Detailed Mechanism Funding and Narrative

Details for Mechanism ID: 8363
Country/Region: Botswana
Year: 2007
Main Partner: Johns Hopkins University
Main Partner Program: JHPIEGO
Organizational Type: University
Funding Agency: HHS/CDC
Total Funding: $250,000

Funding for Care: Adult Care and Support (HBHC): $250,000

07-C0612: MOH-DHAPC: Situational Analysis of the Care and Support for PLHWA.

This activity has USG Team Botswana Internal Reference Number C0612. This activity links to the following: C0613 & C0614 & C0911 & P0513.

This new activity is a collaborative effort between the MOH, the Care and Treatment, and the M&E/Surveillance Sections in BOTUSA.

Botswana has about 272,000 PLWHA who are eligible for one or more components of services in a continuum of care. The country has made significant political and resource commitments to reach these people with basic care and treatment services. Notably, approximately 68,440 PLWHA are currently receiving ARV therapy in the national Masa program; over 80% pregnant women receive services from the prevention of mother to child transmission (PMTCT) program, and 80% of those who test positive receive complete courses of ARV prophylaxis (AZT and/or Neverapine); close to 35% of households with orphans receive psychosocial and food basket support services.

About 12,000 PLWHA have been registered in the CHBC program run by the MOH to receive palliative care in the home environment. This program is one of the oldest HIV/AIDS care programs and has been in existence since 1995. Furthermore, close to 200 NGOs/CBOs/FBOs are currently registered to provide a wide range of psychosocial and material services throughout the country.

FY07 funds will be used to conduct a situational analysis of care and support for PLHWA (targeted evaluation). No systematic data exists on the coverage, utilization, or effectiveness of this program. The client base and packages of care services provided by community-based civil society (CBOs/FBOs/NGOs) are largely unknown.

Objectives • To assess the availability of basic clinical, psychosocial, and economic services for PLWHA both from the providers' and consumers' perspective. • To assess the perceived socio-cultural factors that hinder optimal utilization among PLWHA of available psychosocial and clinical services. • To assess the knowledge, attitudes, and behavioral factors influencing sexual and reproductive health decisions among PLWHA. ? To identify existing service delivery gaps, including problems of linkages and referral mechanisms at clinical/institutional and community levels. ? To assess the capacity building needs of PLWHA groups (networks) and CBOs/FBOs/ NGOs for active participation in the care and support services.

Qualitative and quantitative survey techniques will be employed to collect the necessary data. A sample of PLWHA will be interviewed in one-to-one, in-depth interviews and focus group discussions (FGD) by fellow peer group members who will be trained in interview techniques. Service providers including networks of CBOs, will be interviewed to obtain an overview of the objectives, activities and performance of their care and support programs. The MOH CHBC program will be evaluated for its ability to reach needy populations with adequate quality care. Family members taking care of the PLWHA and community leaders will be interviewed to provide this information. Appropriate statistical procedures will be applied to determine the sampling frame and size for the districts to be included, the number of PLWHA, health workers and caretakers to be interviewed. The number of FGDs and in-depth interviews to be conducted will be determined based on the issues and themes to be covered. A comprehensive study protocol will be developed to undergo local and HHS/CDC IRB review and clearance.