The government of the Republic of Botswana was one of the first countries in Africa to launch a nationwide response to the HIV epidemic. With an estimated prevalence rate of 18.5% among population aged 18 months and above, Botswana continues its efforts to overcome HIV, as well as tuberculosis and sexually transmitted infections. I-TECH joined the efforts of the Government of Botswana to combat HIV in 2003, and continues to work closely with the Ministry of Health (MOH), the U.S. Centers for Disease Control and Prevention (CDC) Global AIDS Program, and local and international partners to respond to the current health needs of the people of Botswana.
Drawing on the expertise from I-TECH’s global network, including the University of Washington and the University of California, San Francisco, I-TECH Botswana offers technical assistance to achieve the Government of Botswana’s health priorities, specifically UNAIDS 90-90-90 goals, with a focus on the first 90 which aims to ensure that 90% of HIV-positive people know their status. I-TECH Botswana does this by utilizing the government's strengths in health systems strengthening, continuous quality improvement, monitoring, evaluation and operations research, health informatics support and direct service delivery to support government partners in their response to HIV/AIDS. Sustainable transition to local ownership is a key component of all work conducted by I-TECH Botswana.
I-TECH Botswana has had a vast portfolio of activities since 2004, with past activities and achievements including:
- a robust secondment program where I-TECH supported staff were placed within the Botswana Ministry of Health and the University of Botswana to build technical capacity in institutional planning, management, leadership, and other areas;
- support to the nationwide safe male circumcision program through direct service provision and national coordination;
- support for sustainable prevention, care, and treatment for Batswana living with tuberculosis and TB/HIV co-infection;
- support to the national prevention of mother-to-child transmission activities and roll-out of monitoring systems;
- monitoring and evaluation trainings and development of staff within the cadre; and
- operations research activities of MOH programs and activities.
National-level Quality Improvement
- To strengthen health systems to improve quality of HIV service delivery in Botswana through the secondment of a quality improvement technical advisor and support for the development of continuous quality improvement activities at the Ministry of Health.
- To provide technical assistance at the national-level to improve HIV care and treatment, TB/HIV, Option B+, and HIV testing and counselling programs through continues quality improvement activities to help reach epidemic control of HIV/AIDS in Botswana.
Facility-based continuous quality improvement
- Routine HIV Testing & Counselling (RHT): Provide technical assistance and direct service delivery at public health facilities to support increasing HIV-testing rates.
- Laboratory Proficiency Testing: Provide technical assistance to support improved laboratory services by provision of external quality assurance in laboratories.
- TB Monitoring & Evaluation: Ensure the availability of strategic information to support continuous quality improvement initiatives and provide technical assistance at the facility-level to improve the quality of tuberculosis data.
- Real-time Reporting system: Support a real-time SMS-based reporting system which utilizes a toll-free number for monitoring and reporting of key program indicators related to HIV testing, HIV care and treatment, TB, and PMTCT.
- TB Health Information System: Develop and maintain the national TB patient level health information management system based on the OpenMRS platform to increase efficiency in identification, care, and treatment of TB patients.
- Data Warehouse: Ensure the availability of strategic information to monitor progress towards reaching epidemic control, with particular focus on linkages to care and the care continuum.
- To strengthen strategic information systems by supporting development of robust national health information systems.
- To ensure accountability, appropriate policy formulation, program improvements, and efficient resource allocation for HIV and other health programs at the district and national levels through operation research activities as requested on Ministry of Health.
- Male Circumcision Basic Program Evaluation (MCBPE): To conduct operations research to determine influence of safe male circumcision services on sexual behavior and through a longitudinal cohort study.
I-TECH Botswana designs, plans, implements, and monitors programs to ensure efficient transition to local ownership and support strong and sustainable national health systems. Together, I-TECH Botswana, the Government of Botswana, and other partners continue to build an effective and sustainable health care system; an enduring step toward meeting Botswana’s health challenges and supporting the future of its people.
1. Government of Botswana, Botswana AIDS Impact Survey IV (BAIS IV), 2013 Stats Brief, S. Botswana, Editor. 2013.