experiences ...................................................................................................................................................22

    How they got to know their HIV status ..........................................................................................................22

    Access to counselling before and after tests ................................................................................................22

    Discrimination .................................................................................................................................................23

    (b) Needs .............................................................................................................................................................23

    i. Financial Support for Food and Drugs .......................................................................................................23

    ii. Love and Care ............................................................................................................................................24

    iii. Education for their children .......................................................................................................................24 (c) Advice for fellow teachers and educational workers ...................................................................................25

    Take care of yourself ......................................................................................................................................25

    Get tested........................................................................................................................................................25

    Reduce Stigmatisation and Discrimination ...................................................................................................25

    Provide rehabilitation centres ........................................................................................................................26

    Create network of teachers living with HIV ...................................................................................................26 Part 4.................................................................................................................. 26

    Recommendations ................................................................................................. 26

    The Role of the Trade Unions (GNAT and TEWU) ..........................................................................................27 The Role of the Employer (Ghana Education Service) ....................................................................................28 The Role of Government ....................................................................................................................................30

    The Role of the District Assemblies ...................................................................................................................32 Collaboration with other state institutions and NGOs .......................................................................................32 The Role of the National Health Insurance Council (NHIC) ............................................................................33 The Role of the Social Security and National Insurance Trust (SSNIT) and the Pensions Reform

    Commission .........................................................................................................................................................33

    Other Suggestions ..............................................................................................................................................35

    Conclusion ...........................................................................................................................................................35

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    FINAL REPORT

    SUMMARY

Introduction and background

    This study was undertaken by the Ghana National Association of Teachers (GNAT) and the Teachers and educational Workers Union (TEWU) of the Ghana Trades Union Congress to assess the degree of awareness of HIV/AIDS among their members (i.e., teachers and educational workers) and the needs of those already infected by the virus. The aim was to gather information to serve as basis for the provision or negotiation of social protection for their members living with HIV.

    AIDS is a deadly disease. At the household level, the disease can threaten the income security of the family. At the macro level the disease retards social and economic development by destroying human capital. HIV has had a particularly devastating impact in Sub-Saharan Africa. Over 60% all HIV cases in the world are in the region.

    Research has shown that women are more vulnerable to HIV infection in the sub-region. For every ten men infected with the virus in Sub-Saharan Africa there are 14 women infected. The reasons for women‟s vulnerability are both physical and cultural. Previous

    research has also shown that in Ghana married women appear to be almost three times as likely to be infected as women who have never been married. The general prevalence rate in Ghana currently averages less than 3%, with some variations within the country. The Northern part is least affected with 1.2 % prevalence among pregnant women, compared to over 4% in other regions.

    HIV/AIDS is an important workplace issue. This is so because the disease affects labour and productivity. Employers and workers organisations therefore have a vital role to play in the struggle to limit or stop the spread of the disease. The focus of this study seems especially right because teachers and education workers besides constituting the largest group within the public sector workers they also play a unique and extremely important role in the development of human capital in the country. This is why Workers in the Education Sector deserve more attention.

    The study combined a questionnaire survey (which sought to assess HIV/AIDS awareness among teachers and educational workers and a qualitative method which involved interviews with ten teachers and educational workers living with HIV. The aim of the interviews was to assess their needs and their views on how they can be supported. Additional primary and secondary information was gathered from other stakeholders including National Health Insurance Council, Social Security and National Insurance Trust, Ghana Education Service, Pensions Commission, UNAIDS and WHO.

Findings

    The findings of the study are presented under two main themes: (i). HIV/AIDS awareness among teachers and educational workers and (ii) the needs of teachers and educational workers living with the virus.

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    HIV/AIDS awareness among teachers and educational workers

    Almost all the respondents (99.5%) said they have ever heard about the HIV/AIDS. They obtain their information about the disease mainly from four main sources - television, radio, newspapers and information from another person. All these four sources of information

    could thus be relied upon for the creation of HIV/AIDS awareness among teachers and educational workers.

    Direct contact with people living with HIV can also be an important source of information for people on the disease. Over half the respondents said they know someone who has died of AIDS or someone living with the disease. The majority of those whom they knew to have died of the disease were women. Just about 6% know a teacher or education worker living with HIV/AIDS and less than 1% (5 out of 681 respondents) said they know a teacher or education worker at their workplace who is living with the disease.

    Education and counselling are essential tools for prevention and for the campaign against stigmatisation. As many as 78% said they have ever received some form of education on HIV/AIDS and more than half of the respondents indicated that they have attended HIV awareness programme organised by the Ghana Education Service (GES). Teachers are more likely to receive education than the non-teaching staff.

    Voluntary counselling and testing (VCT) is still not popular. Only about 9% of all the respondents have ever attended VCT. The majority of the respondents (85%) think it is important for everyone to know his or her HIV status but just about 21% of them said they have done the test and only 27% reported that they actually know their status. The reasons cited for not testing include lack of or poor access to testing facilities and the ,fear of stigmatisation which can result from knowing that one has the virus. Some of the respondents said they are convinced that they do not have the virus and so there was no need for the test.

