This study investigated employment-related factors influencing treatment adherence among employees in small, medium and micro enterprises (SMMEs) in the Sol Plaatje Municipality, Northern Cape. It analysed employer and employee perspectives on employment and health system conditions impacting treatment adherence and assessed SMMEs’ compliance with labour legislation, particularly the Basic Conditions of Employment Act. It also evaluated employees’ knowledge of their medical conditions and workplace support for those on chronic medication.

Findings revealed that SMMEs generally offer employment conditions favourable for promoting treatment adherence among employees on chronic medication. Accessibility to treatment at health facilities and employees’ understanding of their medical conditions were noted as strengths. Formal workplace policies addressing basic conditions of employment, labour relations and HIV and tuberculosis wellness were however found to be inadequate. More than half of the respondents reported difficulties in adhering to medication schedules at work, pointing to challenges in taking medication at the correct time, skipping doses and experiencing medication-related work interference.