Detailed Mechanism Funding and Narrative

Years of mechanism: 2008 2009

Details for Mechanism ID: 7803
Country/Region: Botswana
Year: 2009
Main Partner: To Be Determined
Main Partner Program: NA
Organizational Type: Implementing Agency
Funding Agency: HHS/CDC
Total Funding: $0

Funding for Care: Pediatric Care and Support (PDCS): $0

09.C.PC01: TBD - Pediatric Care and Outreach Support

ONGOING ACTIVITY FOR WHICH NO NEW FY2009 FUNDS ARE REQUESTED - DELAYED

IMPLEMENTATION

From COP08:

The Pediatric ART program has witnessed tremendous progress in the past five years. Starting from scratch

with no HIV-experienced pediatricians, Botswana has moved to becoming one of the largest pediatric

HIV/AIDS treating countries in the world. Several partners are assisting Botswana improving the provision of

ART services to the pediatric population.

With the improvement of treating staff, especially specialist pediatricians, emphasis is now being shifted to

decentralize therapy at peripheral facilities. These are supported by outreach visits by the specialists from

PMH, the Baylor Center of excellence and NRH.

Lately, a gradual rise can be noted in those presenting to the pediatric clinics with co-morbid chronic

conditions requiring long-term follow up, such as Lymphocytic Insterstitial Pneumonia (LIP), bronchiectasis,

tuberculosis; and non-HIV associated diseases such as asthma, diabetes, heart diseases.

PEPFAR will support for the continued of pediatric patient care and training activities. The selected TBD

organization will work closely with GOB facilities to improve and strengthen the delivery of pediatric

palliative care and ART services countrywide in order to support the national program, increase access to

care and treatment of children, train non pediatrician health care workers in the care of HIV infected children

and maintain high standards of pediatric HIV/AIDS management in Botswana through guidelines and

curriculum development. The selected organization will create a referral service center which will deal with

complicated HIV/AIDS cases in children. It is expected that the TBD organization will put in place a

mentoring /supportive supervision system with an outreach support component in order to standardize

approach to pediatric HIV/ AIDS management.

The TBD organization will continue to facilitate the training of health care workers in pediatric HIV/ AIDS

management in collaboration with the national ART training courses and participate in the revision of the

pediatric module of the KITSO training curriculum. Pediatric training will be in line with the newly developed

national guidelines that will be published in late 2007 or early 2008. The organization will participate in the

national roll out of these new guidelines.

New/Continuing Activity: Continuing Activity

Continuing Activity: 17673

Continued Associated Activity Information

Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds

System ID System ID

17673 17673.08 HHS/Centers for To Be Determined 7803 7803.08 New CoAg-

Disease Control & PediatricCare

Prevention

Table 3.3.10:

Funding for Treatment: Pediatric Treatment (PDTX): $0

09.T.PT01: TBD - Pediatric ART Treatment

CONTINUING ACTIVITY UNDER A PERFORMANCE PASS

ONGOING ACTIVITY FOR WHICH NO ADDITIONAL FY2009 FUNDS ARE REQUESTED - DELAYED

INPLEMENTION

From COP08:

The Pediatric ART program has witnessed tremendous progress in the past five years. Starting from scratch

with no HIV-experienced pediatricians, Botswana has moved to becoming one of the largest pediatric

HIV/AIDS treating countries in the world. Several partners are assisting Botswana improving the provision of

ART services to the pediatric population.

With the improvement of treating staff, especially specialist pediatricians, emphasis is now being shifted to

decentralize therapy at peripheral facilities. These are supported by outreach visits by the specialists from

PMH, the Baylor Center of excellence and NRH.

Lately, a gradual rise can be noted in those presenting to the pediatric clinics with co-morbid chronic

conditions requiring long-term follow up, such as Lymphocytic Insterstitial Pneumonia (LIP), bronchiectasis,

tuberculosis; and non-HIV associated diseases such as asthma, diabetes, heart diseases.

