Botswana’s government was one of the first in Africa to launch a nationwide response to the HIV epidemic, and has continued efforts to overcome a high prevalence of HIV, tuberculosis (TB), and sexually transmitted infections. I-TECH joined these efforts in 2004, and continues to work closely with the Ministry of Health (MOH), the Centers for Disease Control and Prevention Global AIDS Program, the University of Botswana, and local and international partners to respond to the health needs of Botswana’s people.
Drawing on expertise from the University of Washington and the University of California, San Francisco, I-TECH Botswana offers technical assistance to achieve government health priorities, strengthen the health care workforce, and build the national health system infrastructure. I-TECH’s wide portfolio of activities includes a robust secondment program, through which I-TECH–supported staff placed within the MOH and at the University of Botswana are building technical capacity in institutional planning, management, leadership, and other areas. In keeping with the Government of Botswana’s emphasis on combined HIV prevention activities, I-TECH also supports the country’s nationwide safe male circumcision program through direct service provision and national coordination. In addition, I-TECH Botswana provides continued support for sustainable prevention, care, and treatment for Batswana living with tuberculosis and TB/HIV co-infection. Through a dedicated focus on monitoring and evaluation and operations research, I-TECH Botswana also works to ensure accountability, appropriate policy formulation, program improvement, and efficient resource allocation for HIV and other health programs at the district and national levels.
In all efforts, I-TECH works to ensure the successful and sustainable transition of programs to local ownership. Together, I-TECH, the Government of Botswana, and other partners are building an effective and sustainable national health care system—an enduring step toward meeting Botswana’s health challenges and supporting the future of its people.
I-TECH Botswana designs, plans, implements, and monitors programs to ensure
efficient transition to local ownership and support strong and sustainable national health systems.
Staff collaborate closely with local partners to:
- Scale up safe male circumcision (SMC) services through service delivery, capacity building, and other health systems strengthening activities, such as monitoring and evaluation (M&E) and research. SMC initiatives have the potential to reduce HIV incidence among men by up to 60%. [i-iii]
- Build capacity and provide services throughout Botswana’s national health systems by placing seconded staff in key roles within the Ministry of Health and the University of Botswana, including experts in laboratory, tuberculosis and HIV, sexually transmitted infection, prevention of mother-to-child transmission of HIV (PMTCT), strategic information, and SMC. Together, seconded staff and their colleagues are building the technical capacity and systems needed to plan, implement, manage, and sustain successful national health programs. Additionally, seconded staff play a key role in providing service delivery to help meet national program targets that are of significance in the public health arena.
- Reduce the national burden of TB (improve treatment and cure rates and strengthen referral systems) by working with the Botswana National Tuberculosis Programme to provide training and mentoring and M&E activities.
- Support quality, sustainable, laboratory systems, a key element of high quality care, by supporting public laboratory professionals to achieve international accreditation, improve testing, and use new technologies.
- Reduce the prevalence of sexually transmitted infections, complications, and transmission to partners through improved programmatic planning, health care worker training, use of strategic information, and patient education.
- Ensure that providers across the public and private sectors deliver high-quality care for adults and children living with HIV by strengthening the pre-service and in-service education available to health care workers.
- Provide technical assistance to improve national and regional evidence-based planning and policy making.
- Strengthen the capacity of policy makers and health care workers to gather and use strategic health information at the national, district, and health facility levels through training and mentoring in M&E to ensure accountability, appropriate policy formulation, program improvement, and efficient resource allocation for HIV and other health programs.
- Conduct operations research and program assessments to inform planning and policy, build on success, and encourage evidence-based approaches to health priorities. Among other efforts, this work includes
-an assessment and recommendations to inform MOH planning and policy on the prevention, diagnosis, and management of non-tuberculosis myobacteria, and
-a public health evaluation to assess facility-based barriers to implementation, community perceptions, and the impact of SMC on risk compensation.
- Increase the successful prevention of mother-to-child transmission of HIV by improving the collection and use of timely PMTCT data.
i. Auvert B, Taljaard D, Lagaarde E, Sobngwi-Tambekou J, Sitta R, Puren A. Randomized, controlled intervention of male circumcision for reduction of HIV infection risk: the ANRS 1265 trial. PLoS Med. 2005 Nov; 2(11):e298.
ii. Gray RH, Kigozi G, Serwadda D, Makumbi F, Watya S, Nalugoda F, Kiwanuka N, Moulton LH, Chaudhary MA, Chen MZ, Sewankambo NK, Wabwire-Mangen F, Bacon MC, Williams CF, Opendi P, Reynolds SJ, Laeyendecker O, Quinn TC, Wawer MJ: Male circumcision for HIV prevention in men in Rakai, Uganda: a randomized, controlled trial. Lancet. 2007 Feb 24; 369(9562):657-66.
iii. Bailey RC, Moses S, Parker CB, Agot K, Maclean I, Krieger JN, Williams CF, Campbell RT, Ndinya-Achola JO. Male circumcision for HIV prevention in young men in Kisumu, Kenya: a randomized, controlled trial. Lancet. 2007 Feb 24; 369(9562):643-56.