Detailed Mechanism Funding and Narrative

Years of mechanism: 2008 2009

Details for Mechanism ID: 8747
Country/Region: Botswana
Year: 2008
Main Partner: University Research Corporation, LLC
Main Partner Program: NA
Organizational Type: Private Contractor
Funding Agency: HHS/CDC
Total Funding: $900,000

Funding for Testing: HIV Testing and Counseling (HVCT): $600,000

08.C0906 Child and Adolescent Counseling and Testing

In Botswana, counseling and testing for children and adolescents remains an area of critical gaps in legal,

policy and program issues. The legal age of consent for testing in Botswana remains at 21, although major

efforts are underway to reduce the age to 16. Policy and guidelines for C&T of children are unclear, if not

unavailable. There are no C&T protocols to guide service delivery to children and adolescents. In addition,

counselors lack the skills and the confidence to provide services to this group. A number of children are

infected, but their status is not known, yet they would benefit from pediatric treatment and other services to

improve their quality of life. Some children are on HIV treatment, without knowing their HIV status. This has

posed challenges in relation to adherence.

In 2007, the MOH is working to develop policy and guidelines for counseling and testing of children and

adolescents, as part of the process to review and update C&T guidelines in general. A review workshop is

scheduled to take place in September 2007. Technical assistance from WHO/AFRO region has been

obtained for this activity.

2008 plans

Funds will support technical expertise for the MOH and key partners in developing an HIV/AIDS counseling

protocol for children and adolescents. The contractor will be required to form a working group comprising of

key stakeholders in the development of protocols. These stakeholders will include MLG - OVC program,

MOH, Botswana-Baylor Children's Clinical Center of Excellence, UNICEF, and representatives of civil

society organizations.

The process will include the review of current practices and relevant policy and guidelines in counseling and

testing of children and adolescents. The review will also include existing guidance and protocols from

UNICEF, WHO, UNAIDS, CDC and other international organizations, including resources from the region. A

consultative and participatory process will be engaged, to draw from all the stakeholders to develop draft

protocols for pre-testing in relevant settings. It is expected that the protocol will address the needs of health

care workers in providing C&T services for children and adolescents, on-going psychosocial and preventive

support, support for disclosure and referrals, among other areas. A curriculum will be developed for the

training of health workers on the use of the protocols. PEPFAR funds will also support training of 75 trainers

(TOT) of health workers/counselors on child/adolescent counseling.

Funding for Health Systems Strengthening (OHSS): $300,000

X-1424 URC

A number of PEPFAR-supported programs have been underway for several years now. Under this activity,

external process evaluations will be conducted on activities which have been supported for three or more

years and that are planned to continue in 2008. These activities include UMDNJ-FXBC Technical

Assistance to PMTCT, Pre-service Training and Health Worker Wellness, NASTAD Technical Assistance to

Community Planning and Community Capacity Enhancement Program (CCEP). Based on the scope of

work provided, URC will conduct site visits and interviews with key informants and beneficiaries of the

targeted partner activities in order to identify strengths and weaknesses of the program, and in turn, help

map the way forward. The focus of the evaluations will be on the technical content and management of the

activities, as well as the effectiveness of the interventions. Best practices and program challenges will be

documented and recommendations included.