Detailed Mechanism Funding and Narrative

Years of mechanism: 2010 2011 2012 2013

Details for Mechanism ID: 10312
Country/Region: Botswana
Year: 2010
Main Partner: Population Services International
Main Partner Program: NA
Organizational Type: NGO
Funding Agency: HHS/CDC
Total Funding: $700,000

This TBD was named in August 09 reprogramming.

PSI/Botswana is the country office of Population Service International, an international non-governmental organization that is headquartered in Washington, D.C., and that has offices in more than 60 countries around the world. In Botswana PSI is one of the leading organizations involved in HIV prevention, playing a key role in behavior change communications efforts on a number of topics and actively supporting the Government of Botswana through involvement in a range of national fora, such as the Reference Group for the Second National Strategic Framework, the Steering Committee of the Partnership Forum, and as the Chair of the National Prevention Technical Advisory Committee.

The overall goal of this project is to contribute to the efforts to prevent new HIV infections in Botswana through Safe Male Circumcision (SMC). The specific purpose of this project is to increase SMC prevalence while avoiding risk compensation among circumcised men by improving and strengthening the delivery of the behavior change communications component of Botswana's national SMC Strategy, as led by the Ministry of Health. This is in line with international recommendations from groups such as the World Health Organization and UNAIDS, which emphasize the importance of ensuring that communications is an essential part of the package of services offered in relation to male circumcision. Communications is particularly essential to ensure that circumcision is not perceived as a "magic bullet" that makes a circumcised man "immune" from HIV infection.

To contribute to this goal and purpose, this project will work towards achieving the following objectives:

Increase the level of accurate knowledge of the benefits and limitations of SMC;

Increase motivation of the target population to request SMC; and

Establish SMC as a cultural norm.

HIV prevention is the top priority of the Partnership Framework and SMC is a key part of the national prevention package and in line with the overall PEPFAR prevention goals. The national strategy's overall goal is to circumcise 480,000 men in Botswana aged 0 49 years. To achieve this goal, intervention communications speak to all men across the country at different stages of their lives plus females who are either partners or mothers of possible circumcision candidates. National coverage will be attained by using a combination of mass media (TV, radio, billboards and print), interpersonal communications and educational materials within counseling and health settings.

A key element of the program is the strengthening of existing behavior change communications structures within the Government of Botswana via day-to-day capacity building meetings and responsiveness to all Ministry of Health requests for assistance in training needs such as the regular annual Health Education Officers training in behavior change communications.

The project is implemented hand-in-hand with the Ministry of Health. To ensure coordination with other partners, PSI participates regularly in the technical and oversight structures created by the Ministry for SMC, including the SMC Reference Group and the Technical Working Group. To ensure that the SMC communications efforts complement other communications activities, PSI participates in the relevant structures, such as the National Prevention Technical Advisory Committee and the Health Sector Technical Advisory Committee. PSI will also coordinate with other partners financed by PEPFAR to work on SMC, such as Jhpiego and I-TECH. These efforts at coordination will help ensure the sustainability of the project's results.

The primary tool for monitoring the project will be the "TRaC" study. This methodology is used by PSI internationally to measure behaviors and behavioral determinants. In this case, the study will establish what drives men to want (or to avoid) male circumcision across the different life stages of the target audiences, as well as to ascertain the effectiveness of the interventions to date.

The project will be sustained through creating cultural ambassadors in partnerships with Botswana Football Association, National Youth Council, Family Welfare Associations, Council of churches and other faith-based organizations. It is also envisaged that health care workers at national and district levels will be capacitated in the design of BCIC information to ensure appropriate targeting and sequencing of information.

Funding for Biomedical Prevention: Voluntary Medical Male Circumcision (CIRC): $700,000

10.P.MC02: PSI - Expansion of Safe MC - communication - 700,000.00

The specific objective of this project is to increase safe male circumcision (SMC) prevalence while avoiding risk compensation among circumcised men by strengthening the behavior change communications component of the national SMC Strategy.

To achieve this objective, PSI is working with the Government of Botswana to develop a behavior change communications strategy for SMC which comprises of the following facets:

a) Development of a long-term, evidence-based, culturally-appropriate communications strategy in consultation with key stakeholders utilizing the PSI proprietary DELTA marketing tool. The strategy will be informed by data from the 2010 PSI "TRaC" study, which targets specific audiences to find out factors that inhibit or drive SMC services uptake.

b) Continuation of the existing "Know Your Facts Campaign" while the long term strategy is being developed to avoid a gap in SMC communications.

c) Implementation of the long term communications strategy that increases knowledge of and informed demand for SMC via the life-stages approach and leverages them as opportunities for SMC communications. The selection of communication channels will be guided by data to determine the most effective channel for reaching someone in a given life stage.

d) Generation of broad-based support from local community, political, religious and youth leaders for SMC via national sensitization workshops, the creation of cultural ambassadors in youth and entertainment and message dissemination throughout communities and workplaces.

e) Attention to gender and human rights issues as they relate to SMC by ongoing consultative work with local ethical and legal societies that ensure behavior change communications campaigns are equitable to Batswana society. The success of these efforts will be measured primarily through the TRaC survey. This will enable changes in knowledge, risk perception, and behavior to be monitored over time, as well as to assess the extent to which the campaign's messages are reaching the target audience which are those deemed most at risk, (i.e., an HIV-negative man in a sexual relationship with an HIV-positive woman, men with multiple concurrent sexual partnerships, and men with reported high risk behaviors especially in areas with low circumcision rates and high HIV prevalence). This will also involve mothers of circumcising newborn/infant males. In addition, PSI will continue to collaborate with the PEPFAR partners working on SMC service delivery to develop a strong monitoring and evaluation system that monitors acceptance, safety and impact of SMC.