Background:

Over 33 per cent of Nigerians living with HIV do not know their status. Further, it is estimated that the National Health Insurance Scheme covers only 3 per cent of Nigerians. Most of these are workers in the formal economy. Through the VCT@WORK Initiative, the ILO contributes to the national testing targets, which aim to test 80 million Nigerians by 2020.

Salient features of the Strategy:

A multi-faceted approach was adopted to implement the VCT@WORK Initiative. A communication strategy promoted the initiative to Nigerians and communication materials were developed and disseminated for demand creation. Monitoring in partnership with the National Agency for the Control of AIDS (NACA) was used to track the number of people tested and linked to care, to ensure data could feed in the national data collection system.

The National HIV and AIDS Workplace Policy was revised based on ILO recommendations concerning HIV/AIDS in the World of Work to guide and promote access to testing, care, treatment and support for workers, and to build an enabling non-discriminatory environment to encourage workers to be tested. A broad partnership was established with key stakeholders and an integrated approach ensured that HIV testing was undertaken within the context of a broader health approach. The ILO also integrated social health protection into all State level VCT programmes and educated workers on the benefits and opportunities health insurance with a focus on informal economy workers.

This leadership role of the Government and social partners was demonstrated through the Director General of the Nigeria Employers’ Association, Mr Olusegun Oshinowo, who came out to undertake the HIV test before the general public on World AIDS Day 2018.

Key Results:

• Over 218,000 workers mobilized to access HIV voluntary counselling and testing through the ILO VCT@WORK. All workers who were found HIV positive (438 women, 251 men) were referred to access anti retroviral treatment.
• Over 200,000 workers were reached with information on HIV prevention, treatment and care, including information of health insurance opportunities.
• The ILO supported the development of a draft National HIV Workplace Programme Assessment and Gap Analysis Report.
• ILO and UNFPA jointly reached 8,400 young people with HIV testing within the context of the National HIV Prevention Campaign in Lagos and Abuja.

Lessons Learned:

• Placing the VCT@WORK under the national plans enhanced the buy-in and support from a wide range of actors.
• Adopting a multi disease testing approach which included screening such as blood sugar test, blood pressure checks and BMI checks increased the uptake of HIV testing among workers.

• 

• Strong management support that ensures confidentiality and assures a stigma-free work environment is essential.
• Demonstrating clear and strong linkages between workers’ health and productivity have proven to be effective in attracting the management and workers’ attention.
• Strategic partnerships forged with many providers at the country level helped leverage funding for testing.
• Mobile service provision has shown some success in this case as well as the establishment of linkage between workplace, communities and health facilities.
• Leading by action works as demonstrated by the Director General of the Nigeria Employers who took an HIV test himself publicly and spoke about its benefits.

Next Steps:

• Undertake multi state VCT outreach programmes to increase access to treatment for people living with HIV targeting high burden states and promote enrolment in health Insurance.
• Scale up intervention to reach young people through the National Prevention Campaign.