The survey also revealed that “Abstinence from casual sex” is by far the most popular

    method/form of prevention. 60% of the respondents favour that method and recommended it to others to follow. Approximately 27% said they “use condom all the time” and 16% said

    they use condom when they engage in casual sex. 22% said they abstain from sex completely.

Experiences and Needs of Teachers and Education workers living with HIV/AIDS

    The interviews with the ten teachers and educational workers living with HIV revealed some important experiences. 7 out of 10 got to know about their status incidentally. They reported that they were asked to do the test either because they were ill or their spouse or child tested positive. 7 out of the 10 said they did not receive any form of counselling before they were tested and they paid for the test by themselves. 9 of the 10 are however currently receiving regular counselling. Discrimination is found to be a real problem. Five out of the ten had experienced discrimination and stigmatisation because of their HIV status. But out of the remaining five three said they have not experienced discrimination because they have not revealed their status.

    People living with HIV/AIDS have certain needs that have to be addressed to enable them to cope with their situation. Three main needs emerged throughout the ten interviews. First, they need financial support. Their salary is often not sufficient to buy them the food and

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    drugs they need for survival. Second, they need care and acceptance from family friends and colleagues. Finally, a major concern of the ten respondents was the future of their kids. Most of them expressed the need for support for their children particularly in their education.

Recommendations

    Respondents in the questionnaire survey were asked to make suggestions on how teachers and education workers living with HIV should be supported. The three main forms of support mentioned were financial support and professional counselling for those living with the virus and continuous education for the general public.

    Other suggestions made by the respondents show that there are still serious misconceptions about HIV/AIDS in Ghana. For example, some suggested that people living with HIV/AIDS should be kept in special villages, in special schools or special homes. People still think they can be infected by coming into contact with people living with HIV. Only education and information can change these misconceptions.

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Part 1

    ________________________________________________________________________ Introduction and background

    1.1 This study was undertaken by the Ghana National Association of Teachers (GNAT) and the Teachers and Educational Workers Union (TEWU) of the Ghana Trades Union Congress to assess the degree of awareness of their members (i.e., teachers and educational workers) of HIV/AIDS and the needs of those already infected by the virus. The ultimate objective of the study was to use the information gathered from the study as basis to provide or seek social protection and/or support for their members infected or affected by HIV/AIDS.

    HIV/AIDS

    1.2 HIV/AIDS is a deadly disease which, according to UNAIDS and WHO

    estimates, has killed more than 25 million people all over the world since it was discovered in 1981. Most of those infected with the virus are in the working-age population including teachers and educational workers who are the focus of this study. The disease is different from other diseases in the sense that an infected person can live for many years without knowing her or his status. In this period during which the infected person does not yet feel the disease, he/she is able to transmit the disease to other persons, particularly through sexual intercourse. This makes the disease difficult to control. Once a person is infected, his/her CD4 count will eventually drop and his/her immune system is weakened. Other opportunistic diseases such as tuberculosis and severe cough can then easily attack the victim. In many cases the result is premature death because there is no cure for the disease. Antiretroviral (ARVs) drugs are currently the most effective drugs being prescribed for persons living with HIV/AIDS. But the drug cannot cure the disease. It can only slow it down so that the infected person can live longer. The drug is, however, very expensive making it difficult for most poor people to have access without financial assistance.

Consequences of HIV/AIDS

    1.3 The consequences of the HIV/AIDS are severe at every level of society. At the household level, income of the family can be threatened. If the breadwinner of the family is infected and is no longer able to work it has serious social, psychological and economic effects on all members of the family. Loosing income affects the family‟s ability to provide themselves with proper food, clothes and housing not to mention treatment and drugs for the infected person. In some cases, the children of the infected persons have to dropout from formal education to work and earn income to support the household. This can limit their future possibilities of getting a good job and a decent living. As noted above, the HIV/AIDS pandemic mainly affects people in the working-age population. According to the International Labour Organisation (ILO), 65% of all people infected with the HIV virus are aged between 15 and 49 years. This has serious implications for the economy as a whole. HIV/AIDS retards the economy by destroying human capital

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The Impact of HIV/AIDS in Africa (UNAIDS)

    1.4 The HIV/AIDS pandemic has had a particularly devastating impact in Sub-Saharan Africa. Almost 25 million people in the sub-region are living with HIV/AIDS. This means 63% of people living with HIV/AIDS are in the sub-region. This number corresponds to an estimated adult prevalence rate of 5.9 % meaning that almost six people out of every hundred people in the region are infected. In 2006 alone, an estimated 2.1 million people died from the disease in the sub-region. This was the equivalent of almost three quarters of all HIV/AIDS related deaths globally in 2006. Some effort has been made to provide treatment, but it has not been sufficient. It is estimated that in 2006 alone, 2.8 million new infections were recorded among children and adults in the Sub-Saharan African region which is more than all the other regions of the world put together.

     Source: UNAIDS annual report, 2006

    1.5 Significant variances are found within the region. Several countries in Southern Africa have prevalence rates of between 20 and 25 %. In Swaziland, for example, 33.4% of the population is infected. In East Africa, the epidemic has been more moderate with a prevalence rate of between 4 and 6 percent. West Africa has much lower prevalence rates (around 2%). Côte d‟Ivoire has the highest prevalence rate of more than 4 percent.

    1.6 The prevalence rates also differ by gender. Women have been

    disproportionately infected by the virus. Available data show that women are twice as susceptible to HIV infection compared to their male counterparts during heterosexual sex. Culturally, women are also more vulnerable. They are often left with fewer choices in society, including which relations they want to be in. For instance, if the husband is unfaithful it can be difficult for the woman to force the man use condom. In fact, a significant number of women are infected with the disease by their spouses. In Sub-Saharan Africa, there were fourteen infected women for every ten infected men in 2006. This means 59 % of all those who were infected by the virus were female.

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    HIV/AIDS in Ghana

    1.7 The HIV/AIDS prevalence rate in Ghana is among the lowest in the Sub-Saharan African region and it has been falling in recent years. In 2003, for example, the 1. The rate dropped to 2.7% in 2005. The number of people prevalence rate was 3.6%

    living with HIV/AIDS in Ghana is estimated at 400,000.

    1.8 The prevalence rate differs across the country. The rate is lowest in the northern part of the country (1.2%). The Eastern region has the highest rate (4.7 %). There are also some differences within age groups. The prevalence rate is high among women between the ages of 35 and 39 years and men between the ages of 40 and 44 years. As in other African countries, in general, women in Ghana are more likely to be infected with the disease compared to men. Marriage is a big risk factor for women in Ghana. Married women appear to be almost three times more likely to be infected than women who had never been married. For men mobility seems to be a significant risk factor. Thus, men who travel more are more likely to get infected.

    Purpose of the Study

    1.9 HIV/AIDS is an important workplace issue. The disease affects labour and productivity and employers and workers organisations have a vital role to play in the struggle to limit or stop the spread of the disease.

1.10 The following are some of the reasons why employers and workers

    organisations must be concerned about HIV/AIDS:

    ; Employers loose valuable skills and experience when their employees die of

    HIV/AIDS;

    ; Even one infection in an organisation increases the risk of additional infections;

    ; A high HIV prevalence in an organisation means low productivity and high cost of

    health care for the workers;

    ; The organisation‟s short and long term investments can be undermined because of

    the high cost of health care for employees;

    ; At the national level, HIV/AIDS adversely affects the supply of labour and may

    reduce investor confidence in the economy;

    ; HIV/AIDS affects fundamental rights of workers, particularly with respect to

    discrimination and stigmatisation aimed at workers and people living with HIV/AIDS.

    1.11 Teachers and education workers constitute the largest group within the public sector workers. Currently, they number about 210,000. The study focuses on teachers and educational workers not only because they are the largest group within the public sector but more importantly because teachers and educational workers play a unique and extremely important role in the development of human capital in the country. They have a special role in educating children and the youth who are very vulnerable. Thus, HIV/AIDS awareness among teachers and care for teachers living with the disease are important in the fight against the disease and the attendant stigmatisation and social exclusion. This is particularly important since teachers are often taken as role models in their communities.

    1.12 The reasons outlined above motivated GNAT and TEWU to commission this study to assess the level of awareness among their members and the needs of those living

     1 The estimates are the prevalence rates among pregnant women.

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    with the disease. The ultimate aim is to use the information gathered in this and subsequent studies as basis for engaging their employer to provide the necessary support for teachers and educational workers living with the disease and continuous HIV education for the entire workforce in the education sector.

Methodology

    1.13 The study combined both quantitative and qualitative method of data gathering. Part of the information was gathered from a questionnaire survey. Questionnaires were designed and administered among teachers and educational workers in selected districts across the country. In all 1300 questionnaires were sent out. 710 questionnaires were returned but 681 (52%) of these questionnaires were analysed (29 of the questionnaires were returned late). Table 1.1 below shows the distribution of the 681 questionnaires by district.

Table 1: Distribution of respondents by district

    Region Districts Number of

    Respondents

    Ashanti Amansie West 79 2 Obuasi 36

    Central Odoben Brakwa 80

    Assin North 70

    Upper West Nadowli 93

    Greater Accra Tema 65

    Upper East Bawku East 76

    Brong-Ahafo Techiman 95

    Northern Tamale 13

    Western Jomoro 8

    Western Other Districts in Western 66

    Region (including 30 from

    Sefwi Wiawso District)

    Total 681

    Note: In all 710 questionnaires were returned. Out of this number 681 were analysed. 29 of the questionnaires were returned late and could not be included in the analysis.

Brief Profile of respondents

1.14 Teachers constituted 86% of the respondents who returned their

    questionnaires. The remaining 14% of the respondents were education workers. The age of the respondents ranges from 18 to 63 years and the average was 38 years. Men and women constituted 61 and 39 percent of respondents respectively. 67% of the respondents were married; 30% were single and 3% were widowed.

     2 22 questionnaires were returned from Obuasi after the analysis of the data. The total number of questionnaires returned from Obuasi was 58 but the responses in the 22 questionnaires were not captured in the report. They have been incorporated in the SPSS data.

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