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BMC Public Health. 2012; 12: 44.
Published online Jan 18, 2012. doi:  10.1186/1471-2458-12-44
PMCID: PMC3269375
Diabetes, HIV and other health determinants associated with absenteeism among formal sector workers in Namibia
Leonor Guariguata,corresponding author1 Ingrid de Beer,2 Rina Hough,2 Els Bindels,2 Delia Weimers-Maasdorp,2 Frank G Feeley, III,3 and Tobias F Rinke de Wit1,4
1PharmAccess Foundation, Trinity Building C, Pietersbergweg 17, 1105, BM Amsterdam, Zuidoost, the Netherlands
2PharmAccess Foundation, P.O. Box 9895, Windhoek, Namibia
3Boston University School of Public Health, 715 Albany Street, Talbot Building, Boston, MA 02118, USA
4Amsterdam Institute for Global Health and Development (AIGHD), Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
corresponding authorCorresponding author.
Leonor Guariguata: leonor.guariguata/at/gmail.com; Ingrid de Beer: ingriddb/at/namibia.pharmaccess.org; Rina Hough: r.hough/at/namibia.pharmaccess.org; Els Bindels: e.bindels/at/namibia.pharmaccess.org; Delia Weimers-Maasdorp: d.maasdorp/at/namibia.pharmaccess.org; Frank G Feeley, III: ffeeley/at/bu.edu; Tobias F Rinke de Wit: t.rinkedewit/at/pharmaccess.org
Received October 31, 2011; Accepted January 18, 2012.
Abstract
Background
As countries in sub-Saharan Africa develop their economies, it is important to understand the health of employees and its impact on productivity and absenteeism. While previous studies have assessed the impact of single conditions on absenteeism, the current study evaluates multiple health factors associated with absenteeism in a large worker population across several sectors in Namibia.
Methods
From March 2009 to June 2010, PharmAccess Namibia conducted a series of cross-sectional surveys of 7,666 employees in 7 sectors of industry in Namibia. These included a self-reported health questionnaire and biomedical screenings for certain infectious diseases and non-communicable disease (NCD) risk factors. Data were collected on demographics, absenteeism over a 90-day period, smoking behavior, alcohol use, hemoglobin, blood pressure, blood glucose, cholesterol, waist circumference, body mass index (BMI), HIV status, and presence of hepatitis B antigens and syphilis antibodies. The associations of these factors to absenteeism were ascertained using negative binomial regression.
Results
Controlling for demographic and job-related factors, high blood glucose and diabetes had the largest effect on absenteeism (IRR: 3.67, 95%CI: 2.06-6.55). This was followed by anemia (IRR: 1.59, 95%CI: 1.17-2.18) and being HIV positive (IRR: 1.47; 95%CI: 1.12-1.95). In addition, working in the fishing or services sectors was associated with an increased incidence of sick days (IRR: 1.53, 95%CI: 1.23-1.90; and IRR: 1.70, 95%CI: 1.32-2.20 respectively). The highest prevalence of diabetes was in the services sector (3.6%, 95%CI:-2.5-4.7). The highest prevalence of HIV was found in the fishing sector (14.3%, 95%CI: 10.1-18.5).
Conclusion
Both NCD risk factors and infectious diseases are associated with increased rates of short-term absenteeism of formal sector employees in Namibia. Programs to manage these conditions could help employers avoid costs associated with absenteeism. These programs could include basic health care insurance including regular wellness screenings.
Keywords: Absenteeism, Namibia, Work force, Sub-Saharan Africa, Non-communicable disease, HIV
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