PEPFAR will support for the continued of pediatric patient care and training activities. The selected TBD

organization will work closely with GOB facilities to improve and strengthen the delivery of pediatric ART

services countrywide in order to support the national program, increase access to care and treatment of

children, train non pediatrician health care workers in the care of HIV infected children and maintain high

standards of pediatric HIV/AIDS management in Botswana through guidelines and curriculum development.

The selected organization will create a referral service center which will deal with complicated HIV/AIDS

cases in children. It is expected that the TBD organization will put in place a mentoring /supportive

supervision system with an outreach support component in order to standardize approach to pediatric HIV/

AIDS management.

The TBD organization will continue to facilitate the training of health care workers in pediatric HIV/ AIDS

management in collaboration with the national ARV training courses and participate in the revision of the

pediatric module of the KITSO training curriculum. Pediatric training will be in line with the newly developed

national guidelines that will be published in late 2007 or early 2008. The organization will participate in the

national roll out of these new guidelines.

The selected organization will be charged with reviewing and evaluating pediatric care and treatment,

designing educational materials and using them in training activities.

New/Continuing Activity: Continuing Activity

Continuing Activity: 17809

Continued Associated Activity Information

Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds

System ID System ID

17809 17809.08 HHS/Centers for To Be Determined 7803 7803.08 New CoAg-

Disease Control & PediatricCare

Prevention

Table 3.3.11:

Funding for Care: TB/HIV (HVTB): $0

09.C.TB14: TBD - Pediatric TB/HIV Management

ONGOING ACTIVITY FOR WHICH NO NEW FY2009 FUNDS ARE REQUESTED - DELAYED

IMPLEMENTATION

From COP08:

The diagnosis and treatment of TB in children is difficult and this more so in HIV-infected children, where TB

is a major cause of disease and death. The new WHO Stop TB Strategy was announced in 2006 with the

aim of ensuring equitable access to care of international standards for all TB patients - infectious and non-

infectious, adults and children, with and without HIV, with and without drug-resistant TB. International

guidance for national TB programs on managing TB in children was released in 2006, with the aim of

addressing this neglected area of TB control.

Botswana has one of the largest pediatric HIV/AIDS treatment programs in the world, an example of

effective partnerships in the provision of ART services to the pediatric population. ART services are being

decentralized to peripheral facilities with the support of outreach visits by specialist pediatricians from PMH,

the Baylor Center of Excellence and NRH. The management of TB in HIV-infected children has not matched

this scale up of quality HIV treatment and care.

PEPFAR funding will be requested to improve pediatric TB/HIV patient care and training activities to raise

the quality of TB care and treatment according to the latest national and international recommendations.

Baylor will work closely with the BNTP and GOB facilities in the southern part of the country (Kgatleng,

Kweneng, South-Eastern, Southern districts) to improve and strengthen the delivery of pediatric TB/HIV

services, to increase access to quality TB/HIV care and treatment of children and to train non-pediatrician

health care workers in the care of TB/HIV infected children according to the national guidelines.

The selected organization will create a referral service center which will deal with complicated TB/HIV

disease and multidrug-resistant TB (MDR-TB) in children, and will implement a mentoring/supportive

supervision system with an outreach support component to standardize the approach to pediatric TB/HIV

and MDR-TB management. Baylor will assist hospitals in this region to improve TB screening and diagnosis

of pulmonary TB in children, and will develop appropriate screening algorithms for TB in children.

The selected organization will be charged with reviewing and evaluating pediatric TB/HIV and MDR-TB care

and treatment, and in designing and implementing an information, educational and communication (IEC)

strategy targeting parents of children with HIV/TB disease, and adolescents at high risk of HIV and TB

infection.

New/Continuing Activity: Continuing Activity

Continuing Activity: 18701

Continued Associated Activity Information

Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds

System ID System ID

18701 18701.08 HHS/Centers for Baylor University 8743 8743.08 $253,000

Disease Control &

Prevention

Emphasis Areas

Health-related Wraparound Programs

* TB

Human Capacity Development

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Food and Nutrition: Commodities

Economic Strengthening

Education

Water

Table 3.3.12: